Facial Feminisation Surgery
Facial Feminization surgery (FFS) refers to Plastic Surgery Procedures which are combined to alter the male face to bring the features closer in shape and size to those of an average female face. The concept of feminizing the male face was promoted by Douglas Ousterhout during the 1980s and 1990s in the USA, who popularised the term FFS combining various bony and soft tissue procedures using well established Plastic, Cosmetic and Reconstructive Surgery techniques.
FFS has become increasingly sought after by Transgender women, since FFS is considered just as important or for some, more important than Gender Reassignment Surgery, GRS or SRS, because it enables them to integrate socially as women. While most FFS patients are Transgender women, some women who are conscious of their faces being too masculine will also undergo FFS.
Facial Feminization Surgery, FFS Procedures
Hairline correction, Hairline Lowering Surgery
Hairline correction or advancement is used to lower the hairline, reduce the height of the forehead and correct the normal male temple recession to give a more rounded female hairline. The Hairline lowering foreheadplasty is commonly combined with Browlift Surgery or Brow Contouring Surgery. Where significant hair line recession, male pattern hair loss has occurred, Hair Transplantation may be necessary.
Forehead, Brow Contouring Surgery
The typical male forehead has prominent brow ridges, frontal bossing, with a relatively flat upper forehead. The aim of Brow Contouring Surgery is to reduce the frontal, brow bossing and shape the forehead to give a more feminine smooth, gently curved forehead with the eyebrows above the supra-orbital ridges or bony rim of the socket. Hydoxyapatite may be used to provide a smooth appearance of the forehead. Brow Contouring is frequently combined with Hairline lowering and Brow lift surgery.
Brow Lift Surgery
Brow Lift Surgery is a Plastic Surgery procedure performed to elevate the eyebrows to a feminine curve, arching above the bony rim of the orbit, in a Male to Female Transgender patient.
Rhinoplasty, Nose Job
The Rhinoplasty, Nose Job in Male to Female Transgender patient aims to soften and refine the nose to give a more feminine appearance. The Nose Job frequently requires reduction in the size of the nose, narrowing of the bony nose and nostrils, together with refinement and lifting of the nose tip to give a natural female nose or feminization of the nose.
Cheek Implant Surgery, Cheek Enhancement
Cheek Enhancement is a Plastic Surgery procedure frequently used to give a feminine facial shape, with full cheeks and heart shaped face. Cheek Augmentation can be achieved by the use of Cheek Implants, Fat Grafting or Dermal Filler injections. Cheek Implant Surgery is commonly combined with Jaw, Chin Shaping Surgery and Brow Contouring Surgery to give a full Facial Feminization, FFS.
Chin Shaping, Chin Contouring Surgery
Chin Shaping Surgery is used to reduce the typical male chin which is larger, more square with prominent corners. Feminization surgery for the chin involves reduction in the height and shaping of the chin to give a more feminine appearance. Chin Contouring Surgery is commonly combined with Brow Contouring, Cheek Implant Surgery and Thyroid Cartilage (Adam’s Apple) Reduction. Liposuction of the neck may also be used to remove excess fat.
Jaw Contouring Surgery
Jaw Contouring, Jaw Shaping Surgery is an operation is reduce the normal wide male jaw and also the height of the jaw to achieve a more feminine facial appearance. BOTOX injections can be used to reduce large masseter muscles which cause a Square Jaw appearance.
Lip lift
The Lip Lift is a Plastic Surgery procedure to reduce the length of the upper lip, to give a more feminine shape and position of the upper lip. The Lip Lift is commonly combined with Lip Enhancement.
Lip Enhancement, Lip Augmentation
Lip Enhancement is a procedure to give shapely, fuller feminine upper and lower lips to feminize the lips in a Male to Female Transgender patient. Lip Enhancement can be performed using Dermal Fillers or Lip Implants.
Thyroid Cartilage Reduction, Adam’s Apple Reduction
Surgery to reduce the prominent Thyroid Cartilage, Adam’s Apple, is a frequent operation to feminize the neck. It is commonly combined with Chin Shaping, Brow Contouring and other Facial Feminization Surgery, FFS.
Other Facial Procedures, Treatments
Facial Feminization Surgery, FFS provides dramatic changes to the male face which enables Male to Female Transgender patients to fully live in the female role with confidence. However, many ancillary facial treatments or procedures may be necessary to achieve the optimum results. Various Facial Surgery procedures such as Eyelid Lift, Blepharoplasty, Face Lift, Neck Lift together with Skin Care Programs including Skin Peels, Obagi Blue Peel, will complete the Facial Feminization Surgery Program.
The optimum procedure for you will depend on your goals and specific anatomy.
Q: What is Facial Feminization Surgery, FFS?
A: Facial Feminization Surgery, FFS is the combination of Plastic Surgery procedures designed to transform the male features to a normal female face, in a Male to Female Transgender patient.
Q: What are the benefits of Facial Feminization Surgery, FFS?
A: Facial Feminization Surgery aims to alter the normal male facial features to enhance the feminine appearance which gives the Male to Female Transgender patient the confidence to live fully as a normal female. The procedure which is best suited to your goals will be determined at your consultation. Your result can restore self-confidence and boost self-esteem.
Q: Am I the ideal patient for Facial Feminization Surgery, FFS?
A: If you are concerned about the male features of your face and would like to achieve a more feminine look, then Facial Feminization Surgery, FFS may be suitable for you. You should be realistic as to what can be achieved by the Facial Feminization Surgery and understand the risks and side effects of this surgery.
Q: Does Facial Feminization Surgery require a general anaesthetic or hospitalisation?
A: Facial Feminization Surgery, FFS is performed under general anaesthetic requiring a hospital stay of 1 or 2 nights.
Q: How long is the procedure?
A: Facial Feminization Surgery, FFS normally takes approximately 4 to 6 hours to perform depending on the complexity of the surgery.
Q: What about the scars following Facial Feminization Surgery?
A: The incisions are placed in the natural skin creases, hairline or inside the mouth to be as hidden as possible. These incisions heal well in 7 to 10 days. The amount or extent of the incisions will depend on the complexity of surgery required to achieve the optimum results.
Q: Will a special garment be required after Facial Feminization Surgery, FFS?
A: In the majority of Facial Feminization Surgery, a facial support garment is fitted at the end of surgery to help control swelling and reduce movement post operatively. This should be worn day and night for the first week.
Q: What reassurance do I have with Facial Feminization Surgery, FFS?
A: At LBPS, we understand that your decision to have Facial Feminization Surgery can be a daunting and anxious time for you. Our aim is to fully understand your concerns and desires, and assess your face accurately, before agreeing on a treatment plan which is in your best interest. If for any reason you are unsuitable for Facial Feminization Surgery, you will be advised against this form of surgery. We will provide you with all the information you need and support before, during and after your surgery.
Q: How long is the recovery time?
A: Moderate pain / discomfort is expected for 3 – 5 days. Patients can go back to their normal daily activities after 1 to 2 weeks, but avoid strenuous exercise / activity for 6 weeks including any contact sports.
Q: What about the results?
A: The results are first and foremost natural. The goals of Facial Feminization Surgery, FFS are to provide an aesthetically pleasing, feminine facial shape which is in balance with your facial features – i.e. looks natural and does not appear abnormal. Remember it can take 6 weeks or more for the final result to be achieved.
Q: What are the risks of Facial Feminization Surgery?
A: Common to all surgical procedures there are always risks associated with surgery. However, complications are uncommon even with complex Facial Surgery. Bruising can occur and may take 2 weeks to resolve, while major bleeding is rare. Infection is infrequent (less than 0.5%) and will require a course of appropriate antibiotics. Facial muscle weakness is uncommon, but typically affects the forehead or corner of the mouth and is temporary lasting 6 weeks. Permanent weakness is rare – this risk is greater with redo Facial Surgery. Abnormal scarring, hypertrophic and keloid scars are uncommon. Some altered sensation around the cheeks is expected and will commonly return to normal between 6 to 12 weeks after surgery.
