Facial Feminization Surgery: Rhinoplasty
(Nose Feminization)

The nose is one of the few facial features that can be considered beautiful or ugly at first sight. Usually beautiful female noses are smaller than those of men, in all aspects. The bridge tends to be narrower and straighter, or to have a gentle curvature. Usually the tips are more sharply defined than those of a male nose.

There are sexual differences in the angles formed where the nose meet other facial areas too: The angles between the nose and the forehead and between the nose and the upper lip tend to be more acute in males and more open in females. If you are thinking about getting feminization surgery on your forehead, it is advisable to get surgery on your nose at the same time so these adjacent facial features get a harmonious and naturally female continuity.

The goal of rhinoplasty in the context of a Facial Feminization Surgery is to make the nose smaller and to give it a clear feminine outline and proportions, taking into consideration that the result should match the whole facial frame. The surgeon gains access to the cartilages and bone beneath the skin of the nose through the nostrils. Then he shaves and cuts them where it is necessary to reduce the width and length, and to straighten the bridge and define the tip. When a forehead contouring surgery is performed in the same surgery, the reshaping of the top part of the bridge is done from above, through the incision used to work on the forehead bone. This way both facial areas get a smooth continuity. The nostrils can also be narrowed by making two incisions at the base of their wings. This is called alarplasty and the resulting scars should become undetectable soon after the surgery.

Anesthesia
Rhinoplasties are usually done under general anesthesia, especially when performed as part of a Facial Feminization Surgery, but in certain minor cases local anesthesia and sedation may be used.

This facial surgery takes one or two hours

If you don’t mind to be seen with the bandage and the swelling, you will be able to return to your social activities a week after the surgery. You will have to wait a bit longer before doing any hard work or physical exercise: about a month or so, according to the special characteristics of your own healing process. During the first days you will have to sleep with your head elevated to improve the healing process.

After the surgery your nose will be completely blocked with gauze packs for at least two days, while the inner wounds heal, and this was reported by some patients as one of the most uncomfortable parts of the recovery. If you are not used to breathe through your mouth, practice it. Block your nostrils with cotton balls and breathe through the mouth as part of the training. This might dry your lips, so if you have any lip balm of your preference, bring it with you.

During the first weeks some patients tend to suffer from depression. You may find it difficult to come to terms with your new look and you may even feel that having a surgery was a big mistake. But don’t worry: most of the people who today are happy and satisfied with the results of their surgeries have also gone through that phase.

Bandages
After this facial surgery your nose will be extremely sensitive but you will have a cast applied on it to help maintaining the shape, to restrain swelling and to protect it. This cast will remain in place during 2 or 3 days and then will be removed. You will also have gauze plugs into the nostrils to help the internal wounds heal and prevent bleeding.
If only the tip of the nose was modified, then a cast would not be necessary.

Level of Pain
The level of pain of this facial surgery is medium, most of times reported as a strong discomfort.

Bruises and swelling
The bruises under the eyes usually get more intense the first two or three days after Feminizing Rhinoplasty and then they begin to vanish and spread down to lower facial areas. You may look like a beaten boxer and it may be a bit shocking for those around you, but you will feel much better than you look. 2 or 3 weeks later, only you and your facial surgeon will be able to notice any traces of the surgery. During the healing process cold compresses are very helpful. Your nose will get a completely normal appearance very soon, but the definite results will be fully appreciated between 6 and 12 months or later. The tip is the area that takes longer to acquire its final shape. Some sporadic bleeding could be expected during a week or ten days, but this is normal and you should not be worried.

Scars
All the incisions remain well hidden inside the nose, except those made on the base of the nose wings when an alarplasty is considered necessary to reduce the width of the nostrils. However, the scarring on this type of facial skin is very good and the scars are small, so they should become unnoticeable shortly.

Every surgery, no matter how simple it may be, has certain risks, and we should not rule them out. However, it is very unlikely for a feminizing rhinoplasty to present any complications when performed by a qualified facial feminization surgeon.

• Asymmetry. The nose is a crucial facial feature and it is, literally speaking, constantly before our eyes, making any imperfection very noticeable, no matter how trivial it may be. Even though the surgeon marks very carefully the areas he is going to treat, there may be asymmetries. According to international statistics, rhinoplasties are the procedures that have the highest rate of revisions. These revisions, if necessary, may be carried out after six months.
• Adverse reactions to anesthesia.
• Infections (they are very unusual if you take the right antibiotics).
• Bleeding.
• Appearance of small red dots on the skin due to broken capillaries.
• Deformities due to hits or lack of care before the completion of the healing process. Remember that your new nose will be quite fragile at first and you will be responsible for avoiding any kind of accident.