Generally speaking, bony work will have a far more dramatic effect on the shape of a face. In frontal view, the most important goal is to change the overall square form of most masculin faces to the more oval shape of a women’s face.
This bony work is often combined with soft tissue procedures to achieve an aesthetic result. Soft tissue work may be necessary to get the full result of bony work for some patients.
CT scan of the skull of a patient before and after her facial feminization surgery. Here you can see clearly the effect of the bony work.
Pictures of the same patient Ella before and two months after facial feminization surgery. For most patients, however, soft tissue changes alone will not bring the desired result.