Facial feminisation surgery

The goal of this type of surgery is to achieve more feminine facial features that look natural and beautiful at the same time, making you feel perfect, more confident and comfortable with your gender identity. 

FFS is a wide range of procedures to change facial features. As a result, after the facial gender affirming surgery, the patient achieves a softening and more feminine appearance. These procedures can be carried out in combination or on a specific area of your face, with minimally visible scars.

The face is usually divided into three parts: the upper, middle and lower third. On each of them, different operations may be carried out. Furthermore, other techniques exist such as facelifts, which are performed on the entire face, or treatments using aesthetic medicine which also contribute to feminising your face.

In the upper third of a female face, thickening of the bones above the eyebrows is a feature that gives a tougher appearance and expression. The hairline may also be a masculinising feature of the face. For this reason, feminising the upper third of your face means modifying this area. The surgery consists of modifying your forehead by reshaping the frontal sinus to soften its prominence. The same procedure can also be used to lower your hairline. This results in a smaller forehead while also enhancing your eyes.

Usually, the faces of cisgender women appear more oval, whilst a male face tends to be squarer. Therefore, often our patients also wish to change these features by modifying the angles of their chin and jaw, along with lip height through facial feminisation surgery of the lower third.

Other aesthetic treatments such as lipoplasty, cheek augmentation, rhinoplasty or bichectomy will help to improve your features in the middle third while distributing facial volumes. Also, the feminisation can be combined with voice surgery as well, in order to attain a higher pitched and feminine tone. The result is a voice consistent with the appearance.

This are the most common surgeries involved in MTF facial surgery:

• Forehead feminisation: This involves reducing the brow ridge and reshaping the forehead to create a smoother and more rounded appearance. The surgery may include a brow lift to elevate the eyebrows and open up the eye area.
• Rhinoplasty: Commonly known as a nose reshaping, this procedure reshapes the nose to be smaller and more refined. The goal is to achieve a nose that is harmonious with other facial features and more feminine in appearance.
  
• Cheek augmentation: This surgery enhances the cheeks to create a fuller, more prominent appearance. This can be achieved through implants or lipofilling, where fat is taken from another part of the body and injected into the cheeks.
• Lip lift: A lip lift shortens the space between the upper lip and the nose, giving the lips a more youthful and feminine appearance.
• Jaw reduction and thyroplasty: Jaw contouring reduces the width of the jaw and alters its shape to appear more feminine. A thyroplasty, or Adam’s apple reduction, involves shaving down the thyroid cartilage to reduce the prominence of the Adam’s apple.
• Chin reduction: This procedure reduces the size and alters the shape of the chin to make it appear smaller and more pointed, which is considered more feminine.

The plastic surgery team works with the patient to develop a specific plan focused on the patient’s needs and preferences. For this, you might need a CT scan that will help your doctor to obtain detailed anatomical information.

Your FFS surgeons will explain to you all you need to know about anaesthesia and adjust medication for a proper healing. He will provide you as well some advice about eating, drinking and probably quitting smoking for a season.

The postoperative period can be different depending on the type of facial feminisation surgery performed, but it typically lasts from several weeks to a few months. Your surgeon will give you instructions on how to care for your incisions, such as keeping them clean and dry and avoiding any irritation or trauma to the area.

It is recommended that you sleep on your back for at least the first few weeks. You can usually shower within the first week after operation, but it is important to follow your surgeon’s instructions. Be careful not to let the water pressure hit your incisions directly and avoid submerging your face in water, such as taking baths or swimming until your incisions have fully healed.

During the recovery process, patients can expect some swelling, bruising, and discomfort around the treated areas. It is important to follow your surgeon’s instructions carefully to ensure proper healing.

Depending on the procedures performed, you may need to wear a compression garment or special dressings to support the surgical area and promote proper healing. Your surgeon will provide instructions on what you need to wear and for how long.

Like any surgical procedure, MTF facial surgery carries side effects or risks of complications. These are the most common risks:

• Infection and bleeding.
• Poor wound healing.
• Suture rupture along an incision line.
  
• Seroma under the skin.
• Bruising and swelling.

It is important to follow your surgeon’s instructions and report any concerns or symptoms promptly. Sometimes additional surgery may be needed to improve the final result.

Can I undergo FFS while taking hormone replacement therapy (HRT)?

Yes, it is generally safe to undergo FFS while taking hormone replacement therapy (HRT). In fact, many patients undergoing FFS are taking HRT as part of their transition. However, it is important to inform your surgeon about any medications you are taking, including HRT, before the procedure.

Your plastic surgeon may advise you to temporarily stop taking HRT before and after surgery to reduce the risk of blood clots. They may also adjust your medication dosage during the recovery period to ensure optimal healing.

Overall, it’s important to be open and honest with your surgeon about any medications or medical conditions you have before undergoing surgery. They can provide guidance and make any necessary adjustments to help ensure a safe and successful procedure.

How much does facial feminisation surgery cost?

The cost of MTF facial surgery can be different for each patient, as not everyone has the same features or needs. Therefore, it is very important to have an initial consultation with the surgeon to evaluate which parts of the face need improvement and which surgical treatments would be most appropriate for the patient. With this assessment, we can provide you with a personalised quote for your treatment.

What are the differences between female and male craniums?

In these images, you can see the most significant differences between a female and a male skull. Many of these bone structure peculiarities can be modified by performing various facial treatments.