Since the female face is relatively smaller and softer than the male face, for female-to-male facial remodeling, the original skeletal contour should be augmented and expanded to present the relatively masculine angle and curvature, so various models and sizes of facial implants can be used for sculpting the features of the male face, and implants for different sites should be conscientiously evaluated to unleash the compatibility of materials. Common female-to-male facial conversions include enhancing the eyebrow bone, widening the cheekbone or filling the submalar triangle (apple cheek augmentation), enhancing the square chin and mandible angle, and, for some patients, autologous fat injection is conducted to thicken the skin to make the implant appear more natural. The surgical implant should be determined based on the original conditions and subjective requirements of the patient, and generally, multiple implants need to be used to obtain distinct changes. The implants frequently used by Dr. Chuang are available in the following two categories of materials and models:
Medpor has hard structures and can be used to sculpt the masculine angle of a male face. It comes in cheekbone, orbital bone, nasion, nasolabial groove, square or round chin models, and various models of the mandible bone; it is available in various sizes and is able to satisfy the needs of the overwhelmingly majority of female-to-male face change patients. The advantages of such a material are its high biocompatibility with the human body, a lower probability of infection or rejection, stable results, a lower likelihood of deformation, conformity to the structure, resilience of the natural human skeleton, and life-long use without any need for replacement. The disadvantages are the requirement of bone screws for the fixation of implants, the relatively high surgical indications and complexity, close adhesion between materials and skin tissues, and difficulty in removal or revision. Currently, Dr. Chuang frequently utilizes Medpor to thicken and expand the female chin, nasolabial groove, cheekbone, and mandible angle and confers a customized revision based on the requirements of patients.
Gore-Tex has been widely used for the augmentation of the eyebrow bone, cheekbone, chin, or nasolabial groove for the long term and has obtained a positive response. Nevertheless, because the model and size of Gore-Tex are relatively limited and less diverse than those of Medpor, Gore-Tex is now less frequent to use in female-to-male face sculpting. Because Gore-Tex is softer and more elastic than Medpor and does not necessitate fixation with bone screws, the surgery is relatively simple and the recovery is rapid. Its advantages are the high biocompatibility, lower incidence of rejection or infection, and stable and long-lasting results. However, because Gore-Tex also closely combines with skin tissues like Medpor, it is relatively difficult for future revision or removal. Currently, Dr. Chuang utilizes Gore-Tex for sculpting the eyebrow bone, cheekbone, and nasolabial depression, which all attain long-term and stable results.