After a lot of procrastination I finally sent pictures to Alexandra for virtual FFS. I just got them back the other day and WOW! The pictures I sent were of me with no makeup and my hair combed back. This is so she can better evaluate things like hairline and what my features are like w/o the help of makeup. I'll admit, looking at those pictures I really had second thoughts showing them to anyone. But I swallowed my pride and sent them anyway.
When I got them back I knew if what she did was possible I could go anywhere w/o makeup and be gendered female. But was it possible to achieve those results? I got my answer today. I sent my before and after pictures and the analysis to a nearby FFS doctor. Everyone who has seen his work says he's an artist with an amazing eye. Add to that he's about half the price of the big names and recovery is much quicker. I was keeping my fingers crossed he felt it was possible to really make me look like that. In his reply he said, "I believe your goals are realistic and very obtainable." My heart soared! To think I could go anywhere without makeup and not worry about being gendered male seemed impossible. So when I received his reply I was unbelievably happy!
I set up an appointment with him for the end of the month. Then I'll know for sure. And he's not one of those doctors who will make promises he isn't sure he can keep. Or worse, one of those who acts like he's selling snake oil!
Here's the after photos. Below that is her analysis of the work she did, etc.Please remember that these virtuals are not and could not be 100% accurate but I hope they will give you a good idea of the possibilities and take you a long way towards planning how best to proceed.
The eye takes a little while to tune-in to facial changes so you may be disappointed at first glance. It is best to spend a few days getting used to the pictures before you make any decisions.
Hairline:
The height of your hairline in the middle is fine but it looks from the frontal shots like you do have some recession in the corners giving your hairline the masculine "M" shape. I have filled in the corners to give your hairline a more rounded and feminine shape and this can be achieved with a scalp advance or hair transplants. If you have forehead work then it probably makes sense to have a scalp advance as both procedures can use the same incision. You can always have some transplants later to hide any scarring if necessary. If you don't have any forehead work then I would recommend the transplant route as they are less invasive. Overall it looks like this might be an optional procedure for you to some degree though it's hard to be sure without seeing a profile or 3/4 profile with your hair pulled back.
Forehead:
You have relatively mild brow bossing over the frontal sinus and the orbital rims. I have removed the bossing to bring your forehead into normal female ranges. You also have some horizontal lines across your forehead and some vertical frown lines between your eyebrows. I have reduced these for you and this should be achievable with an injectable filler or botox. Your brow bossing is actually mild enough that you could consider leaving it how it is and seeing how you get on but you did mention some passability problems and the forehead is a very strong gender marker so even relatively small changes in this area can be helpful.
Eyebrows:
Your eyebrows are nicely shaped and sit in a naturally high feminine position. I do not think you need a brow lift.
Eyes:
The soft tissues above your eyes have started to sag and are hiding your upper eyelids. I have given you an upper blepharoplasty to correct this and reveal your upper eyelids. This would be a nice compliment to the face-lift. This is not strictly speaking feminisation because these kind of eye features are common to both sexes - it is more about rejuvenation but blepharoplasties can soften the face and a softer is generally more feminine. This will also hopefully give your eyes more of the open look you mentioned though there isn't really anything you can do surgically to literally make your eyes more open.
Nose:
Your nose is very good already - it is reasonably symmetrical and in good proportion to your face. There is also a feminine turn-up to the base. I would say that in terms of feminisation any rhinoplasty is very optional however you did mention that this is an area you are keen to make changes to so I have removed the slight hump to the bridge and that does have a slightly feminising effect. I have also corrected a minor asymmetry at the tip whir bulges a little more on your left side.
Cheeks:
I don't see any notable problems with your cheekbones that would require implants. Your cheeks are sagging a little but this will be greatly improved by the face lift (see below).
Lips:
The distance between your top lip and the base of your nose is very long. I have given you a strong lip lift to correct this. This procedure is both feminising and rejuvenating. I have also rolled the top lip out a little to give it a fuller and more feminine shape. I have plumped up the bottom lip a little to help it balance with the fuller top lip. I can't see your teeth clearly in the open mouth photo you sent. The thing you need to be aware of is that lifting the lip is likely to expose your upper incisors when your mouth is relaxed and slightly open. This is a good thing because it is very feminising however, you need to make sure that your relatively strong lip lift does not expose so much tooth that it becomes unattractive. It does look like your upper jaw is probably quite tall and there is a procedure called the Le-Fort procedure that can reduce this area. However, this is quite an invasive procedure as it involves detaching the upper jaw. I personally would avoid this procedure if you can. Even if you did reduce the upper jaw - you can't necessarily lift the top lip enough to match it - the lip lift only lifts the middle third of the lip so if you go too far the lip shape becomes too distorted and looks unnatural. To sum up - you do have a long top lip to nose distance and you will still have a relatively long distance here even after FFS, however, with skill, a very considerable and useful improvement can be made here.
Chin:
Your chin only has a slight squareness to it and an asymmetry where it slopes down a little to your right. When the middle third of your face is compared to the lower third (they should be about equal) your chin seems to be a little tall. The thing to remember here is that the height of the chin has to balance with the lip to nose distance so, if you take too much off the chin you can end up emphasising the lip to nose distance and therefore undoing some of the good work of the lip lift. You will need to discuss the possibilities here with your surgeon - if they can lift the lip as much as I've illustrated then reducing the chin becomes an option. If they can't then it may be worth leaving the height in the chin for overall balance. I have also corrected the asymmetry and slight squareness. I think your chin is actually a relatively minor issue overall and chin work only has a mildly feminising effect on you so do feel free to consider leaving out chin work altogether if you prefer - even if the lip lift is not limited. Another thing to consider is that chin surgery has a lot of complications associated with it like numbness in the chin and bottom lip and reduced mobility in the bottom lip. These effects can last for months and can sometimes be permanent to some degree so chin surgery is a decision you have to take carefully. I am sending you an extra set of pictures with the chin correction included - I hope this will help you decide whether or not to have chin surgery..
Jaw:
Your jaw is a little wide towards the back and I have narrowed it for you. This might require work on the chewing muscles as well as the bone. In other respects your jaw fits your face nicely
Adam's apple:
I do not see an adam's apple on you but it is possible that it will be revealed by the neck lift. If this happens you can consider a tracheal shave to reduce it. However, as trach shaves seem to carry a higher risk of complications than most other FFS procedures, it might be worth asking your surgeon to leave enough soft tissue there to hide the adam's apple if possible.
Face lift:
I have given you a full face and neck lift. This procedure is more about rejuvenation than feminisation but having said that, younger faces do tend to look more feminine than older ones. There are various benefits like tightening up the cheeks, giving a nice definition to your jaw line, reducing the lines that come down from the corners of your nose and tightening up the soft tissues of the neck.
Overall:
The key area for you is the lip lift and if you only had one procedure done, that would be the one to go for. The nose, chin and hairline are much more optional. The blepharoplasties and the face lift are just as much about rejuvenation and beautification as feminisation.
Try to see the pictures as plans rather than predictions. They are just a starting point and neither you nor your surgeon has to agree with my suggestions.
