Facial feminization surgery

Facial feminization surgery (FFS) is plastic surgery procedures focused on changing the shape of the face to get a more feminine and harmonious appearance. In order to achieve the patient purposes, the IM GENDER team use personalized techniques.


At IM GENDER, we are specialists in facial feminization surgery. We know that FFS surgery is a delicate intervention that can generate many doubts and concerns in patients who undergo it. That is why in our gender reassignment clinic, we adapt to your needs.

We understand that each patient is unique, and for this reason, we offer a personalized approach in every intervention we undertake. Our team of professionals will guide and advise you every step of the way.

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    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. 

    Facial feminization surgery before and after

    At IM GENDER we know that seeing real cases of before and after MTF facial surgery is important before making any decision. In these images, you can see real cases of patients who have been treated at our clinic, so you can get an idea and make a more informed decision.

    What is facial feminization surgery?

    FFS is a wide range of feminization 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.

    what is facial feminization surgery<br />

    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.

    facial feminization procedure<br />

    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 feminization 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 feminization 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.

    Common surgeries in facial feminization surgery (FFS)

    This are the most common surgeries involved in FFS:

    • Forehead feminization: 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 surgery, 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.

    How you prepare for Facial FEMINIZATION SURGERY

    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 feminization 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.

    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 feminization 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 personalized 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.

    faqs facial feminization

    Anna La Spisa
    Anna La Spisa
    28 Noviembre 2023
    Esperienza positiva chirurghi ottimi, infermiere molto preparate e dolcissime, Aida e Rosa super umane, ma la dottoressa Brandalisio ha fatto la differenza su tutti, preparata, umana, dolce, disponibile, un'amore di persona. Una critica costruttiva devo farla tutto lussuoso ma non pensato per stendere pochi indumenti lavati
    Tone Vik
    Tone Vik
    31 Julio 2023
    I had GRS in May 2023. Here is a short summary of my experience. When you contact the clinic, you’ll get a personal patient coordinator that will answer and support you through the whole process, both before and after the surgery. The communication is professional, personal and efficient. WhatsApp is the main communication platform, and it works very well. The clinic is beautiful and top notch on all levels. You almost forget that you are in a clinic and might think of it more as a hotel (with surgery services). Please see the attached pictures, and you will understand what I mean. The staff is warm and friendly and really do what they can to make you feel comfortable, from the nurses to the cleaning personnel. It is really nice to be so well looked after, and I have such good memories from my week at the clinic. The surgeons, I was so fortunate to have Dr. Labanca, but they are all world class, which ensures that the results probably will exceed your expectations. Of course this is a very personal opinion, but for me it was like that. It’s hard to describe how happy I am now. You can bring a friend or a family member for no extra cost the week you are at the clinic. My best friend came down on the 5th day, and that was also one important factor when I chose this clinic. The support you get from having a friend or family member present is almost priceless. A short 5 minute walk from the clinic you’ll find apartments you can stay at for an additional week or two while you recover and heal. It was very reassuring and comforting to have the clinic so close the two weeks I stayed after checking out from the clinic. An important part of the healing process is to just move your body, and the beautiful city of Sant Cugat is a nice 20 minute walk from the apartment, where you can enjoy shopping, restaurants and just the nice relaxing atmosphere. The aftercare and regular follow up when you have left the clinic ensures that everything is working as it should, and if not, they will correct at no extra cost. The aftercare period lasts one year after the surgery. To sum up, you are really in the best hands and in the best place at IM Clinic. I highly recommend this clinic for GRS.
    Victoria Timoniere
    Victoria Timoniere
    24 Abril 2023
    Due mesi fa ho avuto la grande fortuna di affidarmi al team di IMgender , un esperienza indimenticabile che mi ha cambiata la vita facendomi rinascere finalmente nel corpo giusto . La clinica è super moderna è attrezzata , pulita e tutto lo staff è super gentile e accogliente .
    Renn Love
    Renn Love
    14 Abril 2023
    My experience with IM Clinic from the start to where I am today has been nothing but exceptional. From my initial contact with Aida, to my consultations with my surgeons Dr's Gómez, Herrero and Beltrán, my anaesthetist and care from the nurses. The cleaning staff were extremely discrete and the food for both myself and my wife, who was also looked after during my stay, was good. Myself and my wife were made to feel welcome from the moment we arrived. On the day of my surgeries my surgeons continuously re-assured me as they could see how nervous I was and it felt like nothing was too much trouble. My wife was also informed of my progress during surgery and reassured all was ok. I highly recommend IM Clinic and would not hesitate in returning, should I feel the need.
    Sun Belardinelli
    Sun Belardinelli
    11 Marzo 2023
    Ho aspettato qualche mese dopo l'operazione prima di scrivere questa recensione perché volevo essere sicuro dei risultati. La parola che mi viene in mente è PERFETTO, la clinica è perfetta, l'operazione è andata ancora meglio di quanto sognassi, il trattamento che ho ricevuto da TUTTI, medici, infermiere, tutto il personale, è stato impeccabile, caloroso e amichevole; mi hanno fatto sentire meglio che a casa (non solo a me, ma anche alla persona che mi accompagnava), ancora meglio di un hotel di lusso; mi hanno veramente trattato come un re, non solo come un paziente. L'operazione in sé è stata perfetta, il pre- e post- operatorio gestiti benissimo anche a distanza; mi hanno dato istruzioni chiare e medicinali appositi per curare le ferite e il dolore. Grazie a questo sono rimasto tranquillo per tutto il tempo, sapendo di essere nelle migliori mani. Un consiglio che mi sento di dare a chi vorrebbe operarsi da IM è: fate tutte le domande che vi vengono in mente e anche quelle che non vi vengono in mente! Soprattutto per chi viene dall'estero come ho fatto io è importante avere ben chiaro ogni dettaglio, e le persone con cui parlerete saranno felici di chiarire qualsiasi dubbio. Raramente ho trovato persone così pazienti, competenti e alla mano. Se e quando avrò bisogno di fare un'altra operazione la farò sicuramente da IM. Ormai ho trovato il posto dei sogni e non lo lascio più!
    Alexa Valianatos
    Alexa Valianatos
    10 Agosto 2022
    Hey, I am Alexa Valianatos and on 14th June i had my vaginoplasty surgery at IM Clinic. Here i found a greate, super friendly and profesional team which whose totally prompt answering to all my needs. Viewing my research before surgery and my experience in the clinic and after that, i can say that IM Clinic I'd the best clinic in Europe at least regarding my surgery tipe and my needs, i can say 100% that i found the 5* clinic . After two months from my surgery i already decide to make the next steps for next surgery in the same clinic . Many worm thank to doctor Ivan Mañero and entire clinic team . You are the best .
    Aaron O'Donnell
    Aaron O'Donnell
    19 Julio 2022
    Thank you IM Clinic!!! I had FtM Top Surgery (double mastectomy/gender reassignment) at IM clinic in July 2021. As I was travelling from the UK I was weary about the procedure, however their standard of care goes above and beyond to accommodate their patients and ensure maximum comfort. I had surgery with Dr Herrero, who was an absolute pleasure to meet and a brilliant surgeon. The team were a delight and made me feel genuinely safe and as comfortable as possible. The procedure I had is not very common and is somewhat hard to acquire in the UK, but the team at IM Clinic took me in with ease and listened to my worries and requests. The care i received at IM Clinic was impeccable - between the food, the staff, the surgery and everything else - i cannot fault it. I am forever grateful to Dr Mañero, Dr Herrero and the entire care team at the clinic. Thank you so much!! I am now one year post-op and happier than ever.

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