
There are some of my sisters who were fortunate enough to get the genetic luck of the draw and all we needed was hormones and attitude to pass successfully. Others of us started early enough in our lives to avoid the ravages of demon testosterone on our bodies.
But for those peeps who either transition late in life or need help to feminize their appearance from the neck up, they resort to facial feminization surgery to do so.

If you watched the MTV show 'I Want A Famous Face' and remember Jessica, that's basically what she was doing.
Facial feminization surgery involves facial plastic surgery, maxillofacial surgery and reconstructive surgery. While those surgery skills and disciplines are well known, there are not many surgeons that specialize in FFS techniques worldwide. Those that are skilled at it are highly sought after.

Some of the techniques are forehead contouring, in which the bony ridge just above the eyes is removed and shaped to create a more feminine appearance. Scalp advancements, brow lifts are also done to enhance the new smooth forehead.

There's also the tracheal shave, in which the cartilage bulge on the neck is shaved down as much as possible without touching the vocal cords.
Some people undergo rhinoplasty to get more feminine appearing noses, face lifts and lip augmentations as well.
The procedures, when completed and the post-surgical pain and swelling subsides, result in remarkable results, but it ain't cheap. FFS can cost anywhere from $10-40K depending on what procedures you get, which surgeon is doing them and where you get it done.
Bu for some transwomen, the positive effects on their self esteem and peace of mind because they blend in better with society are worth every penny they spent on it.