Facial Gender Surgery

Dr. Coon offers all procedures in facial feminization, including: Hairline Lowering, Frontal Sinus Setback, Forehead Contouring, Brow Lift, Rhinoplasty, Cheek Implants, Genioplasty, Jaw Recontouring, and Tracheal Shave. He has also pioneered new techniques, such as zygomatic osteotomies for cheekbone narrowing. His interest and expertise in facial bony surgery evolved from training at the Baltimore Shock Trauma Center, one of the world’s leading centers in facial trauma and the origin of many of the modern approaches to managing these injuries.

He is recognized as a leader in this field and authored the FFS textbook chapters in Plastic Surgery (Neligan), the main textbook in plastic surgery. In 2019, he chaired the International Facial Gender Symposium at Johns Hopkins University, the first-ever conference dedicated to facial gender surgery. He then developed the FFS surgeon consensus statement publication from this meeting which has been widely cited to support the medical necessity of FFS for insurance coverage.

With his biomedical engineering background, he has pioneered new methods for applying technology to improve FFS. Many of these are described in the open access paper “Computer-aided Planning and Execution in Facial Gender Surgery: Approaches, Concepts, and Implementation”. His series on “Fundamentals of Facial Feminization” and “Advanced Facial Feminization” for the Johnson & Johnson Educational Institute were attended by over 100 surgeons. He also has a longstanding collaboration with the FacialTeam unit and joins them each fall in Spain to teach their week-long FFS course.

Because each patient has their own unique perception of their face and desired changes, FFS is one of the most individualized of all procedures. Dr. Coon uses cutting-edge techology to attempt to more precisely align the surgical results with the patient’s goals. He also performs facial masculinization for patients unsatisfied with testosterone-induced facial changes with procedures such as jaw augmentation and fillers.

About Facial Gender Surgery

Facial gender surgery, often referred to as facial feminization surgery or facial masculinization surgery, is an umbrella term used to encompass one or a combination of several procedures to make subtle changes to the patient’s face to enhance natural features.  While these gender affirming surgeries are less likely to be covered by insurance, increasing studies have shown the medical necessity of these procedures.  One’s face is the first impression an individual has when interacting with others, and facial gender surgery has shown to greatly improve the patient’s health and safety over the long term.

When evaluating patient’s need and surgical goals, it is helpful to focus on the face, divided into thirds. The upper third includes the hair line to the top of the nasal bridge.  Patients seeking to improve features in this area may need to address the following issues: prominent forehead; prominent eyebrow ridge.

Surgical approaches to this area aim to soften these areas if a more feminine appearance is the goal.  This is done through a variety of techniques, which is largely dependent on craniofacial structure and the severity of the reconstruction.