Aggressive vs. Conservative Facial Feminization

We speak often with patients about how facial feminization is aggressive or conservative. 

It is common to hear people interested in facial feminization say, I want aggressive results, so I’d like to have the maximum number of procedures” or, “I’m making a big investment in order to have dramatic and beautiful results.”

This blog post aims to delve deeper to create greater understanding of the topic.

Can facial gender surgery be both aggressive and conservative at once? 

Good question. The seemingly incompatible concepts –dramatic versus subtle– are also highly subjective. Just like the perception of beauty. 

These arguments about looking 100% feminine or 100% natural have come out of an ongoing debate related to expectations in FFS surgery. The variety of people with different gender identities will inevitably have different objectives with facial gender affirming surgery. 

So, we are asked whether our approach to facial feminization is aggressive OR conservative. However, let’s reflect: Does one approach exclude the other?

Facial feminization is aggressive AND conservative

The first things to ask in the debate of aggressive versus subtle FFS Surgery, in our opinion, are: 

  • What does it mean for facial feminization procedures to be aggressive or conservative? 
  • Might these concepts be complementary? Meaning, natural could still be dramatic results and vice versa with techniques?

Please permit us to explain our point of view in this matter. We believe that facial feminizing surgery has the following objective: 

To eliminate masculine features as safely as possible while respecting facial proportions and harmony. 

In other words, feminization is the priority and beauty is a secondary factor. From a technical and professional perspective, the goal of facial gender affirming surgery is NOT to transform a person’s face completely, eliminating their core features and even erasing their identity.

Now, let’s deconstruct aspects of the myth that Facialteam does not provide facial feminization that is aggressive, but instead conservative. In reality, we always apply both concepts to every surgery. 

Dr. Simon on the topic of aggressive and conservative approaches to facial feminization.

Aggressive and conservative FFS methods combined

So you may ask, how can we be aggressive and conservative at the same time?

Well, we are aggressive when we pursue eliminations of the masculine features to the maximum possible, using the most advanced techniques. Combining 3D diagnostics and planning with ultrasonic bone cutting technology, we take bone sculpture and reconstruction to the ultimate limit, if that is what the patient wants and if  it is safely viable. 

On the other hand, we are conservative when we consider that every surgery should deliver natural results, absent of visible scars or nerve damage, and in maintaining each patient’s core identity. So if conservative means working with each person to find what’s best for them, yes, we are. 

Yet our philosophy of maximum safety and naturality does not equate with having conservative techniques.  Actually, it’s quite the opposite! 

Feminizing gender markers with natural outcomes 

Facialteam has put in enormous efforts in the last 12 years, after more than 2600 patients, to develop bone sculpture methods which both reduce risks and are able to predict to the millimeter your new bone contours. 

This way, we can be extremely accurate and efficient, while at the same time, we avoid complications and foresee what your global outcome may look like.  With this approach, we can both offer aggressivity in techniques within the frame of maximum safety without artificial-looking results.  Another example is the coronal approach with hair transplants for hairline feminization, also a method that has revolutionized forehead feminization results in a single surgery, not at all a conservative concept.

In conclusion, facial gender affirming surgery is aggressive AND conservative at once, in our opinion, when we are talking about addressing the gender markers of the underlying bone structures or the hairline format. This is not to be confused with rejuvenation or beautification procedures of secondary characteristics, which can be beneficial but should be considered separately.

For us, the best FFS surgery result means taking each procedure to a precise technical extreme, yet without erasing every last vestige of you– it’s about creating a balance between safe, natural, and the kind of feminine you desire. Discovering your own brand of feminine and communicating with you about this is what the orientation process is all about.

Don’t miss out watching Lilia’s livestream with Dr. Daniel Simon and our psychologist, Mayte Mateo, discussing expectations around aggressive and conservative facial feminization surgery.

Profile picture of Dr. Daniel Simon in surgical outfit, Facial Feminization Expert at Facialteam.
About the author

Hi there, my name is Daniel Simon, together with Luis Capitán I founded Facialteam in 2010. With my contributions to this blog I hope to share some of the experience and knowledge I gained on Facial Feminization Surgery over the past 14 years.