The Role of Rhinoplasty in Transgender Surgery


The nose is a central feature of the face and an important marker for identifying gender. Facial surgery, including rhinoplasty, is often an important part of the transition process for transgender patients, both in MTF and FTM transitions. 

Dr. Brian Machida specializes in facial plastic surgery including transgender rhinoplasty in the Inland Empire. Call STC Plastic Surgery at 800-303-9541 to schedule a consultation. 

Male vs. Female Noses

Male and female noses are different shapes and sizes. Of course, there is significant variation in nasal appearance, and not every nose checks off all the characteristics of their gender. Differences are beautiful, and something we seek to retain, even after rhinoplasty surgery. Our goal isn’t a cookie-cutter nose; in transgender nasal surgery, we strive to create a natural-looking and unique nose that has more gender-specific characteristics. 

How do male and female noses vary? Let’s take a look at some typical characteristics of male and female noses. 

Characteristics of a Female Nose

Female noses are generally smaller, with a narrow bridge and a slightly upturned tip. They are less prominent than a male nose. 

  • Upturned tip
  • Smaller, more slender 
  • Slightly concave nasal bridge
  • Narrower nostrils
  • Less bone

Characteristics of a Male Nose

Male noses are rather prominent. They are significantly larger than a female nose with a wide nasal base, wider bridge, and bigger nostrils. Many have asymmetry from previous nasal injuries. 

  • Larger and more prominent
  • Wider nasal base
  • Straight or arched nasal bridge
  • Not upturned, at a 90-degree angle to the face

The Difficulties of Transgender Nasal Surgery

Rhinoplasty is a highly complex procedure, one of the most difficult facial surgeries we offer. Transgender rhinoplasty is one of the most difficult types of rhinoplasty due to the significant differences between male and female noses. 

  • Since a biological male nose is generally much larger and bonier than a biologically female nose, extensive resections and large-scale tissue removal are needed to shape and modify the nose to a more feminine appearance. MTF rhinoplasty, also called facial feminization rhinoplasty, requires judicious attention to nasal structure and the airway to ensure that breathing isn’t compromised by the large-scale modification. 
  • For an FTM rhinoplasty, also called facial masculinization rhinoplasty, additional tissue and volume are often added to the nose. Dr. Machida may use nasal implants and bone or cartilage grafting to achieve this additional structure. As most surgeons are more familiar with reduction techniques, FTM rhinoplasty requires a highly experienced surgeon with extensive rhinoplasty experience. 

Choose a board-certified plastic surgeon with extensive rhinoplasty experience. Ideally, they will have performed multiple procedures on patients making a similar transition (MTF or FTM). Dr. Machida is double board-certified, by both the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology. 

Schedule Your Transgender Rhinoplasty Consultation 

The decision to transition is never an easy one, but your choice of a plastic surgeon for your transgender rhinoplasty can be. Choose STC Plastic Surgery in Inland Empire, CA for your masculinizing rhinoplasty or feminizing rhinoplasty. Schedule your consultation today to begin exploring options.