Feminization

Most plastic surgeons are capable of performing soft tissue procedures otherwise known as facial plastic surgery, however, for more successful and long-lasting facial feminization procedures, bone work on the facial skeleton needs to be performed by a highly-skilled surgeon with craniofacial training. We believe that only surgeons cross-trained in both general plastic surgery AND craniofacial and orthognathic (jaw) surgery should perform FFS. Needless to say, your surgeon must also have the keen eye of an artist and a deep appreciation of facial aesthetic harmony.

Dr. Deschamps-Braly recommends waiting at least six (6) months after your surgical procedure before pursuing a facelift or any other facial rejuvenation procedure. This is because feminine facial features are generally more petite than masculine facial features, so the facial gender confirmation surgery may leave some individuals with excess laxity of the skin. Depending on your age and facial skin condition, this excess laxity may resolve on its own, or it may need a facelift in order to remove it.

A set of facial gender confirmation procedures most often takes anywhere from 6 to 10 hours, depending on the exact set of plastic and craniofacial surgical procedures that are required. Undertaking multiple surgeries at one time is very common and usually quite safe if you are in reasonable health. Your surgeon will help you to decide if the specific procedures you require are safe to do in a single session.

Unfortunately, one of the most common types of facial gender confirmation procedures we perform is to correct a previous surgeon’s work. This is often because while a surgeon may know technically what is required for facial feminization, they may not understand the subtle qualities of what truly makes a face “feminine” versus what makes a face simply beautiful. To capture authentic feminine gender expression, your surgeon needs to fully comprehend the science and structural proportions behind male vs. female faces, and also have a deep awareness of the more subtle aesthetic qualities of what constitutes gender.

While we recommend that facial gender confirmation is completed in a single stage, the procedure may be broken up into phases—typically an “upper face” and “lower face” phase. Each phase would encompass a cluster of surgical procedures that are closely related to each other to ensure a harmonious balance to the face (i.e. forehead and nose or jaw and chin bone). The two phases can be performed as close as two days, or as long as several years apart. And of course, a single, comprehensive facial gender confirmation surgical procedure can also be performed and is preferable in most cases to save on downtime and expense.

Typically you will stay the night in the hospital immediately after your surgery. Dr. Deschamps-Braly will visit with you in the morning on the day after your surgery to check in with you. The first few days you will experience facial swelling and also feel mild discomfort. However, because we will have taken steps to reduce your pain and swelling before you were operated on, this will subside rapidly. Within about 7 days after your surgery, most of the swelling and bruising will resolve. After about 3 to 4 weeks you should have a full recovery and be able to resume your usual activities and wear makeup. However, your results will continue to improve over the next few months, with the final result being evident at six to twelve months.