This research documents for the first time changes in the facial appearance that occur in female-to-male transsexuals (FTMs) with exogenous testosterone therapy and oophorectomy. Method: 25 FTM transsexual faces were assessed morphologically using comparative facial analysis, and morphometrically using 2D pre-transition photographs and 3D post-transition facial models (FASTSCAN Scorpion laser scanner & Geomagic Freeform - a 3D modeling software with Phantom haptic feedback device). Subjects: The average age of the post-transition subjects was 39 years; all subjects had been taking testosterone for a minimum of 3 years (range 3.3 � 21.1 years), with an average duration of 8.6 years. Objectives: To describe the qualitative and quantitative transformation from a female-appearing to a male-appearing face, and to identify predictable patterns of change due to testosterone treatment. Results: 24% of subjects were classified as male-appearing pre-transition, and 96% post-transition; 96% had beard shadow/facial hair and 52% demonstrated male pattern balding. The majority of subjects (44%) became wider in the face overall, and facial width increases were the most frequently recorded change. 18 subjects demonstrated a narrower nasal width; 55.6% of those by between 7 - 17% of their original dimensions. Conclusions: Testosterone virilises natal female adult faces. One new consistent pattern of change was shown to be predictable: the nose will narrow at the alae. It is hypothesised that this is a result of facial fat re-deposition.