FEMININE TOUCH

Caitlyn Jenner’s grand reveal on the July cover of Vanity Fair made the topic of facial feminization surgery (FFS) a household one, despite the fact the surgery is nothing new. Boston-based facial plastic surgeon Dr. Jeffrey Spiegel has been performing FFS for nearly two decades—and not just on trans women but also on cisgender women (someone who was born female and has always identified that way) who want a younger or more womanly look. “Our ability to tell gender is not really skin deep,” says Spiegel. “Our brains, on a subliminal level, pick up a lot of cues from bones that we don’t consciously understand: Is this a man? Is this an attractive person? Is this a young person?” FFS isn’t as simple as a nose job or a facelift; the changes can be unexpected. For instance, a larger distance between the upper lip and nose is a sign of femininity, as is a rounder hairline. “The jaw might need to be shaped and reduced and contoured,” he says, “so if someone gives you a block of marble and says, ‘Make this into a beautiful face,’ you have to remove some extra marble and sculpt it.”