How to prepare for your facial gender surgery consultation

You have done loads of research and now it is time for some facial gender surgery consultations with your top choices in surgical centers.  It has not been easy filtering through the myriad of websites, forums, support groups, social media and marketing to get to this point in your facial feminizaton journey. Here are some tips on how to be prepared for these crucial medical interviews, so you don’t draw a blank on the day nor miss out clarifying any fundamental details about this very important life decision.

Step 1: Brainstorm a list of questions for the consultation with the facial gender surgeon

Here are some general questions you may ask the facial gender surgeon in consultation, or via other methods of communication, based on a list by the American Society of Plastic Surgeons to help get you started.

• Which competent medical boards in the world certify you as a surgeon?
• Were you trained specifically in the field of plastic, maxillofacial or craniofacial surgery?
• How many years of facial surgery training have you had?
• Are you an active member and participant on any committees of the World Professional Association for Transgender Health?
• What training have you received or do you provide to learning surgeons in facial feminization surgery techniques?
• Do you have access to hospital privileges in facial feminisation?
• Is your surgical facility accredited by an internationally recognised certification agency, such as the ISO in Europe?
• Do you consider me a strong candidate to benefit from FFS Surgery?
• What surgical techniques would be highly recommended for me?
• What would I be required to do in order to obtain the best results?
• How is the plan of procedures contemplated and later established?
• In recovery, what plans should I make and how do you assist in this phase?
• What is your aftercare support system?
• What are the risks and complications associated with my procedure?
• How are complications handled and is there any insurance to cover its occurrence?
• What is the protocol in the event of my dissatisfaction or if the outcome varies greatly from the prediction of results?
• Do you have example images that will help me have realistic expectations about what potential results may be reasonable for me?

Also, don’t be afraid to ask for other important data even before the facial gender surgery consultation :

• The number of facial feminising patients they have operated on
• The number of specific procedures performed and length of their career
• If they have both patient and professional references as a gender-affirming specialist
• What is their revision rate in facial feminisation patients
• What IS INCLUDED and what is NOT included in the services?
• Are they involved in the TNBI community, provide patient education services or have any social responsibility projects?
• Are they active in the scientific and academic area of their field, with frequent international collaborations alongside their peers in the field?

Step 2: Be prepared to talk about yourself and the expectations of your surgical facial gender transition

The patient coordinator may ask for more information from you in advance, such as photos, what facial feature you are most interested in modifying or if you have any skull CT scans or virtual simulations already since the doctor will want to be as prepared as possible for your meeting.  Depending on the type of facial gender surgery consultation, you may expect to have to collaborate with, for example:

• Information regarding your general health status, if there are existing health conditions or risk factors
• An assessment of your facial bone structure as well as an evaluation of the skin quality
• Photographs, 3D images and measurements
• CT scans of the skull
• An open discussion of your objectives and their relation to then realistic possibilities.
• A two-way conversation about the initial recommendations of procedures, both essential and what might be considered “optional”.

Step 3: Learn from others experienced in facial gender surgery consultations

There are a few resources on this topic by surgeons and patients alike.  Seek updated information since the field of facial feminization surgery and patient care is evolving quickly as providers increase, grow and improve.

Here are a few links to discussions on the topic of consultations:

First, the blogger Franches of Hola Soy Yo has some very interesting viewpoints about her own facial gender surgery journey.

First FFS consultation on Friday – less obvious questions to ask from asktransgender

There are valuable conversations on this topic happening in online forums, although it is difficult to weed through all the information, so let me suggest a couple links that you may find useful:

Susan’s Place is a US-based site that has been running for decades on all topics related to gender transition. Support the page with a donation please, if you can.  Alexandra Hamer, facial gender analyst with extensive first-hand experience in thousands of facial feminising orientations in dozens of countries, has a great list of the most common questions that would be useful to read before your facial gender consultation.  On Facebook, the two largest groups in English are FACIAL FEMINIZATION SURGERY / TRANSGENDER and FFS FACIAL AND BODY FEMINIZATION SURGERY / TS TG–the key is to use the search box in the left-hand column so you can easily locate the discussions you need by entering the word “consultation questions,” for example.

After the facial gender consultation, now what to do (and to avoid)?

Advice When Choosing a Surgeon

Now it’s time to process all the information you have discussed in the facial gender surgery consultations.  Then, you will have more questions, so it’s advisable to send these enquiries to the centers you are considering. Be sure to clarify everything and leave time for this as it is a process that is not to be rushed into or made solely based on word-of-mouth information.

In short, it’s important to raise ALL the doubts which arise in your mind before moving forward with this important life decision.  Have some suggestions? Please let us know!

About the Author 

Lilia (pronouns she, her) has been with Facialteam since before the beginning. With over a decade of experience working in a clinical practice serving patients AMAB who are seeking a surgical gender transition, her work has involved orientation events for trans women, networking with the LGBTIQ+ community as well as with other professionals in the sector. She created the Facialteam peer group for people seeking facial feminisation over 7 years ago and continues to be the group moderator of its vibrant community of more than 3000 members.