"To make somebody more feminine, you want to make a lot of their facial features less coarse," explains plastic surgeon Dr. David Alessi, who has not treated Jenner

Credit: Vanity Fair

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Caitlyn Jenner, formerly known as Bruce Jenner, made her debut on the new cover of Vanity Fair on Monday, since transitioning from male to female – and is sharing her story with the world.

“If I was lying on my deathbed and I had kept this secret and never ever did anything about it, I would be lying there saying, ‘You just blew your entire life,’ ” she tells Vanity Fair.

Jenner – who says she has not undergone genital surgery – also revealed she had a breast augmentation and underwent facial feminization surgery.

“To make somebody more feminine, you want to make a lot of their facial features less coarse,” explains double-board-certified plastic surgeon and ENT specialist Dr. David Alessi, who has not treated Jenner. “So you want to basically thin the nose down, you want to raise the cheekbones up and make the cheeks look less full.”

Dr. Alessi estimates that Jenner’s facial feminization surgery costs $35,000 – and adds that the procedure in general can range from $30,000 to $40,000, which includes a rhinoplasty and cheek implants, among other procedures.

Dr. Alessi says a full gender transition that includes genital surgery can cost from $100,000 to $200,000 – “depending on how much work needs to be done and what exactly they’re going to do.”

But first and foremost individuals need to “have a psychological consultation especially for the breast implants or the gender reassignment surgery.”

“There is a requirement that they need to have a psychologist statement that they’ve been under care for a certain period of time – [and] there is a waiting period – [and that] this is a perfect thing for them, that it really is a male or female stuck inside the other sex’s body,” Dr. Alessi says.

There are also standards set by the World Professional Association of Transgender Health (WPATH).

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“They’re very specific about the steps that need to be taken in order for somebody to have these permanent changes on their body,” explains Dr. Scott Mosser, a board-certified plastic surgeon and a specialist in female-to-male chest surgery and male-to-female breast augmentation. He has not treated Jenner.

“Surgeries are performed at a very late stage in the game – [once] everybody is on board with the gender transition being the correct step to treat the condition called gender dysphoria,” says Dr. Mosser, who explains that gender dysphoria is “the dissatisfaction with one’s gender.”