Nose feminization surgery


FFS nose

Nose feminization is, for many patients, an important part of the overall FFS surgery process, and one that’s key for giving patients the aesthetic and the confidence that they are hoping for.

What is Nose Feminization?

The nose is the central feature of the face. Many patients believe that refinement of the nose can make a significant improvement to their appearance by making the eyes seem larger as well as emphasizing the cheeks.

Surgery to make changes to the appearance of the nose is known as a rhinoplasty.

An FFS rhinoplasty isn’t always necessary for every patient but can have an overall complimentary effect, making a face appear more delicate.

Why is FT a pioneer in Facial Gender Affirming Surgery for the nose?

Facialteam is a leader in rhinoplasties in the context of facial feminization surgery.

We were the first centre to introduce ultrasonic techniques into rhinoplasties and have, in total, performed more than 1000 feminising rhinoplasties. So, you can rest assured that we are the right people to entrust for a rhinoplasty FFS.

We know that an FFS surgery can seem like a daunting prospect, so we have published multiple video explanations of the processes involved.


The use of Piezosurgery® in facial bone surgery is a safe, predictable technique with low morbidity. In the field of Facial Gender Confirmation Surgery, Piezosurgery® has played a a key role in nasal osteotomies since 2015. It minimizes trauma to the soft tissues and increases precision when eliminating the bony cap and performing the osteotomy under direct view, using an external approach with an extended subperiosteal dissection. This reduces postsurgical edema and ecchymosis and provides better control of the osteotomy line when narrowing the nasal pyramid and reducing the bony hump, either via osteotomy or osteoplasty.


  • What is Nose Feminization surgery?
  • Why is FT a pioneer in Facial Gender Affirming Surgery for the nose?
  • The gender of the nose
  • Objectives of Nose Feminization
  • How is Nose Feminization performed?
  • Post op and results: What to expect after Nose Feminization
  • Rhinoplasty combined with other FFS procedures

The gender of the nose

Usually, the masculine nose is larger and wider than the feminine nose because it has more bone, as evidenced by more prominent ridges.

The forehead also plays an important role here, because of the transition between the nose and forehead. This transition in males tends to be sharp and prominent.

Therefore, for each individual patient we will need to consider whether the nose and forehead should be approached simultaneously, which is common.

Female noses are normally less prominent than males in all aspects, tending to be more narrow and straight or with a gentle curve or more petite tip. On the other hand, the tip of the nose is often sharper in females than males. Finally, the nostrils tend to be smaller in females.

Objectives of Nose Feminization

In the context of Facial Gender Confirmation Surgery, a feminizing rhinoplasty has three objectives:

  • To feminize the nose to help patients feel better represented by their outward appearance.
  • To harmonize the nose in relation to the other modified structures (mainly the forehead and the lower jaw and chin complex).
  • To achieve a pleasing aesthetic result.

Standard rhinoplasty techniques can be used to make the nose smaller and give it a more feminine contour. The proportions will be in harmony with the rest of the face and forehead.

A reduction rhinoplasty generally consists of making the back of the nose smaller and the tip discreetly lifted. The correction of the brow prominence softens the angle between the nose and the forehead.

The type of skin in the nasal area can determine the final results of the procedure. Thin skin can make the procedure easier. However, if the skin is thicker, as is more common in males, the reduction, although noticeable, may have some limitations.

This video provides more information about the objectives of our nose feminization procedures.

How is a Nose Feminization performed?

A rhinoplasty or nose surgery is a highly personalized procedure and requires an exhaustive evaluation of the bone and cartilaginous structures that form the nose.

Since 2015, Dr. Raúl Bellinga has used ultrasonic technology for sculpting the nasal structures with specially adapted instruments known as Piezosurgery®.

As this tool does not cause trauma to the surrounding soft tissues in the process and allows for greater precision, both the healing and the results are improved significantly.

In general, a rhinoplasty is performed under general anesthesia. In some minor cases, it can be done under local anesthesia or sedation. The surgery lasts between one to two hours.

Depending on the individual needs of the patient, the following procedures are possible:

  • Refinement of the tip: by removing a small section of the cartilage of the tip and with sutures we achieve the improvement or narrowing of the nasal tip.
  • Feminization of the profile: the excess of bridge composed of bone and cartilage is removed and a nasal file is used to smooth for a more optimal result.
  • Narrowing of the nasal bone: if the bridge is wide, it can be reduced by a nasal bone fracture on each side and posterior approximation of both towards the midline.
  • Narrowing of the nostrils: removing the base of the alar cartilage can reduce the volume of the nostrils.

Structured rhinoplasty: a long term philosophy

Nose surgery, statistically, is one of the procedures worldwide that present larger complication rates in the mid and long-term (asymmetry, deviation, tip collapse).

This happens mainly when only aesthetic problems of the nose are addressed by the surgeon, without considering the nose’s inner structure and support. In these cases, the immediate results are satisfactory but in time the nose tends to suffer from the problems mentioned above.

Our approach is always based both on Structure and Aesthetics. For example, the main areas prone to collapse (tip and dorsum) are protected in our rhinoplasty technique as they are always reinforced with cartilage grafts. This helps to avoid undesirable postoperative shifts during the long-term healing process.

Post op and results: What to expect after a Nose Feminization

After a rhinoplasty, it will take some time for the final results to become clear. After the initial swelling and bruising goes down, the nose will continue to be slightly larger for a while, before the skin adjusts to the new structure below it.

However, you will be able to go about your normal life sooner than you might think.

In this video, Dr Raul Bellinga explains what you can expect after your nose feminization surgery.

Rhinoplasty combined with other FFS procedures

We always take a global approach to facial feminization surgery, and that may mean we recommend that you undergo a liplift in combination with your rhinoplasty.

Taking advantage of the same incision, a rhinoplasty and liplift can be performed during the same operation, saving on hospital costs.

That means you only have to visit us in Marbella for surgery once, rather than making multiple trips, and helps keep scarring to a minimum.

In many patients, the combination of these two procedures can be extremely effective in making this whole section of the face appear more feminine.


If you are interested in learning more about the Feminization Rhinoplasty techniques, please read our scientific article titled:

Technical and Clinical Considerations for Facial Feminization Surgery With Rhinoplasty and Related Procedures.

Raúl J. Bellinga, Luis Capitán, Daniel Simón and Thiago Tenório
JAMA Facial Plastic Surgery
December 2016