Facialteam trains Next-Gen FFS Surgeons

In any field or industry, when research or education are lacking, we can only expect subpar results at most. This is why we dedicate a week each year to training FFS surgeons

  • Our mission: model excellence in facial gender surgery
  • Our vision: increase access to quality FFS the world over

It’s about thinking deeper about every technique, every method and every result so you, the patient, can count on up-to-date FFS professionals.   

Also, it is about consolidating facial gender surgery as a respected niche that brings value to the fields of plastic, maxillofacial and reconstructive surgery. Positioning Facial Feminization Surgery as a reference in pioneering techniques gives weight to the need for equal-access trans healthcare. 

How FFS Surgeons are trained

What are the most important points to address with FFS surgeons?

Apart from technical aspects, in our immersive training program we like to highlight points that are important for your experience, for example:

  • What’s best for healing
  • How to ensure predictably safe results 
  • Keys to establishing realistic expectations

Educating the future generation of trans healthcare providers is crucial in this time of political polarization. So an underlying message of this professional development course is that trans people are people who deserve quality, respectful and inclusive healthcare. 

Visiting faculty, Professor Devin O’Brien-Coon of Harvard Medical School, put forth important questions to our six selected fellows this year:

“What is a hallmark of suboptimal FFS?” 


“Some claim that the jaw is less important in FFS. This misses the point. There are no absolutes as each case is different.”

FFS Techniques and Methodologies

Surgical techniques and methodologies are in constant evolution. The field of FFS is no exception. 

Dr. Luis Capitán shared a few key pearls at this year’s FFS Training Program on what experience has taught:  

“Never incorporate any part of the supraorbital frame in the frontal osteotomy.” 

“If necessary you can use titanium mesh to preserve the functionality of the sinus and to allow bone growth underneath.”  

“It’s critical how gentle you have to be when managing and raising the pericraneal layer.”

Dr. Daniel Simon also encouraged the trainees to consider different theories around jaw feminization. 

“There are myths about the difficulty of jaw surgery. With precise planning, correct instruments and 3D printed surgical guides, it is not.”  

What about suboptimal results such as skin sagging?  Dr. Simon mentions discussing every detail with patients in advance: age, weight, the bone volume to remove, supportive stitching and anchoring, as well as reparative therapies such as hilotherapy, compression therapy and HIFU (High Intensity focalized Ultrasound). 

“Everything you can do to prevent skin sagging, the better.”

FFS Training, setting New Standards for Surgery

It’s only in the last five years that formal training for FFS surgeons has started to take shape. 

After Facialteam’s first FFS Training program in 2018, some wondered why we were revealing the secrets to the “competition.” We don’t see it that way. We see a program that brings together young and experienced surgeons, creating the perfect environment to develop new practical know-how. 

Dr. Javier Gutiérrez explained the tracheal shave to this year’s fellows from both private and public sectors in the US, Canada, UK and Israel:  

“When you evaluate the Adam’s apple, it is primordial to pay attention to the angle of the neck, which may be more open or closed. The influence of this detail on the results must be discussed with patients in advance in order to adjust expectations.

One fellow gave feedback on the training for FFS surgeons: 

“We need well-rounded training that’s not just the latest theory on methods, but also live observations and applied technologies in a full-day cadlab. I’m inspired by the top professionals, both surgeons and device providers, here sharing their knowledge.  The opportunity to put 3D virtual planning and ultrasonic techniques to practice with cutting guides in cryogenically preserved specimens brings our learning full-circle.” 

The learning curve is already very steep, with new professionals needing years to polish expertise. So why hold the field back by keeping experience hidden in a safe?

FFS Instruments and Technology

A good surgeon has more than just good technique. They also depend on the right instruments and technology to push facial gender affirming surgery to the future. 

Mectron representative, Filippo Ballo, supported Facialteam’s FFS Training Program’s CadLab at IAVANTE, Granada’s premier scientific center for medical simulation and technological innovation in healthcare. 

Mectron is the developer and producer of Piezosurgery®, the ultrasonic instrumentology employed by Facialteam in their trademarked facial feminization surgery methods, such as FOREContour, REVONose, JAWContour and TContour

Called “Piezo” for short, Mectron and Facialteam have worked closely together for years to further specialize their high-speed bone cutting technology known for precision and avoiding soft-tissue trauma.

Mectron’s engineers praised the FFS training sessions:

“The presentations of the complex surgical steps left plenty of space for questions. During CadLab surgeries, the trainees could practice with Piezosurgery tools and 3D cutting guides using Mectron’s specifically-designed tips for Facialteam’s facial feminization procedures.”

“Being able to practice with our technological solutions inspires us to continue improving the medical applications in FFS surgery.”

Roll up banner during the 2022 edition of the Facialteam Facial Feminization Training Program.

Research and Education, the differentiating factor

What else do providers gain, apart from technique, when trained by leading experts in facial feminization?

The multidisciplinary team model is one of the stand-out factors to the best care for FFS patients. A commitment to excellence involves everything from the consultation to  bedside manner and intraoperative or postoperative protocols.  

The scientific initiatives such as those of Facialteam Research & Education help build the foundations to develop new methods.

Collaborations such as that with Mectron are key to innovation in facial gender surgery. FFS trainee surgeons are therefore introduced to the best materials, instruments and technology available today thanks to the contribution of many groups in the industry, such as:

Anton Hipp

Maxillofacial Surgery Fixation


Software for anatomically personalized models and surgical guides


CAD/CAM Maxillofacial Lab for 3D printed replicates and anatomically personalized cutting guides


International provider of technologies for healthcare


Clinical and surgical material

By involving experts in related fields, a good FFS Training Program provides the perfect sandbox in which to stimulate new research and developments in the sciences behind facial gender affirming surgery.  

The benefits will return three-fold: first, in higher quality results for patients. Second, in greater access to safe surgical alternatives. And finally, in solidifying FFS as a valuable surgical field, we also normalize trans people and their need for inclusive healthcare.

Training FFS Surgeons is important to us because your happiness and health matter.

Patient Relations Manager Lilia Koss, presentator of Lilia's Livestreams
About the author

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.