Beverly Hills Feminization Procedures
Our highly qualified Beverly Hills facial feminization specialist treat many men who wish to
transform their appearance into a more feminine one!
With over years of experience in the field of plastic surgery, Toby G. Mayer, M.D., F.A.C.S.
works to provide their patients with the most up-to-date surgical techniques on the market, as
well as specialized personal care.
The Feminization Process
At The Beverly Hills Institute of Aesthetic & Reconstructive Surgery, more and more
transsexual men are seeking the help Dr. Mayer for their feminine transformation.
As a leading Beverly Hills facial feminization professional, our doctor can perform various
surgical procedures that can yield a more female look in men. Some procedures may include
cheek augmentation and rhinoplasty, also known as "nasal surgery."
If you wish to alter the pitch of your voice, you might want to consider Dr. Mayer as your
Beverly Hills voice modification expert. With his help, you can achieve complete
Dr. Mayer is board certified by the American Board of Facial Plastic and Reconstructive
Surgery (ABFPRS) and the American Board of Otolaryngology (ABOto). Because of his vast
expertise in the field of plastic and reconstructive surgery, you can rest assured that your
cosmetic needs are in good hands!
Interested in scheduling a consultation with our Beverly Hills voice modification physician?
Feel free to contact our office at (310) 278-8823 or toll-free at (800) 854-8823. You can also
e-mail us with any questions or concerns. In addition, please browse through our many before
and after photos and patient experiences.
Below is a list of the most commonly performed procedures for Facial Feminization and a
brief description of each procedure and how it is used in this process. For additional
information on any of these procedures, go to www.bevhills.com or contact us.
A forehead lift is often performed on transgender female patients to raise the brows to a more
feminine position. Orbital bony contouring, or a reshaping of the bone underneath the
eyebrows, is often combined with a forehead lift to soften the area around the eyes. (For these
patients we will require a skull x-ray prior to surgery). In addition, many of our patients
would like to lower their hairline (since men tend to have a larger forehead than women) and
we often combine a forehead lift with hairline lowering.
Through the unique hairline forehead lift procedure we developed, these procedures can all be
performed at the same time allowing us to resolve these related problems simultaneously. The
incision is naturally concealed within the hairline.
Please note that some patients have more extensive male pattern baldness that may require
other hair replacement procedures to correct. These procedures can often be done in
conjunction with a forehead lift as well.
There is not particular cheek shape or definition that most men or women have. In general a
fuller, more prominent cheek is the ideal for the Facial Feminization process. There are 3
different main types of implants, which come in a variety of sizes so that each patient can
receive a customized fit.
Cheek implants (malar): These are placed directly on the cheek bones to increase
prominence or give "high" cheek bones.
Below the cheek (submalar): These are placed just under the cheek bone to correct a
hollow or sunken-in appearance and to create more fullness
Combined (malar/submalar): These implants go over and below the cheek bone to
increase prominence and to correct hollowness under the cheek.
This procedure is usually performed through incisions inside the mouth so there are no visible
Nasal Surgery (Rhinoplasty)
As with the other components of Facial Feminization, nasal surgery is primarily performed to
soften this feature. Our goal is to provide you with a more feminine nose, but at the same
time, not give you an artificial or overly scooped or pinched look. Each patient’s nose is
unique and there are a variety of techniques to “feminize” a nose. We evaluate each patient
individually. The extent of the nasal surgery will depend on the patient and what is necessary
to both feminize the nose and to bring the nose into balance with the face without creating an
The chin and jawline are as variable as the nose in men and in women. While some believe
that men tend to have a wider chin and squarer jaw, and women a more pointed chin with a
narrower jaw, we do not feel that this generalization is accurate. We see a large number of
women with a wider, square jaw and men with a narrow jaw and pointier chin.
There are several ways of reshaping the chin and jaw area to soften their appearance.
Chin implant: This redefines the shape and softness of the chin.
Chin/jowl implant: This redefines the shape of the chin and the jowl area. It is often
used to correct depressions in the jowl
Pre-jowl implant: This reshapes the jaw without changing the chin
This procedure is usually performed through an incision under the chin, where most of us
have a naturally occurring crease. There is less chance of infection than when the incision is
placed in the mouth.
Tracheal Shave (Thyroid Cartilage Reduction)
This procedure involves a reduction or shaving of the upper portion of the trachea known as
the Adam's Apple. This procedure is performed on a large number of transgender patients.
The tracheal shave is performed through an incision in one of the natural creases of the neck
and creates a flatter appearance to the Adam's Apple. This procedure can be performed with
any of the above procedures
The tracheal shave procedure is performed under a local anesthetic. An incision is made in a
natural crease in your neck. The trachea is shaved and tiny stitches are used to close the
incision. Stitches are removed six days later. (Once it is healed, you won't even be able to find
Dr. Mayer can also use a technique similar to the technique used in hemming a skirt. He
would make a loop in one end and in six days after surgery you would just pull the end and
the stitches would come out. In that case, you would only need to be here let's say Monday for
your consultation/pre-operative appointment, Tuesday for your procedure, Dr. Mayer would
check you on Wednesday and you could fly out that day. The following Monday, you would
just pull the end to release the stitches.
Hair Replacement Procedures
Unfortunately, transgender patients do not escape the perils of male pattern baldness
completely. The good news is that once hormone therapy has been started, the progression of
hair loss is usually stopped. The bad news is, you can not "regrow" what has already been
lost. There are however, several options depending upon the extent of the hair loss.
Scalp Advancement - This procedure is often performed at the same time as a hairline
forehead lift for patients will some frontal hair loss. It is essentially a lowering of the hairline.
In some instances, there is not enough elasticity in the scalp to provide adequate
advancement, so we will place a tissue expander under the hair bearing scalp. The expander is
then filled slowly, over time, to create the adequate of amount of scalp needed for proper
placement of the hairline.
Fleming/Mayer Flap – For patients with more extensive frontal baldness, we can perform
our renowned Fleming/Mayer Flap procedure to give the patient a full head of their own hair
–with their own natural density A second flap may be needed to address more extensive
baldness. In some cases, a Tissue Expander may also be required prior to the flap procedure.
We also recommend that all of our flap patients undergo Micrografts (1-3 hair per transplant)
to the hairline to soften the hairline for the most natural result possible.
Hair Transplants – Micrografts (hair transplants consisting of 1-3 hairs per graft) and
Minigrafts (hair transplants consisting of 4-7 hairs per graft) are also used to treat male pattern
baldness. These can be placed on any area of the scalp where hair loss is a problem. It usually
requires several sessions for each area, and has less density than the flap procedure. However,
some patients prefer this option.
The ultimate goal with hair replacement surgery is the same as with all of the other
procedures we offer: a natural, more feminine look. We will review all of the options
available to you and give our recommendations for the best possible solution to your
individual hair loss concerns.
For a complimentary video on the Fleming/Mayer Flap procedure, and a complimentary copy
of the Everyman’s Guide to Hair Replacement, please e-mail us at email@example.com.
For more detailed information on the Fleming/Mayer Flap procedure, and other forms of hair
replacement, please visit our main website at http://www.bevhills.com/hair/
Voice Modification Surgery
It has been more than fifteen years since that first transsexual patient asked me if there was
not some operation I could do to modify her voice. Her body surgery had been successful, and
I was about to perform both hair restoration surgery and nasal surgery to complete the
physical transformation. Yet, she was still quite distraught about her voice.
She explained to me that it was quite embarrassing to speak to someone over the telephone
and have them say, "Well, thank you for your help, Sir." Her voice was quite deep, and she
was not able to place the pitch into the female range; this obviously presented serious
problems in completing a successful transition for gender reassignment.
I explained to her that there was no surgery that I knew of for voice modification, but I would
attempt a procedure which might work. I told her that there was no guarantee of success, but
she said she was willing to take this chance, even though the procedure might fail, because of
the problem that her voice presented. Well, not only was the experimental procedure
successful, but it succeeded beyond my wildest dreams. The patient's voice was well within
the female range and nobody referred to her as "Sir" after that! (All transsexual patients owe
this person 'J' a great deal of gratitude, as she allowed me to develop this revolutionary
procedure by her willingness to "take a chance.")
That was more than fifteen years ago, and since then several hundred patients have undergone
similar surgery with a success rate of more than 95%. (The remainders do not achieve a
significant change in voice pitch.) This voice modification surgery is unique, it was developed
by me, and no other surgeon I am aware of uses this technique.
The voice modification surgery is performed as an outpatient procedure in our surgery suite
under local anesthesia. There will be a small, fine, one-inch line in the neck crease after the
procedure. If desired, the Adam's apple can be shaved during the same operation. There is
very little discomfort afterwards, and the patient is able to fly home in 48 hours. Contact
sports and extreme athletic endeavors are to be curtailed for several weeks after the procedure.
The voice remains somewhat hoarse for a few weeks afterwards.
The goal of the surgery is to create a voice which sounds female on the telephone. The
surgery is performed to the best of my ability. There can be no guarantee of the results, but
there have been no serious complications or problems with this procedure to the present time.
The cost of this surgery is $5750.00. (Click here for audio samples of voice modification
Quite often other types of surgery are performed in conjunction with the voice modification
procedure, such as our unique method of hair replacement for transsexual patients using the
flap technique. Facial feminization procedures including; forehead and brow lifts with
lowering of the hairline can also be done as well as contouring of the forehead-orbital bone.
Nasal surgery to create a more feminine nose, without an artificial or overly scooped or
pinched look, is often requested.
Our method of hair replacement depends upon the degree of hair loss already experienced by
the patient. In some patients the hairline can be moved forward since there is no further hair
loss once the patient is on estrogen. A simple advancement with or without tissue expansion is
all that is necessary. Using a procedure which has been developed and perfected by Dr.
Fleming and myself, hair will grow through the incision that is made at the frontal hairline so
no scar will be detectable afterwards. Utilizing this same approach, excess bone over the
ridges of the forehead can be smoothed to create a more feminine appearance as well.
For patients with more advanced hair loss, the Fleming/Mayer Flap procedure can be used to
create a natural hairline, without "corn rows", hair texture change, and poor density associated
with the hair transplant procedure. With the Flap procedure an entire section of hair is
transferred at one time from the sides of the scalp to the front, resulting in a very natural and
thick hairline. Dr. Fleming and I are recognized as authorities on hair flaps throughout the
world, and we are the originators of this advanced development. We have performed more
than two thousand hair flap procedures on patients from all over the world, including
numerous entertainers, celebrities, athletes and professionals.
Toby G. Mayer, M.D., F.A.C.S. and Richard W. Fleming, M.D., F.A.C.S. are Medical
Directors of the Beverly Hills Institute of Aesthetic and Reconstructive Surgery. They each
have dual Board certifications, and are Fellows of both the American Academy of Facial
Plastic and Reconstructive Surgery and the American College of Surgeons. Dr. Fleming and
Dr. Mayer are clinical professors and former co-chairmen of the Facial Plastic and
Reconstructive Surgery Division of the University of Southern California. The doctors have
been partners in private practice for over twenty years; their Beverly Hills office is designed
for patient comfort and privacy with state-of-the-art surgical suites designed to accommodate
the specific, delicate procedures they perform.
Highly regarded as world-renowned authorities on cosmetic and reconstructive surgery, Dr.
Fleming and Dr. Mayer are frequently requested as speakers at medical conferences all over
the world. As recognized leaders in hair replacement surgery they have co-directed the
National Symposium on Hair Replacement Surgery for seven years. Dr. Fleming and Dr.
Mayer have published numerous papers on their innovations to the revolutionary flap
technique for permanent hair replacement, and both doctors have contributed to many leading
textbooks on cosmetic and reconstructive surgery. Their medical reference textbook,
Aesthetic and Reconstructive Surgery of the Scalp, made its debut in January 1992. A
subsequent book entitled The Everyman's Guide to Hair Replacement Surgery was published
in 1995, and is available by request.
For more information on any of the above procedures, Dr. Mayer can be contacted by calling
(800) 854-8823 or by writing to him at:
The Beverly Hills Institute of Aesthetic & Reconstructive Surgery
416 North Bedford Drive, Suite 200
Beverly Hills, California 90210
E-mail : firstname.lastname@example.org
Recontouring your body through the use of liposuction is a common procedure in the
Feminization process. We use the Power Assisted Liposuction technique, which is the latest
advancement in liposuction technology. This device gives us greater control during the
procedure which results in better contouring and sculpting of the areas. The patient
experiences less bruising and swelling, and therefore a faster recovery period. Unlike
Ultrasonic liposuction, which can burn the skin, it is very safe for the patient.
Liposuction is commonly performed on the abdomen and flanks, but can be performed just
about anywhere on the body that excess fat accumulates.
The procedure is performed through very tiny incisions which are placed in inconspicuous
locations. A post-operative garment is worn for a minimum of one month after surgery,
possibly longer, depending upon the areas treated and the doctor's recommendations.
Enlarging the size of the breasts, to bring them into balance with the rest of the body, is very
commonly associated with feminizing the body. We work very closely with colleagues who
perform this surgery, and we can coordinate this procedure to occur at the same time as your