Advice

Facial Feminization Surgery Complications: The Risks of FFS.

Facial feminization surgery is a life-changing process, and for many trans women and non-binary people, it’s a significant step in aligning their physical appearance with their true identity. And like any other surgical procedure, FFS comes with risks – it’s important to remember that, with an experienced team, these risks are minimal, and complications are rare.

As world-leading experts in FFS, at Facialteam we consider it’s our duty to offer more than we can, before, during, and after Your Revelation Journey – By putting a group of professionals at your disposal who ensure your health, safety, and proper healing from the first moment.

Now, one of our great values is transparency, we want our patients to be fully informed on the decisions they make – and as a part of it, we created our Open Data Hub with rates on risks, complications, and other interesting topics. Let’s go through some of them and explain some of the Facialteam protocols and practices that promote your well-being and protect your health during the facial feminization surgery process.

How Does The Body React to FFS?

Recovering from FFS involves a multi-step process. Many patients say the post-op discomfort is generally mild to moderate – more like a headache or muscle soreness than intense pain. Knowing what you might experience can help put your mind at ease.

Inflammation After FFS

Right after your surgery, your body gets to work immediately. Your blood vessels first tighten up and then open up to let a clot form – this is your body’s natural way of starting the healing process. It’s totally normal to notice some redness, swelling, warmth, and a bit of pain. You’ll likely see a scab over your incision, and that’s just your body protecting the area.

Proliferative Phase After FFS

During this phase, your body shifts its focus to repairing the damaged tissue. Fibroblasts – specialized cells – begin producing collagen, which is essential for rebuilding and strengthening your tissue. Additionally, new blood vessels form to ensure the healing tissue gets enough oxygen and nutrients. As collagen builds up and scar tissue begins to form, the surgical area might appear reddish. You might notice gradual improvements in movement as your tissues start to regain their strength.

Maturative Phase

Over the course of months to up to two years, your body continues to refine the healing process. During this final stage, the initially formed scar tissue undergoes remodeling, the scar gradually becomes less prominent as the tissue strengthens, the temporary collagen is replaced by a stronger, more resilient form, giving the healed area increased stability, and any additional blood vessels that formed during the repair phase begin to fade.

What Are the Most Common Complications in FFS?

Like any surgical procedure, there is a possibility of encountering minor issues. It’s important for you to be aware of this, and it’s also important to remember that our team is well-prepared to identify and address any anomalies that may arise efficiently.

During Your Revelation Journey, our coordinators, nurses, and surgeons will be vigilant for any signs that deviate from a normal recovery process. Once you return to your home country, our post-operative care department will be available to address any concerns you may have.

Although we take every precaution to minimize complications during your recovery, it’s possible for setbacks to occur, especially in the initial days following the surgery.

Bleeding and Hematoma or Bruises After My FFS.

While excessive bleeding is uncommon, it can happen, especially in surgeries involving the forehead, scalp, and jaw. Hematomas (collections of blood outside blood vessels) might occur, but they are usually treatable.

Scarring After My FFS.

Most scars are hidden in natural creases or within the hair. However, in rare cases, some patients may develop raised or thicker scars (like keloids). For those prone to this, we offer strategies to reduce scarring, including silicone-based treatments or steroid injections.

Infection After My FFS.

Infections can occur after any surgery, but the risk is low, especially with proper care. At Facialteam, we emphasize strict hygiene protocols during surgery, and we provide detailed aftercare instructions to minimize infection risks.

Nerve Damage After My FFS: Numbness or Tingling.

A temporary decrease in sensation – often in areas like the eyebrows – is expected as small nerve fibers might be affected during surgery, don’t worry it generally improves as nerves regenerate. These signs, often described as tingling or “pins and needles,” indicate that nerve healing is underway.

Many patients feel a firm, “tight” sensation around the operated areas. As your body repairs incisions and repositions tissues, you may feel reduced elasticity and mild discomfort as your skin and underlying tissues readapt to their new position. This is a natural part of wound healing and scar formation.

Facial Asymmetry After My FFS.

It’s completely natural for our faces to have some asymmetry, and even after surgery, minor differences can remain – most of the time it’s due to swelling and will fade away over time.

In cases where asymmetry is more pronounced and stays over time, adjustments can be made in follow-up consultations.

Forehead Feminization Surgery Complications

Forehead Feminization Surgery is designed to create a softer, more feminine brow bone structure. However, like any surgical procedure, it carries potential complications that patients should be aware of. Understanding these risks helps you prepare for your journey ahead.

Coronal Approach Forehead Recontouring Risks

  • Hematoma: Right after surgery, some bleeding from the scalp or under the tissue can cause a hematoma to form. While most aren’t a serious concern, larger ones can spread toward the eye area. To avoid this, we take special care with bleeding control during surgery, use drainage devices for 24-48 hours, and apply gentle compression. If a hematoma does form, it might need to be drained and the bleeding managed again.
  • Suture Dehiscence: When there’s too much tension on the sutures, the wound might pull apart, slowing down healing and possibly leading to noticeable scars or hair loss. To prevent this, we make sure the coronal incision is closed without tension.
  • Alopecia: Sometimes patients may notice some temporary hair loss near the surgery site. This is usually due to hormonal changes from the stress of surgery and typically resolves over time. We might suggest vitamin supplements to help with recovery.
  • Perforation of the Posterior Wall of the Frontal Sinus: Although rare, this complication can happen during bone reshaping and may cause cerebrospinal fluid leakage. It’s crucial to seal the perforation immediately to prevent serious issues like meningitis or empyema.
  • Sinus Dysfunction: Though uncommon, some patients may experience sinus problems, such as blocked frontonasal ducts. This can lead to sinus pressure, extra mucus, or even infection in severe cases. Treatments range from outpatient care to surgery to restore drainage or fix any bone defects.
  • Reabsorption of the Anterior Wall of the Frontal Sinus: This later complication, usually due to improper bone cuts or weak fixation, can cause both functional and aesthetic problems. Surgery is needed to fix the anatomy and restore proper function in the affected area.

Painful Bumps On Your HeadEndotines

Mild and asymmetrical pain may occur after forehead surgery. If it is localized, it is probably due to Endotines, which are small dissolving devices designed to mobilize the internal layers temporarily. They will begin to re-absorb 6 months after the surgery and could persist for 15 to 18 months. It is frequent to feel swelling and minor discomfort in the area, appearing as small lumps on the scalp. We placed them there, you don’t have anything to worry about.

Hairline Lowering Surgery Risks

While hairline lowering is infrequently performed, one of the main complications associated with it is poor scarring. Scars in the forehead area are particularly visible, and the quality of the scar can depend on factors such as the patient’s hair type, the tension applied during closure, and individual healing tendencies.

If scarring issues arise, they can be challenging to manage and may require further treatment.

Nose Job Complications

Botched Nose Job After FFS: Is My Rhinoplasty Botched?

Some people might consider Rhinoplasty one of the main pillars of Facial Feminization Surgery, one of the procedures that can bring your facial features into […]

Jaw And Chin Reduction Risks

As we explore the complexities of Jaw and Chin Feminization, designed to create a more harmonious facial structure and stereotypically feminine facial shape, it’s important to stay informed about possible complications that might arise.

  • Bleeding and/or Hematoma: Though rare, a hematoma can form in the floor of the mouth after a mentoplasty, and immediate action is crucial to prevent airway blockage. Treatment usually involves draining the hematoma and controlling the bleeding.
  • Infection: While uncommon, infections can occur in the short or mid-term after surgery, especially if they stem from dental issues due to the area’s proximity to the teeth. Treatment can range from medication to surgery, depending on the severity.
  • Fracture: Fractures can sometimes happen during or shortly after surgery, particularly in fragile areas of the jaw. Immediate realignment and fixation with surgical hardware are needed to restore function and avoid long-term issues.

Adam’s Apple Reduction Risks

Adam’s Apple Reduction is one of the most common steps for those seeking a stereotypically feminine look. And again, as with any surgery, it’s very important to understand the risks involved, including potential complications that may affect not just looks, but other aspects of your life.

  • Vocal Cord Damage: While rare, vocal cord damage can occur during thyroid cartilage reshaping, potentially leading to voice issues. Although direct injury to the vocal cords is unlikely, damage to the surrounding area can still cause significant problems.
  • Airway Impairment: Over-burring or injury to the cricothyroid membrane can expose the larynx, leading to complications during anesthesia or recovery. This requires careful surgical handling to avoid issues.

How Do I Know If My FFS Is Botched?

Recovering from Facial Gender Affirming Surgery isn’t just about time – it’s about giving your body the right conditions to heal as smoothly as possible. The tightness, numbness, and stiffness you feel now are temporary, but how you care for yourself during this period can shape your long-term results. By combining patience with proactive aftercare—gentle movements, advanced techniques like Hilotherapy, and staying connected with your post-op team—you’re actively supporting your journey toward a natural, comfortable outcome.

Want To Know If Your FFS Is Botched?

At Facialteam, we don’t just perform surgery; we invest in your healing, from innovative surgical planning to personalized recovery strategies designed to optimize your results. Learn how Facialteam ensures your recovery and take the next step toward a confident, seamless healing experience.

FFS Risk Stats at Facialteam: Open Data Hub

Let’s talk numbers. Since 2008, we’ve performed over 8,400 procedures on more than 2,500 patients. Complications, although possible, are rare, and the vast majority of patients are highly satisfied with their results. Here’s a look at some key data:

Reintervention Rates on FFS

Sometimes, small revisions are needed to fine-tune the results. Between 2018 and 2022, the need for revision surgeries remained low:

  • Jaw recontouring: 0.85%
  • Chin recontouring: 0.91%
  • Forehead reconstruction (coronal approach): 1.37%
  • Rhinoplasty: 4.66%
  • Lip lift: 5.04%

As you can see, even for complex surgeries like rhinoplasty, the chances of needing a revision are minimal.

Postoperative Satisfaction of FFS

We’re proud to say that most patients report high satisfaction a year after surgery. In a survey of 346 patients:

  • 65.9% felt “totally recovered” within one year.
  • 28% felt “partially recovered.”
  • Only 6.1% reported ongoing discomfort, and 0% felt no improvement.

When it comes to returning to work and social life, the stats are just as encouraging:

  • 93.3% were fully back to work after one year.
  • 94.7% had resumed their social life.

These numbers reflect the high quality of care and surgical expertise our patients receive. We don’t just aim for good outcomes—we strive for excellent ones.

What Does Facialteam Do When a Complication Happens?

First of all, we want our patients to feel safe and comfortable talking to us about any concerns. We know this can be a challenging and vulnerable time, but sharing any symptoms or issues is really important so we can offer the right support and answer your questions quickly.

During their visit, patients have plenty of moments to bring up any concerns, whether it’s with their coordinator, therapist, psychologist, nurses, or surgeons – whoever they feel most at ease with. Just a reminder that social media isn’t a suitable place for discussing any complications related to facial feminization surgery, as it doesn’t meet Data Protection and Privacy Policies.

Our patients can count on these communication channels while they’re in Marbella and continue to reach out to our postoperative department when they’re back home.

Preoperative Comprehensive Care 

When you decide to begin your facial gender-affirming journey, a comprehensive protocol kicks into gear. This first step involves reviewing your health status before your procedure.

During this phase, our medical team, the anesthesiology department, and your coordinator will request a series of specific reports to understand your preoperative situation.

Identifying any minor issues before your arrival helps us anticipate factors that could pose risks during surgery.

Additionally, our psychology department is available to assist with mental preparation if needed.

Intraoperative Health Protocol

The entire process surrounding your surgery is highly controlled and follows strict protocols to ensure continuous monitoring of your health throughout the procedure. Our team has developed pioneering surgical techniques that prioritize predictability and safety.

This means we have a dedicated care system in place for your immediate postoperative period, implementing methods that help reduce inflammation and enhance your recovery. You’ll benefit from a system designed to promote your gradual improvement and overall well-being.

As soon as your surgery is complete, you’ll automatically receive a series of planned treatments, including hilotherapy to alleviate pain and swelling after facial feminization surgery, cervicofacial lymphatic drainage massage, and medical acupuncture. During your stay at Hotel La Villa Marbella, our nursing team will check in on you daily. They will closely monitor your progress and carefully observe your incisions and other areas that were operated on.

This early-detection monitoring during your recovery is key to preventing complications in the first week after your procedure.

How is Facialteam’s Post-Op Like?

On the day of your final check-up, the postoperative coordinator will meet with you to go over your specific instructions and recommendations in detail. You’ll also discuss the most common questions related to your recovery from the procedures you underwent.

You’ll receive a post-operative guide via email, which opens a direct line of communication with both the postop coordinator and the lead surgeon from our comprehensive care department. They’ll be available to address any doubts, issues, or questions related to your surgery.

Every message or call is handled promptly. Some inquiries may require further consultation before we can provide a response, depending on the specifics of each case. We guarantee that you’ll receive a reply 100% of the time, as quickly as possible.

The scenarios can vary in complexity, for example:

  • A simple question that can be answered via email by the surgical team.
  • A relatively minor issue that requires you to send photos or reports for proper resolution. Once we have those, we’ll arrange a video consultation with a surgeon.
  • A situation that necessitates diagnostic tests or a personal evaluation in Marbella with a team surgeon or an external specialist in your country.

Our comprehensive care department is committed to providing as much support as possible, whether through instructions and recommendations, face-to-face or video consultations, or arranging any additional tests that may be needed. We also provide detailed reports on the procedures performed by our team.

Surveys of Satisfaction and Postoperative Result

We remain in periodic contact with the patient in order to know how the evolution of her recovery is going.

The postoperative department sends two quality assurance surveys in the first year.  The first is right after leaving Marbella and again one year after surgery. These surveys are analyzed and gleaned for constructive criticism which helps us offer the highest quality services possible.

Periodic Clinical Sessions

We conduct regular clinical sessions in which surgeons jointly assess any postoperative issues that have occurred.  In addition, clinical sessions that simulate potential problems help the team develop the best way to prevent and address complications in facial feminization surgery.

Preparing for your life after FFS is important, we encourage you to always report any incident to the postoperative coordinator so that she can inform the medical team as soon as possible.

At Facialteam we are here to listen and help you with any question, doubt or complaint you have, openly and honestly. You have professionals at every stage of your process, especially in the most difficult moments.

The Importance of Choosing the Right Clinic

While Gender Affirming Facial Surgery does come with some risks, we are here to make the process as safe and comfortable as possible. From careful planning before surgery to advanced techniques in the operating room and dedicated follow-up care, we’re all about keeping complications rare and manageable. 

Conclusion

As you embark on Your Revelation Journey, understanding the potential risks and complications is crucial for making informed decisions.

At Facialteam, we prioritize transparency and patient education, ensuring you feel supported every step of the way. Our experienced team is dedicated to providing you with the highest quality of care, from preoperative planning to postoperative follow-up. 

We take pride in our patient’s recovery after FFS, with many reporting high levels of satisfaction with our services. To visually convey this information, we’ve included graphics throughout this blog that illustrate our patients’ perspectives on their own recovery and their satisfaction with our post-operative service rates, helping you see the positive outcomes that others have experienced.

By fostering open communication and a comprehensive approach to your health and well-being, we aim to make your experience as smooth and rewarding as possible!

Need an FFS Redoing? Speak with one of our Expert FFS Surgeon

Would you like to know more about our FFS Redoing methods for your previously done facial feminization surgery?

We help you address the problems from previous operations that have been incorrectly implemented.

Our solution is to help you find the most comfortable and safest path to correcting those issues.

Authors

  • Author profile picture of Facialteam Social Media Specialist and Content Creator Victoria Vera

    Hi! I'm Victoria Vera, social media specialist and content creator at Facialteam. My journey took an exciting turn when I got the chance to be part of Facialteam – a life-changing experience! From the first minute, I've been warmly supported and encouraged by the team. I'm especially fulfilled to be able to contribute to the trans and LGBTQA+ community with our work. I look forward to meeting you soon! Let's stay connected on Facialteam's social media!

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  • Author profile picture of Lilia Koss, transgender activist and public relations manager at Facialteam, a surgical clinic specialized in Facial Feminization Surgery

    Hello world! I’m Lilia Koss and I use she, her, and they pronouns. What are yours? With a background in humanities and diverse professional experiences, I have been working with the Facialteam founders and directors since 2008. Involved from the ground up, so I’ve had hands in many pots: patient coordination, orientation events on 3 continents, social media, written and audiovisual content about our gender-affirming healthcare...but now life is more defined. Lately, I focus my energies on Public Relations, community management and live streaming to help raise the visibility of trans health. Life is pretty complete.

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