Hormone Therapy during Transitioning

By Dr. Cohen

“Hormone therapy barely helped my FTM transition. What cosmetic procedures will help me look more masculine?”

Great question! Transitioning is a highly personal, multi-step process that is different for everyone who experiences it. Most FTM (Female to Male) trans men find great comfort in achieving a masculine appearance. It helps alleviate the unsettling effects of gender dysmorphia, boosts self-confidence, and – most importantly – allows trans men to look and feel more like the person they are meant to be.

Hormone therapy is a common first step, but it rarely provides enough physical changes to meet most transition goals. Fortunately, there is a wide range of surgical and non-surgical cosmetic procedures that can transform feminine features to be more masculine, providing the life-changing results trans men are seeking. Below are a few options based on specific areas of the body you may want to treat.

For the Face – There are certain facial features that can have a significant effect on whether a person appears male or female, including:

• The Nose – Male noses are generally larger and more angular than female noses. Nasal augmentation can be achieved with Rhinoplasty surgery and/or strategically placed dermal fillers, if the person would prefer a non-surgical approach.
• The Chin & Jaw – A sharp, defined jaw and strong chin are hallmarks of the typical male face. The chin and jaw can be augmented with facial implant surgery, dermal filler treatments, and/or liposuction to remove excess fat, creating a more pronounced masculine profile.
• The Cheeks – females tend to have softer, oval-shaped cheeks while men have more angular, chiseled cheekbones. The cheeks can be enhanced with implants and/or fillers.
• The Forehead – The male forehead is generally denser and bonier than a female’s forehead. Facial implants and fillers can be used to achieve this more masculine look.
• Adam’s Apple – The Adam’s Apple, located in the mid-thoracic area (neck), is one of the most predominant exclusively male anatomic features. Adam’s apple implant surgery, also known as thyroid cartilage enhancement surgery, can provide trans men with this signature masculine feature.

For the Chest – Front and center, breasts are hard to ignore; which is why most trans men are eager to remove these telltale signs of femininity. A transgender mastectomy, commonly known as “Top Surgery,” involves removing unwanted breast tissue and adjusting the position and size of the nipples and/or areolas to create a smoother, flatter, more masculine chest.

For the Body – Liposuction and CoolSculpting are body contouring techniques that eliminate unwanted, excess fat to create a slimmer, more masculine physique. Both procedures work well on traditionally curvaceous feminine body parts, including the hips, thighs, belly, buttocks, and arms. Liposuction is a surgical procedure that provides precise results. CoolSculpting is non-surgical procedure that can freezes away fat in just one hour – with no surgery, stitches, or downtime – but results are less precise and multiple treatments are required.

For the Hair – Facial hair is another hallmark of typical masculinity. NeoGraft Hair Restoration is a great way for trans men to achieve a masculine beard, mustache, eyebrows, sideburns, and hairline. It involves removing individual hair follicles from a “donor” site with similar quality and look to facial hair – like the chest, abdomen, pubic area and the back of the head – and carefully transplanting them, one by one, in a precise pattern to create fuller, more masculine facial hair that looks and feels natural.

When you are ready to complete your FTM transition, the practice and surgeon(s) you select are your most important decisions. These procedures can be complex and require the advanced expertise of well-trained, skilled, experienced practitioners. I recommend you start by consulting with reputable board-certified plastic surgeon(s) with experience caring for the transgender community and makes you feel comfortable.

About Dr. Michael D. Cohen

Dr. Michael D. Cohen is a board-certified plastic surgeon and the Founder & Medical Director of Belcara Health – a multidisciplinary practice offering unique mix of medical and aesthetic services designed to help men and women live happier, healthier, more vibrant lives. For over 25 years, Dr. Cohen and the world-class team of specialists at Belcara Health have helped thousands of cis and transgender people look and feel their best. Learn more at belcarahealth.com or call 410.296.0414.