Facial procedures for transgender patients
Facial surgery that reflects who you are.
Facial features carry a great deal of gendered signal — the brow, the nose, the cheeks, the jaw, the thyroid cartilage. The procedures below are the same techniques our surgeons perform every week, planned toward a different goal: a face that reads the way you understand yourself.
Your goals lead
We ask what you want your face to communicate before we discuss any technique.
Staged sensibly
Some procedures combine well in one operation; others heal better apart.
One accredited facility
Consultation, surgery, recovery, and follow-up all happen in the same building.
Private and unhurried
Extensive consultations, and a team you can reach throughout recovery.
Five procedures
What each one changes.
The nose sits at the center of the face, and its width, bridge profile, and tip shape carry strong gendered signal. For transgender patients, rhinoplasty is usually about refining scale and definition relative to the rest of the face — softening a prominent dorsal hump and narrowing the bridge and tip for a more feminine profile, or building a straighter, broader dorsum for a more masculine one. Because Dr. Sandel is also board-certified in otolaryngology, breathing function is assessed and protected in the same plan.
What it typically addresses
The upper third of the face reads as gendered largely through brow position and how open the eye appears. Brow surgery repositions the brow itself, and blepharoplasty removes excess upper-lid skin and reduces puffiness — together they set how open and how high the upper face reads, and brow lifting also softens forehead lines. For transgender patients these are often planned together: a higher, more arched brow and a more open upper lid create a softer, more feminine upper face, while leaving the brow flatter and lower supports a more masculine one.
What it typically addresses
The jaw and chin define the lower third of the face. A stronger, squarer jawline and a more projected chin read as masculine; a narrower, more tapered lower face reads as feminine. Augmentation builds projection and width using implants placed on the bone, or filler for a non-surgical trial of the same change. Where the goal is a narrower jaw, the approach shifts toward reduction and contouring of the surrounding soft tissue instead.
What it typically addresses
Fullness high on the cheek is one of the most reliably feminizing changes to the midface, and it also shifts visual attention upward toward the eyes. We offer three routes: silicone cheek implants secured to the cheekbone through hidden incisions for a permanent change; autologous fat grafting, which uses your own fat and contours a donor area at the same time; and dermal filler as an in-office, no-incision option that also lets you preview the result before committing to surgery.
What it typically addresses
Often called tracheal shave or chondrolaryngoplasty, this procedure reduces the prominence of the thyroid cartilage — the Adam’s apple — to create a smoother neckline. It is a focused procedure with a small, well-hidden incision, and it is frequently the single change patients say they notice most in profile. Because the larynx sits directly beneath the cartilage being reduced, this is work that belongs with a surgeon trained in head and neck surgery.
What it typically addresses
How we plan it
Sequenced, not rushed.
Most patients do not have every procedure at once. In consultation we discuss which features matter most to you, which can be staged together safely in one operation, and which are better separated so healing does not compete.
Vectra 3D imaging lets you preview likely outcomes on your own anatomy rather than someone else’s photographs, which is particularly useful when several features are being changed together.
What to bring up at consultation
Which features bother you most in photographs, and which you would leave alone
Whether you are on hormone therapy, and how long you have been on it
Any prior facial surgery, and what you liked or disliked about the result
Whether you want to trial a change with filler before committing to an implant
How much recovery time you can take, and how you would prefer procedures staged
Any letters, documentation, or care coordination your other providers require
Start with a conversation.
Every patient receives an extensive consultation with a comprehensive review of options. No one feels rushed, and we answer every question before anything is scheduled.
Candidacy, staging, and expected outcomes are determined in consultation. Results vary from patient to patient.