FAQs – Facial Feminization

FAQs – Facial Feminization

FAQs – Facial Feminization

Will I still look like “myself” after Facial Feminization Surgery (FFS)?

Many people considering facial gender confirmation surgery fear that post-surgery they will no longer be recognizable to their family or friends. If your surgery is performed properly, by a Board Certified surgeon, this would not be the case. By combining subtle changes over a variety of facial features, the end result will be a dramatically more feminine appearance, but you will still maintain the essence of “you.”

Do you have “Before & After” photos of your work? How can I see them?

We have an extensive collection of pre- and post-surgical facial gender confirmation patient photos spanning the several decades that we have been in practice (since 1973). We are more than happy to share these images with prospective patients during their in-office consultation.

In order to respect the privacy and confidentiality of our patients and uphold our promise to never put their photos on the Internet, we do not share these photos on our website.

Additionally, we do not share these photos via email or phone consultations; they are strictly for use at in-office consultations and/or medical conference presentations (medical and transgender conferences).

Do you offer pre-surgical surgical simulation imaging or Photoshop morphing?

We believe that surgical photo “morphing” is a better reflection of Photoshop/computer software skills – rather than actual surgical skills; therefore, we do not offer this service.

Is facial gender confirmation surgery painful? If so, how is the pain managed?

Overall, our patients report their pain levels to be very low after surgery. In fact, the majority of our patients do not need to use any type of narcotic pain medication following surgery.

We use a combination of pre- and intra-operative medications to help minimize post-surgical pain, and provide our patients with post-surgery pain medications as needed.

Read more about pain management and relief after plastic surgery here.

How long do I need to take off work or school in order to recover?

We recommend our patients take two (2) full weeks off from school or work in order to prepare for, and undergo the surgery, and attend post-op appointments.

After two weeks, the majority of swelling and bruising will be gone or easily concealable with cosmetics, at which point the majority of patients feel ready to return to work or school.

That being said, if you are able to work from home you can ‘return to work’ as soon as just a few days after surgery; however, individuals who do not want to return to school or work until they are completely healed, may need to plan for four (4) weeks off.

Can any face be feminized?

Yes. Any face is capable of having its features made more feminine or masculine. However, surgery of any type can only be performed on individuals who are deemed to be medically-safe surgical candidates.

If for some reason you are not suitable for surgery, it is important to remember that beauty is not synonymous with feminization.

Should I wait until I’m on hormone replacement therapy (HRT) before I have FFS?

No, you do not need to be on HRT before having facial gender confirmation surgery. However, for safety reasons, we may ask you temporarily stop or reduce your HRT in the weeks leading up to, and following your surgery.

Can I go to a ‘generic’ plastic surgeon? Or do I need one with craniofacial qualifications?

While general plastic surgeons are capable of performing soft tissue work, we believe bone work on the facial skeleton must be performed in order to achieve the best possible outcome with any type of facial gender confirmation surgery. That being said, we feel only surgeons cross-trained in both general plastic surgery AND craniofacial surgery should perform FFS.

How do I know what to look for in a facial confirmation surgeon?

Your surgeon should be board certified by the American Board of Plastic Surgery, as well as have completed training or fellowships in both general plastic surgery AND craniofacial surgery.

Will I have any scarring?

It is impossible to perform any type of surgery without leaving a mark to some degree. Nonetheless, the majority of incisions for facial gender confirmation surgery are placed in extremely well-concealed areas and tend to heal quite nicely.

If you are prone to forming keloids, or ‘bad’ scars, we have a variety of techniques that will help mitigate the appearance of post-surgical scarring.

Which is better: hair transplants or a scalp advancement?

Depending on your specific needs and desired outcome, either, both, or neither of these techniques may be incorporated as part of your surgery.

For patients who are bald, nearly bald, or wear a hair piece full time, neither scalp advancement nor hair transplants would be necessary.

For patients with a ‘high’ hair line (or a long forehead), scalp advancement may be recommended to bring the hair line ‘down’ or shorten the forehead. Additionally, hair transplants may also be combined with scalp advancement to help fill in temporal hollowing (receding areas of the hair line) or placed along the incision line to further help conceal the scar. Because part of the hair-bearing scalp is removed with scalp advancement, that hair can then immediately be used to perform a hair transplant at the same time as the scalp advancement.

Can I do a face lift at the same time as my facial gender confirmation surgery?

Even if a facelift is recommended as part of your FFS, we advocate waiting at least 6 months after any plastic surgery procedure before pursuing a face lift or any other facial rejuvenation procedure.

Because feminine facial features are generally smaller or more petite than male features, FFS can leave some individuals with excess laxity of the skin. Depending on a person’s age and health, this excess laxity may resolve on its own or it may warrant a facelift in order to remove it.

Still, regardless of gender or facial surgery, most individuals would benefit from facial rejuvenation at some point in their life.

Can I do my facial gender confirmation surgery in different stages, or does it have to happen all at once?

While we recommend that facial feminization surgery be undertaken in a single, long format surgical session, it may also be broken up into parts—typically an ‘upper face’ and ‘lower face’ phase if so desired.

Each “phase” would encompass a few procedures that closely relate to each other in terms of keeping a harmonious balance to the face (i.e. forehead and nose or chin and jaw).

These two phases can be performed as close as two days or as long as several years apart. Of course, a single, comprehensive surgical procedure is typically performed to save on recovery time and surgical costs. For those seeking to undergo complete FFS with simultaneous hair transplants, we usually recommend splitting the entire procedure over two consecutive days.