Introduction
Facial Feminization Reversal refers to surgical and non-surgical approaches used to reverse or soften the effects of prior Facial Feminization Surgery (FFS), typically to restore more traditionally masculine or neutral facial features.
What “Reversal” Really Means
FFS alters bone and soft tissue for a permanent change, so reversal may only be partial, not a true undoing. The goal is typically one or more of the following:
- Restore masculine structural cues
- Reduce features perceived as feminized
- Achieve a more neutral or androgynous appearance
Outcomes depend heavily on:
- Which FFS procedures were done
- How aggressively bone was altered
- Time since surgery
- Scar tissue and healing quality
Common Reversal Options
1. Forehead & Brow
FFS changes: Brow bossing reduction, orbital rim reshaping
Reversal options:
- Custom forehead implants
- Fat grafting or dermal fillers (limited structural effect)
- Brow repositioning (lowering) which is very difficult to do
This is one of the most technically challenging reversals.
2. Jaw & Chin
FFS changes: Jaw angle reduction, chin narrowing
Reversal options:
- Custom jaw angle implants
- Custom chin implants
- Custom jawline implants for complete V line Reversal
- Fat grafting to widen lower face (limited effect)
- Rarely, bone grafting
This area is often more successfully re-masculinized than the forehead.
3. Nose
FFS changes: Smaller, refined rhinoplasty
Reversal options:
- Revision rhinoplasty with cartilage grafts
- Dorsal augmentation (grafts or implant)
- Increased projection/width (grafts)
The limits of masculinizing a nose are based on the materials used and the amount of scar tissue from the prior surgery.
4. Cheeks & Midface
FFS changes: Cheek implants or fat augmentation
Reversal options:
- Implant removal
- Fat dissolution or debulking
- Conservative fat removal (if excessive)
Cheek fat grafts can be very diffcult to reverse
5. Lips
FFS changes: Lip lift, augmentation
Reversal options:
- Surgical shortening correction, not possible
- Filler dissolution
- Fat removal, difficult
Surgical lip changes work by skin removal which can not be reversed.
6. Hairline
FFS changes: Hairline lowering
Reversal options:
- Hairline advancement reversal can only be done by tissue expansion.
- Camouflage with hair styling or transplantation patterns
Non-Surgical Options (Adjunctive Only)
These do not reverse bone work but can help visually:
- Strategic filler placement to widen face
- Botox avoidance or selective use
- Weight changes (affects facial fat distribution)
Risks & Considerations
- Higher complication rates than primary surgery
- Scar tissue makes anatomy less predictable
- Implants may be required where bone was removed
- Emotional and psychological considerations are significant
Surgeon Selection Is Critical
You want a surgeon who:
- Performs both FFS and masculinization surgery
- Has experience with revision craniofacial work
- Uses custom implants and 3D planning
Many FFS surgeons do not do reversal well.
Bottom Line
Facial feminization reversal is:
- Possible
- Not a full undo
- Technically demanding
- Requires realistic expectations and expert care
Dr. Barry Eppley
World-Renowned Plastic Surgeon