Surgical Facial Esthetics for Gender Affirmation

The sexual identity of an individual is obvious to most observers with a glance or when only noticing a portion of the face. The overall appearance of the male face is quite different from the female face. Differences in facial structures-such as brow bone, chin, nose, or lips-can be quite small. It is the sum of these differences that creates the obvious dimorphism in facial appearance. This article outlines sexual differences between facial features and discusses surgical procedures designed to alter facial appearance and sexual identity. The diagnosis of facial dimorphism and limitations of these techniques are outlined.