Gender-affirming rhinoplasty
A nose that belongs with the forehead, the lip, and the jaw, whether the plan is feminizing or masculinizing.
The nose as part of a face, not a catalogue of tips
Gender-affirming rhinoplasty is still rhinoplasty: dorsum, tip, septum, airway. What changes is the brief. A feminizing nose is often narrower, with a softer radix-to-tip line and a tip that does not compete with a newly contoured forehead. A masculinizing nose may need a stronger dorsum and a wider base so it does not look like an afterthought on a heavier jaw.
Dr. David N. Sayah, MD and Dr. Toby Mayer plan the nose with the rest of the facial work. Doing rhinoplasty months apart from forehead or jaw surgery is sometimes right. Doing it without looking at those thirds is how faces end up with a beautiful nose that belongs to someone else.
Breathing is not optional. We correct septal and valve issues in the same operation when they are there. Insurance may cover the gender-affirming portion and, separately, medically necessary airway work. We help you sort which is which before surgery day.
What we address
Feminizing rhinoplasty
Dorsal refinement, tip definition, and width reduction planned against forehead and lip changes in an FFS plan.
Masculinizing rhinoplasty
A stronger profile and base that sit with jaw and chin augmentation rather than against them.
Airway and septum
Straightening and valve support so the nose you want is also a nose you can breathe through.
Revision after prior rhinoplasty
When a previous cosmetic nose does not serve a gender-affirming face. Cartilage grafting when tissue allows.
What to expect.
Consult with photographs
Front, profile, and three-quarter views. We talk about what you see, not only what a simulation can draw.
Plan with the rest of the face
Whether the nose is same-day as FFS/FMS or staged. Graft needs, if any, are decided here.
Surgery and splint
You leave with a splint, written care, and a timeline for swelling that is honest about months, not days.
Frequently asked questions
Is this different from cosmetic rhinoplasty?
The techniques overlap. The plan does not. We are matching the nose to a gender-affirming facial structure, including work that may happen on the same day or in another stage.
Can rhinoplasty be done with FFS?
Yes, frequently. Swelling in the midface is expected. We will tell you if your tissue or airway makes staging wiser.
Will insurance pay for gender-affirming rhinoplasty?
Many plans cover it as part of medically necessary FFS or FMS. Airway work may be billed on its own medical indications. We itemise after consult.
Talk through a gender-affirming nose
Bring prior operative notes if you have had rhinoplasty before.