Aside from the trachea shave, nose reshaping is probably the most common facial feminisation procedure. The nose is the most prominent feature of the face. Many transwomen find nasal refinement can create marked improvements in their female facial appearance. It tends to make the eyes look larger, bring out the cheekbones and adds delicacy to the overall facial impression.
Before reduction rhinoplasty
After reduction rhinoplasty
Gender of the nose
Male noses are usually larger than those of women, with a broader nasal bone. Men more often have a nasal hump. Usually, beautiful female noses are smaller than those of men, in all aspects. They tend to be narrow and straight, or to have a gentle curvature like a slide.
The angle between the male forehead and nose is sharper than in women and the angle between the nose and lip is also smaller (points upwards more). The angle of the tip of the nose is sharper in women than in men. Women´s nostrils are also usually smaller.
Bianca before reduction rhinoplasty
Bianca after reduction rhinoplasty
Nicole before reduction rhinoplasty
Nicole after reduction rhinoplasty
Feminising the nose
Standard rhinoplasty techniques can be used to make the nose smaller and to give it clear feminine outline and proportions, taking into consideration that it should be harmonious with the rest of the face.
In a reduction rhinoplasty, generally the dorsum and tip of the nose need to be made smaller and the tip lifted. Correction of the frontal bossing will improve the angle between the nose and the forehead.
If one has thin skin, a significant size of reduction can generally be completed. If the skin is quite thick (as is often the case in males), the contour can still be markedly improved, but there may be a definite limitation to the size reduction possible. However, contour changing alone greatly feminises the basic nasal appearance.
Before rhinoplasty
After rhinoplasty
Procedure
Rhinoplasties are usually done under general anesthesia. In certain minor cases, local anesthesia and sedation may be used.
The operation generally lasts between one and two hours.
For feminising rhinoplasties we prefer the ‘open method’ because it gives the surgeon more working room. In the ‘open’ approach one small incision is outside the nose across the columella (the skin between the nostrils). This incision is generally extremely difficult to see.
According to your individual needs following actions may be done:
Refining the tip: A section of the tip cartilage is excised to achieve refinement or ‘narrowing’ of the nasal tip.
Shaping the profile: The bone-cartilage hump is removed. A surgical file or rasp is commonly used to smooth the bony hump, in order to achieve more precise results.
Narrowing the nasal bone: If the bridge of the nose is wide, it can be narrowed by fracturing the nasal bone on each side and moving it closer to the centre.
Narrowing the nostrils: The volume of the nostrils can be reduced by alar base excision.
A splint will be put on your nose to help support the new shape.
Packing is placed inside your nostrils to help stabilize the interior structure of your nose.
Small sutures will be used to close the incisions.
Recovery
Breathing: The most difficult part for most people is being unable to breathe through their nose until the packing is taken out. Your mouth and lips can dry out very easily and swallowing can be difficult. Usually the packing stays in for three to seven days.
Stiches: The stitches underneath the nose come out in a week to ten days.
Cast: The cast comes off after nine days. The nose is usually very tender at that point and extra care must be taken to avoid bumping it or sleeping on it.
Bleeding: Some sporadic bleeding could be expected during the first couple of weeks, which is normal and should not be a cause of concern.
Bruising: Most people get bruising around the eyes and cheeks. The bruises under the eyes will intensify during two or three days before they begin to vanish. 15 days later, only you and your surgeon will be able to notice any traces of the surgery.
Appearance: Your nose will regain its normal appearance very soon, but the definitive results will be fully appreciated after six months. The tip is the area that takes the longest to acquire its new shape.
Complications
Assymetries: The nose is, literally speaking, constantly before our eyes, making any imperfection very noticeable, no matter how trivial it may be. Even though the surgeon marks very carefully the areas he is going to treat, there may be asymmetries. According to international statistics, rhinoplasties are the procedures that have the highest rate of revisions. These revisions, if necessary, may be carried out after six months.
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