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What is FFS surgery?

May 19, 2020
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The Basics of FFS Surgery, aka Facial Feminization Surgery

What is facial feminization surgery?

As society’s attitudes towards transgender people slowly shift, topics such as FFS Surgery are becoming more openly discussed. At the same time, the medical community is beginning to agree on the importance of making facial features more feminine for trans women’s wellbeing.

But for many people, the concept of FFS surgery remains a mystery. That’s why here at FACIALTEAM we wanted to put together this simple guide to the basics of facial feminization surgery.

In this post, we’ll briefly define FFS surgery and discuss what it is. We’ll look at what types of procedures it includes and what patients can expect if they decide to proceed.

“FFS” or “FFS surgery,” as it’s commonly referred to on the internet (albeit incorrectly), are acronyms for Facial Feminisation Surgery. Not to be confused with the initials of an expletive used on social media ;).

Let’s start with a mini video explanation about what to look for in an optimal FFS surgery process:

What is Facial Feminization Surgery? Who gets facial feminization surgery? 

First, let’s define facial feminization surgery. This is an umbrella term for a group of maxillofacial and plastic surgery techniques. It can also be referred to as Facial Gender Confirmation Surgery (FGCS) and Facial Harmonization Surgery or simply facial gender surgery.

It’s exactly as it sounds. Any surgical procedure designed to alter the facial appearance, usually to reduce any excessively prominent features or to become more ‘feminine’. This topic is most frequent in the context of women assigned-male-at-birth, sometimes referred to as “MtF.”

However, face feminization surgery is actually sought after by people of any and all genders. It goes beyond the traditional binary roles of “male or female”: trans-feminine, gender-queer, gender fluid, two-spirit and more.

Anyone who wishes to balance and harmonize their facial features could be a candidate for this type of surgery.

In the specific case of male to female patients undergoing a medical gender transition, it’s far from a cosmetic whim. On the contrary, FFS surgery can truly be a life-saving service.

Hundreds of testimonials prove that gender-affirming surgery opens the door to improved self-perception and greater community integration. It helps people to avoid the consequences of social isolation, suicide, hate violence and crippling discrimination.

what is ffsFACIALTEAM, World Leader in Facial Feminization Surgery


Define FFS Surgery: What procedures are included in facial feminization?

So, exactly what is FFS Surgery? What kind of operation does it entail?

The combination of surgical techniques employed in a personalized FFS Surgery plan is highly individualized. It all depends on the patient’s goals, facial features, underlying bone structure, and overall health.

There is no one size fits all set of procedures used in facial feminization. The types and combinations of techniques are more aggressive or subtle depending on anatomical limitations and each patient’s individual goals. For example, consider a patient with an underbite or overbite that’s a candidate for an orthognathic correction of the jaw. They should be presented with a plan that addresses both issues, the anomaly of the skull and feminization.

This is a topic for another blog post. Every face has a unique combination and each person also has different objectives and, more importantly, a different perspective.

Some patients are already high on the extremely subjective conceptual scales of femininity or attractiveness. This can include many patients under the age of 24. They tend to require more subtle touches to the bone. It might involve the use of Facial LipoFeminization (FLF) to make the face more delicate, as they require more subtle results.

On the other hand, patients with several prominent masculine features will require multiple bone procedures, or more aggressive ones so the resulting differences are considerable.

Some of the most common approaches to facial gender surgery include:


– Brow & Orbital reduction surgery

– Jaw reduction and/or reshaping

– Chin surgery, reconstruction and contouring

Facial cosmetic surgery of soft tissue structures

– Lip lift or lip surgery

– Blepharoplasty (eyelid surgery)

– Neck liposuction

Other procedures that are helpful for feminizing the face

– Hairline feminization via hair transplants or lowering

– Rhinoplasty (nose job)

– Adam’s apple reduction (tracheaL shave)

As mentioned, in facial feminization surgery, specific procedures are recommended to varying degrees. Procedures are selected based on each patient’s unique case. The goal is to soften certain strong features that can make a face appear more masculine.

The objective is a naturally more feminine appearance without an obviously “operated” look and, more importantly, without visible scars. Any professional who promises “scarless” surgery is misleading since an incision is always necessary.

What is involved in getting FFS surgery?

The very first step in any facial feminization process is an in-depth, personalized evaluation with a FFS Surgery specialist. It’s advisable to meet with multiple facial feminization providers for an initial consultation. That means you can make a more informed decision about who’s the right expert for you.

There are many plastic surgeons who offer FFS Surgery. However, it’s best to concentrate on those with a proven track record in transgender health and surgery.

This consultation should include a conversation about what your desires and expectations are. It should consider the type of results you want from your facial gender-affirming procedures. It’s the specialist’s responsibility to help adjust those expectations into realistic parameters. These should take into account your existing facial features and personal objectives as well as your safety.

It’s always good to ask about several things, including the degree of correction they might achieve with each procedure. You should also ask about typical complications that exist. Lastly, enquire about the number of times they have performed this specific procedure so you know if they are experienced.

The cost of the FFS surgical plan proposed by each specialist should be presented in a formal written quote. Each patient’s face is unique, so each quote should be unique too. It would be overly simplified to have a predefined price list for each procedure. The surrounding care and coordination provided always need to be considered.

For example, there are many different factors that can affect the cost of forehead feminization surgery. This includes the type of forehead osteotomy, if it’s corrective surgery and the location of the incision. It will consider whether and how the eye orbits or the hairline will also be made to look more feminine. Another element is if hair transplants will be harvested, amongst other details.

All of these aspects need to be assessed on a case by case basis. As suggested above, comparisons should also take into account the numerous logistical aspects that, together, represent global patient care:

• Hospital ICU availability
• Necessary medication packs
• Provisions of self-care kits with special shampoos, sprays, creams, etc.
• Emergency insurance coverage duration
• Provisions for companions in the hospital
• Accommodation or transport included (or not)
• Inclusion of healing aftercare treatments like hilotherapy (facial cooling mask), acupuncture, lymphatic drainage, nurse “home” visits, or psychological support.

It is often the small details which make for a low-stress FFS Surgery experience.

The current trend in aesthetic surgery, after well-known cases of going too far, is that “less is more”. But this requires creative changes in approaches to reduce trauma to tissues while obtaining highly predictable target results, which may be as aggressive or subtle as required.

The key to optimal FFS Surgery is balance and harmony. Surgical outcomes at FACIALTEAM aim to reveal the feminine face that’s already yours, which changed during puberty. The experience would be incomplete without a comprehensive approach to patient care before, during, and long after surgery.

#beyondgender #beyourself