Facial Feminisation Surgery

Facial feminisation surgery (FFS) is generally well accepted combination of procedures to change the main features of the face. Commonly utilised for transgender women, it could also be used to feminise the masculine features of a female face. Mr Tekeli's approach to facial feminisation surgery (FFS) is slightly different than mainstream facial feminisation surgeons. Combining his background in Oral & Maxillo - Facial Surgery with his fellowship training in Aesthetic and Cosmetic Surgery, Mr Tekeli believes the procedures under this category should provide feminisation as well as aesthetically pleasing outcomes optimal for the patients.

In Mr Tekeli's practice, the set of procedures providing hard tissue changes are the main pillars of the feminisation surgery. The soft tissue procedures generally compliment the hard tissues ones.  He does not believe in 'one size fits all' set of procedures. Instead, he thinks every face is different and requires a tailored treatment plan for ultimate results. 

 

Feminisation surgery generally takes all day and due to the complexity of the procedures, Mr Tekeli prefers to operate in surgical centres with complete intensive care backup. Therefore, he only operates on feminisation patients at Spencer Hospitals utilising the advanced facilities of William Harvey Hospital in Ashford , Kent which is a Level II trauma centre with complete theatre and intensive care backup. The additional benefit to carry out the surgery at Spencer Hospitals is that it is part of East Kent Hospitals University NHS Foundation Trust and part of the income is invested back in the NHS. 

Mr Tekeli can instigate the consultation process and arrange follow up in his clinic in Harley Street London. Therefore, patients would only need to travel to Kent for the main surgery to be carried out at Spencer Hospitals. He firmly believes that this approach will prioritise the patient safety and ensure consistent, good outcomes. 

Importance of Lower Jaw in Feminisation of Face

Lower jaw generally dictates the overall shape for the face and it is not unusual the shape of lower jaw is overlooked. Mr Tekeli puts special emphasis on the shape of lower jaw for any feminisation procedure; be it for a transgender woman or woman with strong masculine features. He believes that the altered shape of the lower jaw should be able to fit in with the rest of the procedures and create a harmony among the facial structures. 

Forehead Shaping

The forehead region is one of the most important areas determining the facial gender. Frontal bossing is very common in masculine faces and the glabella area (middle part of the forehead) joining the root of the nose has a wider angle in female face compared the narrow angle in male face. The combination of procedures to correct this area should be tailored for individuals depending on the shape of the forehead and the root of the nose. 

The main procedure to correct this area is osteotomising (cutting) the anterior wall of frontal sinus (forehead) and setting it back within acceptable limits. This procedure will require an incision over the top of the head which also gives the surgeon opportunity to adjust the hairline. The additional procedure of sculpting the forehead bone with eye sockets compliments the forehead procedure.  

Mr Tekeli utilises the latest technological advancements in facial surgery to carry out the forehead procedures safely. He has special interest in 3D imaging enabling him designing patient specific cutting guide. This technology will require every patient to be scanned in an imaging centre and Mr Tekeli works with engineers to design the forehead cuts. Therefore the surgery is not only based on artistry and craft, but also on precise measurements done in 3D computer modelling.

Nose Reduction (Reduction Rhinoplasty)

Reduction of the nose is a very important gender confirming procedure. The typical masculine male nose would have a wide bridge and a bulbous tip. This appearance will be literally feminised with the nose procedure which is generally carried out in conjunction with other procedures. Mr Tekeli has a special interest in nasal cosmetic and plastic surgery. His aim during nasal reduction is not only to feminise the nose but also to create an aesthetically pleasing nose which blends in the harmony of the face. He will explain your design before the procedure and will ensure the highest quality craftsmanship will be utilised for the surgery.

Jaw Line Contouring & Genioplasty

These two procedures should be considered together as they compliment each other. As you can see in the above diagram , a masculine jaw would be wider and more rectangular (chiselled). With this procedure, the chin point can be reshaped as more triangular which may aid the transformation of the face into a feminine heart shape. However, this should be complimented by sculpturing the jaw line to ensure the new chin blends in with the rest of the lower jaw. Mr Tekeli believes lower jaw dictates the overall shape of the face and it is one of the most prominent features of a masculine face along with the nose. 

Cheek Implants 

Cheek bones (zygoma) attribute to the attractiveness of male and female faces. Prominent cheek bones make the eyes even more appealing and the increased width of the cheek bones would contribute to the feminine heart shaped face. There are differences between male and female cheek bones structurally. However, Mr Tekeli does not believe in reduction of cheek bones which may give the false impression of an ageing face. His emphasis regarding the cheek bones is mainly around augmenting them if they are inadequate size and this is not always done for feminisation. Both masculine and feminine facial types will benefit from prominent cheek bones. If the cheek bone size is inadequate, he uses Medpore implants to augment the cheek bones via an incision through the mouth. He likes minimal augmentation which would compliment the current cheek bones enabling slightly increased prominency harmonising with the other facial structures. 

Thyroid Cartilage Shave (Adam's Apple)

This is another complex procedure which is carried out through a small incision in the upper neck behind the chin in order to avoid an obvious scar over thyroid cartilage. There are limitations to the surgery as excessive removal can impair the voice quality. However, with adequate adjustment, thyroid cartilage can be reduced into an acceptable size which could easily confirm the feminine facial gender. 

Hairline Advancement & Brow Lift

These two cosmetic surgery procedures are carried out at the same time during the forehead reshaping as they compliment the feminisation of the forehead. It is not necessary in every patient as over-lifting of brows may give individuals slightly startled appearance. However, this initial level generally comes down after gravity taking its course. Hairline advancement is useful to mask the male pattern alopecia by excising triangular scalp areas not bearing any hair. Advancement of scalp should be carried out very carefully as it can lead to hair loss in the long term. So meticulous surgical technique is paramount important during these procedures. 

Lip Lift

This is a simple plastic surgery procedure done at the base of the nose to compliment the mid face aesthetics. The length of upper nose is increased in masculine male faces as well as in ageing in both genders. The lip lift procedure shortens the upper lip length and also improves the overall appearance of the upper lip by plumbing up the visible white roll. The scar is hidden within the nasal sill and this is a simple but a very efficient way of improving the lip aesthetics. 

  • Forehead shaping

  • Nose reduction

  • Jaw line contouring

  • Genioplasty (chin)

  • Thyroid shave

  • Hairline advancement

  • Brow lift

  • Cheek implants

  • Lip lift

KMT Facial Plastics

Mr Kemal M Tekeli FRCS (OMFS)

Secretary: Amanda Eason

Tel: 01227764697

Email: info@kentfacialsurgery.co.uk

KM Tekeli is member of European Academy of Facial Plastic Surgery
Royal College of Surgeons of England
KM Tekeli FRCS BMA Member and Kent Facial Surgeon
KM Tekeli FRCS BAOMS Fellow and Facial Cosmetic Surgeon