Facial masculinization surgery


Facial masculinization surgery is a set of plastic surgery procedures that can transform the patient’s face to exhibit typical masculine morphology. Cisgender men may elect to undergo these procedures, and in the context of transgender people, FMS is a type of facial gender confirmation surgery, which also includes facial feminization surgery for transgender women.
FMS can include various bony procedures such as chin augmentation, cheek augmentation, as well as augmentation of the forehead, jaw, and Adam's apple. In FMS, most procedures involve "having structures added to give more angles to the face."

History

Trans men have requested FMS procedures since the 20th century. FMS is currently less common than FFS. Urologist Miriam Hadj-Moussa notes that "transgender men rarely undergo facial masculinization surgery since testosterone therapy leads to growth of facial hair and makes it easier for them to present."
In 2011, Douglas Ousterhout outlined the available FMS procedures, drawing on the work of Paul Tessier. In 2015 Shane Morrison published an overview of all gender confirming surgeries for trans men, including FMS. In 2017, Ousterhout's successor Jordan Deschamps-Braly published a case report on the first female-to-male facial confirmation surgery that included masculinization of the Adam's apple.
According to the World Professional Association for Transgender Health, for many transgender men, FMS is considered medically necessary to treat gender dysphoria.
Following the WPATH recommendations, several literature reviews and summaries of the state of the art were published.

Surgical procedures

The surgical procedures most frequently performed during FMS often include facial implants and include the following, as outlined in a special 2018 issue of Clinics in Plastic Surgery edited by Loren Schechter and Bauback Safa.
;Forehead augmentation
Forehead augmentation can be done with a customized implant, or with injected materials that are molded into shape before they harden.
;Jaw augmentation
Orthognathic surgery was first performed for functional reasons in the late 19th century, with cosmetic procedures being improved and refined throughout the 20th century. It is performed with fillers or customized implants.
;Chin augmentation
Chin augmentation, also called a mentoplasty or genioplasty, is performed with fillers or customized implants. It can also be performed with an osteotomy plus an implant made of alloplastic materials like Proplast I, Proplast II, and porous block hydroxyapatite.
;Adam’s apple augmentation
This newer procedure uses an implant made from cartilage taken from the patient’s rib cage.