FAQs – Facial Masculinization Surgery

Can a plastic surgeon perform FTM facial masculinization? Or do I need a craniofacial surgeon?

While most general plastic surgeons are capable of performing soft tissue (plastic surgery) procedures, we believe that bone restructuring of the actual facial skeleton — with the aim of FTM facial gender confirmation — must be performed by surgeons cross-trained in both general plastic surgery and craniofacial surgery.

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

Your FTM surgeon should be board certified by the American Board of Plastic Surgery, as well as have completed training (and/or fellowships) in both general plastic surgery AND craniofacial surgery – along with a long history of relevant experience in both fields.

Will I still look like “me” after FTM Facial Masculinization Surgery?

Those considering FTM facial masculinization surgery fear that they will no longer be recognizable after the surgery to their friends and family. This fear is usually unfounded because a good surgeon will take into aesthetic consideration those facial features that are unique to “you” and will work to retain your individuality.

By combining subtle structural changes over a variety of facial features, the result should be a dramatically more masculine appearance, but still the essence of “you.”

Do you have “before and after” photos of FTM facial masculinization patients? Are they on your website?

When you visit our office you will be able to browse through our extensive collection of pre- and post-surgical FTM patient photos spanning the decades that we have been in practice (since 1973). We will share these images with you during your initial in-office consultation.

Note, we do not post these photos on our website, nor anywhere else on the Internet, for a very good reason: in order to respect the privacy and confidentiality of our patients.

Also, this is why we will not share these photos via email or Skype consultations; they are strictly for use at in-office consultations, medical conference presentations, and/or medical and transgender conferences.

Do you offer pre-surgical simulation, computer imaging or Photoshop “morphing”?

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

Is FTM Facial Gender Confirmation Surgery painful? If so, how is the pain managed?

We use a combination of pre- and intra-operative medications to help minimize post-surgical pain, however, we do provide post-surgery pain medication as needed.

Overall, our patients report any pain to be very mild after surgery. In fact, the majority of our patients do not need to use any type of narcotic pain medication at all.

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

Can any face be masculinized?

Any face is capable of having its features made more 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 facial masculinization.

Should I wait until I’m on testosterone therapy before I have facial masculinization surgery?

You do not need to be on testosterone therapy before having FTM facial surgery. However, for health and safety reasons, we may ask you temporarily stop, or reduce your testosterone treatments in the weeks leading up to, and following your surgery.

Will I have any scarring after FTM surgery?

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

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.

Can I have my FTM masculinization surgery performed in different stages, or does it have to happen all at once?

Typically, we recommend that FTM masculinization surgery is to be undertaken in a single, long format surgical session, but it can also be broken up into “upper face” and “lower face’ phases. Each phase would encompass those procedures that closely relate to each other to ensure a harmonious balance to the face (i.e. forehead and nose, or chin and jaw completed in the same session).

The two phases can be performed as close as two days, or as long as several years apart. Usually, a single, comprehensive procedure is performed and is the most common choice for our patients.