There is a complex, yet well-established association between youth, beauty, and femininity within the face. While facial rejuvenation procedures are commonly performed to restore the appearance of youth, these procedures can play a particularly important role in creating and enhancing facial femininity in trans women. A thorough understanding of the pathophysiology of aging, facial anatomy, and facial aesthetics is crucial when considering potential facial rejuvenation procedures. Surgical procedures such as rhytidectomy, blepharoplasty, fat grafting, and cheek augmentation can significantly alter the contour and gender appearance of the face. This chapter focuses on the role of facial rejuvenation surgery for transgender women.