Rhinoplasty for facial masculinization

The nose is a very dominant feature on every person's face. This is the reason why it is a fundamental, phenotypic distinguishing feature. In men, the nose is typically larger and more prominent, while in women it is smaller and more delicate.

Transgender patients having a very feminine nose can adapt it to their male identity in the context of a nose correction. This intervention is an important building block on the way from the biological woman to the man.

Typically man, typically woman: this is how the nose differs between the sexes

A big nose is considered a sign of masculinity. Men's noses are on average 10 percent larger than women's noses are. As an explanation for this phenomenon, researchers have found that the male body needs more oxygen due to its higher muscle mass. A larger nose is able to hold more air per breath. This is the reason why the typically male nose is longer and larger than the narrower, more delicate nose of women.

These differences usually develop during the period of puberty at the latest. A big nose automatically makes the face look more masculine. In the context of a rhinoplasty, we can change the nose so that it fits your identity better and your whole face becomes more harmonious.

Build-up of the nasal bridge by endogenous material

Depending on the patient's wishes, the rhinoplasty may include different areas:

• Correction of the nasal bridge
• Correction of the nose tip
• Adjustment of the nasal septum

Usually, transgender patients being on their way to becoming men want a bigger and more prominent nose. In the context of a rhinoplasty, a change in the cartilaginous nasal skeleton or in the bony nasal structures can be made. For example, the build-up of the nasal bridge by endogenous material is feasible.

For this purpose, cartilage can be removed from the nasal septum or the auricle and inserted into the nose so that the latter appears larger and more dominant.

Surgical techniques for rhinoplasty

The nose correction (rhinoplasty) results in a better adaptation to the (new) facial profile. There are two different surgical techniques you may choose from:

1. Compensation of uneven surfaces and bumps: the closed nose correction

The closed nose correction is a gentle and minimally invasive surgical technique which does not leave any scars. Small uneven surfaces and bumps may be removed by making minor incisions inside the nose. However, a fundamental change in the nose shape will not be feasible. For this reason, the closed rhinoplasty is rarely used for gender reassignments.

2. Profile adjustments and adaptation of the nose shape: the open nose correction

When performing an open nose correction, an incision is made on the nasal bridge. This incision gives the surgeon has a clear view of the internal part of the nose. This allows the nose to be visibly shaped and changed without affecting the main nasal components and functions. In our beauty clinic, Dr. Funk often performs the incision directly on the nasal bridge so that the soft tissue can be pushed up and the nose lies open in front of the surgeon.

Should a rhinoplasty be performed in the context of every gender reassignment?

After a gender operation, it is not always necessary to also carry out operations on the face. What is important is that the nasal structure fits into the face. A person having a narrow and delicate nose and feeling uncomfortable with it can achieve great results by performing a nose correction.

A surgical intervention is often recommended in the context of a gender reassignment if further interventions have been performed on the face and the nose no longer fits into the newly designed, masculinized face. The rhinoplasty may be ideally combined with other profile-improving corrections, for example with a chin build-up.

What are the risks involved in a nose correction?

In our beauty clinic, the rhinoplasty is one of the routine operations. Our transgender patients are in the hands of an experienced physician. During a preliminary consultation interview, they are informed about the general and individual risks involved in the invention.

Overall, the rhinoplasty has few complications with a very high level of satisfaction in the patients whose profile adjustment results in the development of a new body awareness and a higher self-esteem.

The typical side-effects are swelling and bleeding under the eyes as well as sensitivity, which will subside after 2 to 4 weeks. On the other hand, infections occur very rarely.

Are there any visible scars left after the rhinoplasty in the context of gender reassignments?

If the indication for an open rhinoplasty is given, a minor scar will remain on the nasal bridge. The surgeon keeps it as small as possible so that it is hardly visible from the outside.

Which is the ideal point in time to have a rhinoplasty for facial masculinization?

These days, gender reassignment is often started at a young age before puberty. Ideally, the affected persons take hormones before the beginning of puberty, so that many areas of the body naturally develop in the right direction. For medical reasons, rhinoplasty is only carried out after the age of 18, after the completion of the nasal growth.