Rhinoplasty

Procedure: A Rhinoplasty procedure can be performed using a “closed” technique with no external incisions or an “open” technique with a small incision under the tip of the nose just above where it meets the upper lip. This incision heals very well and is virtually undetectable in most people. Rhinoplasty is a very individualized surgery, because no two noses are the same. The surgical technique selected will be based on the anatomy of your current nose and your individual aesthetic goal.

Procedure: A Rhinoplasty procedure can be performed using a “closed” technique with no external incisions or an “open” technique with a small incision under the tip of the nose just above where it meets the upper lip. This incision heals very well and is nearly imperceptible in most people. Rhinoplasty is a very individualized surgery, because no two noses are the same. The surgical technique selected will be based on the anatomy of your current nose and your individual surgical goal.

Location: Rhinoplasty surgery is normally performed under general anesthesia at a nearby out-patient surgical center.

Recovery: A splint is placed over the nose for 5-7 days to protect it in the early phase of healing. After this comes off, tape is placed over your nose to reduce swelling until the tenth day. Some patients experience swelling and/or bruising around their eyes depending on how easily they bruise. The nose will be swollen in a manner that you and I will know (know what), but that other people generally don’t notice. Approximately 90% of the swelling goes down in 3 months and the rest resolves over one year. Pain is minimal and controlled with pain medications.

Return to work/activities: You can return to work in 10 days. You can resume light lower body exercise, like a light workout on an elliptical machine, at 4 weeks and impact exercise, like running or yoga, at 6 weeks.

WATCH THE VIDEO chin and jaw augmentation

Jaw Enhancement

Masculine features of the jaw vary from person to person. However, a prominent, wider lower jaw that flares outwards can give the face a square and more masculine look. Jaw enhancement surgery can improve the definition between the lower face and the neck by enlarging the margins of the jaw and increasing the width of the lower face.

Procedure: During surgery, Dr. Sturm will make a small incision inside your mouth and create a pocket for a jaw implant. The implant is inserted against your jawbone and sutures are used to hold it in place.

Location: Jaw enhancement surgery requires general anesthesia and will need to be performed at an out-patient surgical center.

Recovery: After surgery, you will experience swelling. The amount of swelling varies patient by patient, in some instances there may be visible bruising. Your mouth will need to be cleaned a few times a day with mouthwash. It may take four to six weeks before the cosmetic improvement will be obvious due to the swelling.

Return to work/activities:You should be able to return to your normal daily activities in about one week.

WATCH THE VIDEO chin and jaw augmentation

Chin Augmentation

A strong, angular chin can indicate masculinity. Depending on the size and shape of the chin currently and the desired goal, a chin implant can be inserted. Implants come in different sizes and are quite safe.

Procedure: Access is gained to the chin from an incision inside the mouth to avoid scarring. A safe, permanent implant that is customized to increase projection, chin height or both is placed in a precise pocket and sewn into place, if needed. The incision is closed with absorbable sutures.

Location: Chin augmentation surgery can be done with IV sedation or general anesthesia and will need to be performed at an out-patient surgical center.

Recovery:You will likely have some swelling and bruising. The chin and lower lip can feel “tight” for about a month. Extensive bone surgery may require four to five weeks to heal.

Return to work/activities: You should be able to return to your normal daily activities within five to seven days post-operatively.

Brow and Hairline Shaping

The relationship of the hairline, brows and eyes convey a lot of information about who we are.

The eyebrows frame the eyes, where most people look first on the face. The masculine brow has a flatter shape at the brow bone and the bone itself is more angular and prominent. The feminine brow lies above the orbital rim (brow bone) and arches on the sides and the bone is rounder and softer. We can use non-surgical techniques, such as Botox, to lower the brow. Forehead lengthening and augmentation surgery can also re-shape the brow and brow bone.

Similarly, the hairline frames the face. Masculine hairlines tend to be lower in the middle and higher in the sides because of the testosterone effect. To masculinize the hairline, the sides, and sometimes the middle, are brought backward making the forehead larger. This can be done with forehead lengthening and augmentation surgery or a combination of the two. Each face is different, so Dr. Sturm will tailor the techniques for each patient.

Forehead Lengthening

Some patients undergo forehead lengthening to bring back and reshape the hairline by lengthening the forehead for a more masculine appearance.

Procedure: During surgery an incision is made along the hairline, the scalp is then lifted and pulled backward. However, the scar heals to a fine, faint line that is often not noticeable.

Location: Forehead lengthening and augmentation surgery is performed at a nearby out-patient surgical center under general anesthesia.

Recovery: Most patients experience some bruising, swelling and numbness of the scalp. Discomfort is mild and managed well with pain medications.

Return to work/activities: You should be able to return to work and daily activities in 7-14 days following surgery. Straining and exercise should be avoided for 4-6 weeks.

Forehead Augmentation

Forehead augmentation surgery enlarges the forehead to a wider, more angular, more masculine appearance.

Procedure: During surgery an incision is made along the hairline that heals to a fine, faint line that is often not noticeable. A safe prosthetic material (methyl methacrylate or silastic) is used. However, there is a limit to how far the scalp can be moved or widened during a single surgery.

Location: Forehead augmentation surgery is performed at a nearby out-patient surgical center under general anesthesia.

Recovery: Most patients experience some bruising, swelling and numbness of the scalp that resolves. Discomfort is mild and managed well with pain medications.

Return to work/activities: You should be able to return to work and daily activities in 7-14 days following surgery. Straining and exercise should be avoided for 4-6 weeks.

Hair Transplantation

Hair transplantation works not only to create a masculine hairline, but can also be used to fill in and even provide facial hair that can be styled in any way you desire.

As a general rule, hair-restoration surgery works best if you have healthy hair-growth areas to serve as donor places; typically this means that the sides and back of your head need to have some hair from which to "harvest" grafts.

Procedure: Dr Sturm uses the popular follicular-unit mini-grafts. She takes hair from dense hair-growth areas, like the back of your head, and replants grafts in thin areas. In certain cases, the hairs can be taken without incisions!.

The hairs are individually and artfully placed on the scalp, in the hairline or in the beard. It may take a few surgical sessions to achieve the degree of hair fullness you want. If that is the case, you will wait a few months between each session for healing. There are many variations on hair-replacement surgery that may be appropriate. When you come in for your consultation with Dr. Sturm, she will develop a treatment plan that is specific to your needs.

Location: Hair transplant surgery can be done on an out-patient basis in our fully accredited in-office surgical suite under local anesthesia.

Recovery: Hair transplantation is associated with minimal pain. You will have tiny areas of swelling and healing around each implanted hair that is easily covered with a hat or will resolve in a matter of days on the face.

Return to work/activities: You should be able to return to work and usual activities in one week.

WATCH THE VIDEO tracheal augmentation

Thyroid Cartilage Augmentation

An Adam’s apple is a prominent notch in the thyroid cartilage. This notch is visible and can be very prominent in men. Therefore, it is considered by many to be a masculine characteristic.

Procedure: With tracheal augmentation surgery, a tiny incision is placed in the crease of the neck below the chin. This allows the scar from the incision to be minimal. The upper edges of the thyroid cartilages are exposed and augmented with a safe implant, similar to what is used in chin or cheek augmentation. The neck muscles are then closed over the implant and the skin is closed while protecting the vocal chords.

Location: Thyroid cartilage augmentation surgery can be done with IV or general anesthesia and will need to be performed at an out-patient surgical center.

Recovery: Post-operatively, you will experience some swelling during the first 24-48 hours. An ice pack applied to the area along with medications that Dr. Sturm may suggest will keep discomfort to a minimum. Mild voice weakness can also occur in the first few days following surgery.

Return to work/activities: You should be able to return to your normal daily activities in about one week.

About Facial Masculinization Surgery (FMS)

There are certain characteristics of a face that are identified as masculine. Many people can experience masculinization changes such as; widening and thickening of the jaw, growth of facial hair, thickening of the brow bone, lengthening of the forehead and growth of the Adam’s apple with hormone therapy alone. Facial masculinization surgery (FMS) encompasses the spectrum of facial plastic surgery procedures that can augment or alter the changes that you already see.

Many facial masculinization surgery procedures are well known cosmetic surgery procedures, including; rhinoplasty and chin augmentation that many plastic surgeons perform. However, there are some procedures that are specific to masculinization, including; thyroid cartilage augmentation, and forehead, and jaw, that are not as widely performed.

Dr. Sturm specializes in facial plastic surgery of the head and neck areas, but can provide recommendations for surgeons who specialize in top surgery and other gender affirmation procedures of the body. Depending on the case, can be performed at the same time as your facial masculinization procedures.