Blog | Latest Publications FFS Surgery
what is ffs

What is FFS surgery?

March 8, 2021
Reading Time: 5 minutes

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 more openly discussed. At the same time, the medical community is beginning to agree on the impact of having facial features more in line with gender identity on the wellbeing of trans women.

However, 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 really is. We’ll look at the types of procedure it involves 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 Feminization Surgery, among other newer synonymous terms. 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:

Who gets facial feminization surgery? 

First, let’s define facial feminization surgery. This is an umbrella term for a specific combination of maxillofacial and plastic surgery techniques, developed to soften overly masculine faces.

It can also be referred to as Facial Gender Confirmation Surgery (FGCS), Facial Harmonization Surgery, facial gender affirming surgery or simply facial gender surgery (FGS).

These may all include any surgical procedure designed to alter the appearance of the face. The objective is typically to balance any excessively prominent or underdeveloped features in order to make the face appear more feminine. Read more in our blog about the goals of Forehead feminization surgery.

It’s something that’s most commonly sought by women assigned male at birth (AMAB), formerly referred to as “MtF” or “male-to-female” people in gender transition. However, face feminization surgery is by no means limited to this group.

Facial gender surgery is applicable to people of any and all genders who have a desire to modify facial features. It goes beyond the traditional binary roles of “male or female” and is increasingly sought out by cisgender, trans femme, gender-queer, gender fluid, and people of other gender identities.

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

In the specific case of AMAB patients undergoing a medical gender transition, it’s far from a cosmetic whim. On the contrary, FFS surgery is life-saving for many. Actually, the quality of life has been measured in our scientific study published in 2020.

Also, hundreds of testimonials prove that gender affirming surgery opens the door to improved self-perception, confidence and, consequently, better community integration. It helps people at risk of social isolation, suicide, hate violence and crippling discrimination.

what is ffsFacialteam, World Leader in Facial Feminization Surgery


What procedures are included in facial feminization?

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

First, the number, type and extent of surgical techniques employed in a personalized FFS Surgery plan is highly individualized. The surgical plan and specific details of each technique will vary from person to person. It also depends on the patient’s goals, facial features, underlying bone structure and overall health.

We cannot emphasize enough that there’s no one-size-fits-all cookie-cutter set of procedures in facial feminization. The type, variations and mix of techniques are adapted to be aggressive or subtle depending on anatomical balance, limitations in safety 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 of these issues, the anomaly of the skull as well as feminization, taking into account the dental situation as well as the soft tissues, depending on the age of the person.

Facialteam recognizes that every face has a unique factions, each person has different objectives and, more importantly, we all have different views on femininity and beauty.
Some patients are already high on the extremely subjective conceptual scales of femininity or attractiveness.

On one hand, many patients under the age of 24 tend to only require subtle changes to the bones. These cases may involve the use of Facial LipoFeminization (FLF) for gentle enhancements of facial fatty volumes.

On the other hand, patients with several prominent masculine features will require multiple bone procedures. They might require more aggressive surgery, meaning the differences are considerable.

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

Maxillofacial surgery: procedures to reshape bony structures of the face

– Brow and 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 through hair transplants or lowering
– Rhinoplasty (nose job)
– Adam’s apple reduction (tracheal shave)

As mentioned, in facial feminization surgery, specific procedures are selected and recommended based on each patient’s unique case. The goal is to soften, in particular, 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 totally “scarless” surgery is misleading since an incision is always necessary. See more about avoiding visible scars in our three-pillar philosophy in FFS Surgery.

What’s involved in getting FFS surgery?

The very first step in any facial feminization process are in-depth, personalized evaluations with different FFS Surgery specialists.

1.FFS consultations

It’s a good idea to meet with multiple facial feminization providers and take your time with the decision making process. That means you can make a more informed choice about where you will undergo your surgery.

A former patient, Franches, speaks about her own process in becoming as informed as possible before moving forward with any surgery bookings.

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 might be involved. Here are more tips to prepare for your FFS consultations.

2.FFS Surgeons

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. The 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 your existing facial features and personal objectives into account as well as your safety.

Lastly, make sure you 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.

3.The FFS Surgery Plan

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.

All of these aspects need to be assessed on a case by case basis.

Other elements to consider when choosing your FFS provider

As suggested above, your comparisons should also take into account the numerous logistical aspects that are part of overall 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’s often the small, seemingly insignificant details that ensure you have a low-stress FFS Surgery experience.

The current trend in aesthetic surgery, after well-known cases of going too far, is “less is more”. This requires creative changes in approaches to reduce trauma to tissues. All that while still obtaining highly predictable target results, 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, but was changed during puberty. The experience would be incomplete without a comprehensive approach to patient care before, during, and long after surgery.

#beyondgender #beyourself