A woman in the mirror
A Marbella clinic has Andalucía’s only medical team specialising in the feminisation of facial features
Since 2000 the Andalusian public health service (SAS) has financed sex change operations, however the problem for many people who have taken that step is that they still see a masculine face when they look in the mirror.
The only medical team in Andalucía that specialises in feminising masculine facial features is based in a Marbella clinic, where procedures are performed that are not covered by the public health service.
Facial Team was formed in 2007 to meet the demand from sex change patients who needed softer features to make their new sexual identity complete.
These techniques are also performed in a Barcelona clinic, but not exclusively. In fact, the Marbella team proudly states that the centres devoted exclusively to this speciality in the world can be counted on the fingers of one hand.
“The aim is to help these people integrate socially and professionally. While sex reassignment surgery is important for many, this does not help them socially because the face is the first thing that people see,” said Lilia Koss, head of patient relations.
According to the statistics provided by the team, who operate in private HC Marbella International Hospital, 98 per cent of patients are transsexuals. The remaining two per cent are men and women whose bodies do correspond to their gender identity but who still wish to soften their features. This is generally because they were born with an overdeveloped forehead or a very square jaw.
The average age of patients seeking this type of surgery is 35 although this is falling. The team put this down to increased awareness of the treatment available.
Facial feminisation consists of sculpting the bone to modify the face. In general if a woman needs this sort of modification it cannot be done at the same time as maxillofacial surgery, but in a second intervention at least six months later.
Same face, more feminine
Unlike with some cosmetic treatments, the experts stress that this surgery is successful in that it does not turn the patient into someone they’re not. This does not stop some patients wanting to be made to look like their favourite film star.
“There are things that can be accepted, but our aim isn’t to make them look like another person, but to soften their features to make them more feminine,” said Koss.
While any part of the face can be manipulated, there is an ABC of feminisation because there are characteristics that always produce a masculine image. The reduction of the forehead is one of the main techniques, along with hair transplants, rhinoplasty and chin moulding.
However the specialists agree that the key is in the forehead.
“In a masculine face it is more prominent and the hairline is in the shape of an ‘N’, so in the reconstruction of this part of the face an incision is made to remove a strip of scalp and hair grafts create a rounder hairline,” said Koss.
While this sort of treatment differs greatly from providing a “new face”, the experts still recommend psychological treatment before and after the operation. Nevertheless the majority of patients have done their homework. Ninety per cent are already seeing a gender dysphoria specialist, are undergoing hormone treatment and attend support groups with other women in their situation.
One of the most common questions is when to undergo this type of surgery. While there are no fixed rules, it is generally carried out six months after starting hormone treatment, which allows enough time for changes in the soft tissue of the face to take place, which can affect the type of procedure used.