Dermal Fillers for Feminization
Hyaluronic acid (HA) fillers are a cornerstone of non-surgical facial feminization. A skilled injector can use them to add volume and create softer, more rounded contours. Common applications include cheek augmentation to create a higher, fuller 'apple' of the cheek; temple filling to correct hollowing and create a smoother brow transition; and lip augmentation for a plumper, more defined appearance. Fillers can also be used along the jawline to soften sharp angles and in the chin to create a more tapered, less prominent shape. Results are immediate but temporary, lasting 6-24 months.
Dermal Fillers for Masculinization
Fillers can also be used for facial masculinization. In this context, they are used to add structure and create more angular, defined features. A provider might inject filler along the jawline to create a sharper, more squared-off angle, or in the chin to create a wider, more prominent appearance. This can provide a powerful masculinizing effect without the need for surgical implants. As with feminization, the results are temporary and require maintenance.
Neurotoxins (Botox) for Facial Shaping
Neurotoxins like Botox, Dysport, or Xeomin work by relaxing muscles. For feminization, they are commonly injected into the masseter (chewing) muscles at the back of the jaw. This causes the muscle to relax and shrink over time, leading to a significant slimming of the lower face and a less 'square' appearance. They can also provide a subtle 'brow lift' by relaxing the muscles that pull the eyebrows down. For masculinization, neurotoxins are used more sparingly but can help reduce fine lines to achieve a rugged look without appearing aged.
Skin Rejuvenation: Microneedling and Lasers
Procedures that improve skin quality can have a significant impact on gender perception. Microneedling uses fine needles to create micro-injuries, stimulating collagen production to improve skin texture, reduce acne scarring, and create a smoother appearance often associated with femininity. Ablative and non-ablative laser resurfacing goes further, removing outer layers of skin to dramatically reduce wrinkles, sun damage, and textural irregularities. These procedures require more downtime but can produce profound results.
Non-Surgical Body Contouring
For individuals seeking changes to body fat distribution beyond what HRT and exercise can achieve, non-surgical body contouring offers options. Cryolipolysis (e.g., CoolSculpting) freezes and destroys fat cells in targeted areas like the abdomen or flanks. Injectable deoxycholic acid (e.g., Kybella) can be used to dissolve small pockets of fat, such as under the chin. While these procedures can help masculinize or feminize a silhouette by reducing fat in specific areas, they are not a weight-loss solution and results are modest compared to surgical liposuction.