Frequently Asked Questions

In the menus below you will find the answers to the most frequently asked questions about facial feminization surgery.

Do you have a question we do not answer in our FAQ’s? Reach out to us, and we’ll get back to you as soon as possible.

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Facial Feminization Surgery

Our facial feminization surgeries include the following procedures;

Besides the above main procedures we offer complementary (aesthetic) procedures, to enhance the feminine appearance even more;

If you are not sure which are the correct procedures for you we recommend you book a free consultation with one of our surgeons. We personalize our quotes for each person, based on your wishes and the surgeon’s recommendation.

We appreciate that the cost is an important factor when considering surgery. For more information about Facialteam’s price ranges, along with the extensive post-operative care and support that we provide, we recommend reading our individual FFS procedure pages;

Most patients spend one to two nights in the hospital after their surgery. Depending on your surgery you will need to stay for another 8-10 days in the city of your surgery.

If you plan to stay in our designated accommodation hotel La Villa in Marbella, a nurse will periodically visit you to check up on you, help with wound care and assist with washing your hair.

Preparing for FFS Surgery

If you are currently taking HRT medication, it doesn’t need to be suspended before or after surgery, as we will administer an antithrombotic agent to counteract the clotting effects of hormones.

Please don’t eat or drink anything for 8 hours before your operation. This also includes water, tea, coffee, chewing gum, and sweets or candy.

If you have any health conditions, or medications that you take, please notify us of the details. They will of course be kept strictly confidential.

Please avoid laser hair removal or electrolysis for 3 weeks before surgery, and 6 weeks after surgery.

It’s fine to pluck your eyebrows in the days before surgery, provided your skin isn’t irritated in any way.

However, you should not pluck or wax your eyebrows for 6 weeks after surgery.

We strongly recommend not to smoke for 3 weeks before and after surgery, as it counteracts the wound healing process, and increases the risk of complications.

Tech
Bring your phone, phone charger, and plug travel adaptor if you require one.
Sun protection
Factor 50 sunscreen is highly recommended, as the last thing you want before or after surgery is sunburn. Bring a light hat, scarf, or umbrella to protect your head from the sun too.
Comfortable clothing
It’s recommended to bring clothes that are easy to put on.
Space in your suitcase
If you’re planning to do any shopping or bring back souvenirs, be sure to leave some empty space in your suitcase.
Makeup
One week after surgery you’re able to wear light makeup again, so consider which cosmetics you’ll actually need.
Sanitary supplies
Antibacterial wipes, hand gel, and face masks are always a good idea too.

After Facial Feminization Surgery

: From the day of the hospital discharge, you can take short and gentle walks that do not tire you. You can start running gently after 6 weeks and increase and increase the intensity gradually.

We recommend waiting 4 months before carrying out contact sports (like boxing), to avoid any risk.
: Botox works by temporary weakening of certain muscles as it blocks the synaptic connection between the motor nerve and the muscle. In any case, Botox affects sensitive nerves which are the nerves more likely to be partially affected during FFS procedures. In our experience, Botox treatment does not affect the nerve recovery nor increase the potential
nerve damage during feminization surgery.

You could start botox treatment immediately after returning home, however, as its effects may be “camouflaged” by the postoperative inflammation, we recommend waiting until inflammation has mostly disappeared.
: Laser, IPL or electrolysis treatment on the operated areas can be done without problems 6 weeks after you’ve had surgery.

In case of a lip lift, we recommend waiting 6 months.
: After surgery, back at the comfort of your own house you will little by little resume your daily routines. Remember that a healthy lifestyle and sufficient rest are crucial for your recovery.

A healthy diet that is rich in fruit, vegetables and proteins as well as enough liquid intake (herbal teas, water, juices…) are as important as getting sufficient sleep.

We advise you to follow below instructions and recommendations to speed up your recovery.
: Bruisings may persist up until 6 months after surgery. In case of dark marks on the skin, you can use a depigmenting cream as well as sunscreen.
: It is not common to experience hairloss after surgery. However, it can be a collateral effect of any surgery under general anaesthesia, especially with forehead surgery and hair transplants.
: After your surgery you can use your usual face wash, creams and lotions as well as make-up. However, avoid applying any of these on the scar itself until you feel that it has completely closed.

Forehead Feminization Surgery

: No, you cannot dye your hair during the 14 days prior to the surgery, since the dye can irritate the skin and facilitate the spread of germs.

You should also not use hair masks, lotions, powders, etc. during the 24 hours before your surgery. These products can interfere with the solution used to prepare your skin before the operation.
: Generally, your forehead is swollen for some after forehead surgery. The brows will settle down as you heal from the surgery.

For this reason, you should wait about 6 weeks to 2 months before having your eyebrows shaped, because pulling the soft tissue in the area can interrupt the healing process and the tissue adaptation to the bone.
: We do not recommend dying your hair until 6 weeks after surgery, after which time the scar is completely closed and there is no danger of the dye entering and irritating the incision area.
: You can wash your hair 24 hours after surgery, cleaning the coronal incision daily with tepid water and Betadine shampoo.

Gently massage towards your incisions, never away from them. Keep the area clean and dry. Use a hairdryer on the cool setting to eliminate moisture around the wound.

It is fine to use hair conditioners as long as they do not contain components that irritate the scalp.
: After any surgery it is common to experience facial stiffness. Tightness and a lack of sensitivity in the areas of the intervention are typical. Time is the main factor for healing tissues that have been significantly moved during surgery: weeks, months, even years after you will continue to notice gradual improvements.

Due to the operation, things will be different, but you may expect to recover to “normal” parameters within 1-2 years after facial feminization.
: It is completely normal to have discomfort after a forehead surgery during the first months after the surgery. It is also normal that this discomfort is uneven, sometimes more on one side than the other.

If pain is localized it can be because of the Endotines, which are small and resorbable devices to keep the skin flap in place after surgery. They will begin to reabsorb after 6 months from the surgery and could last until 15 to 18 months. It is completely normal to feel some
swelling and small discomfort above these devices, which can be felt as small lumps on the scalp. You do not have anything to worry about.

In the very rare case that the discomfort persists or has worsened after 15 months, we can activate the dissolution protocol with lidocaine infiltrations.

Jaw and Chin Feminization Surgery

: Numbness is a completely normal phenomenon after operating the chin or jaw. Your mental nerves are “stretched” during the procedure and your gum, with all the small nerve branches, is incised during the approach. Sensitivity symptoms (paresthesia, numbness, even pain) may appear during the first 3-4 months, these symptoms will disappear gradually.

The main trunks exposed during the lower jaw and chin recontouring are the mentalis nerves. It is essential to understand that these nerves are sensitive nerves and not functional nerves, so they are not responsible for any facial movement but for the sensibility and sensation in certain areas of the lower lip and teeth. Their location is accurately detected in the facial scanner performed before every surgery.

We use a special triple approach to avoid damaging the nerves and to keep them surrounded by mucosa during the whole surgery. We also perform our osteotomies with piezosurgery, with ultrasonic vibration that only cuts bone, respecting the soft tissues.

However, the exposure and stretching of the mentalis nerves during the surgery may produce different degrees of temporary numbness or feeling alterations. This is extremely variable from patient to patient, so it is difficult to predict how your reaction is going to be after the surgery.
: Clean the incisions with the soft toothbrush that you received along with your medication, you can use your regular toothpaste. Some bleeding of the incisions is normal.

After brushing your teeth with your regular toothpaste, for the first 2 to 3 weeks after surgery,
use an antiseptic mouthwash 3 times a day (Perio-Aid, chlorhexidine diluted in water, or saline solution: 250ml warm water with a spoonful of salt). Do not use it after this period as chlorhexidine may stain teeth when using long-term.

In case you notice any staining of your teeth, suspend the Perio-Aid and get a mouthwash without chlorhexidine or simply use water with salt.

We insist that you do not smoke during the healing process.

For jaw and chin surgeries; continue wearing the chinstrap when you are at home and during the night for 3 more weeks.
: The facial nerve, with the marginalis ramus which helps to move the corner of your mouth and lower lip, is situated “far away” from the operated region, although the inflammation can hinder its normal functioning.

It is a temporary matter which will improve once the swelling disappears.
: During the procedures the masticatory muscles (that help to open and close your mouth) are undermined, detached or even cut, so they are now at the beginning of their healing process.

It is common to feel a blocking sensation during some weeks because of the swelling in the articulations.

If you still suffer this lock within two months, please, let us know and we will evaluate. Try to
gently massage the area in order to relax the muscles.

Hairline Feminization Surgery

After Hairline Feminization Surgery

Hair coloring with dye
Avoid the transplant site until 3 months after surgery.

Hair coloring with capillary fibres
These should not be used until 6-8 weeks after your surgery.

Swimming in natural waters
We recommend waiting 1 month before diving in with your head in the sea or other natural water.

Swimming in a pool
Wait 3 months before diving in with your head in a pool, due to the chlorine.

During the first 6 weeks, you should cover the transplanted area and prevent it from direct sun exposure.

In the first 6 months, you should avoid any sunburns on your scalp.

For eyebrow touch-ups, you should wait a minimum of 6 weeks after the forehead surgery. For a new design we advise to wait at least 6 months to give the tissues time to adapt to their new shape.

It is extremely important to not touch the transplant area during the first 7 days after your hair transplant.

It takes some patience for the new hair to grow in fully after the hair transplant. Below indication is applicable to scalps that have not been operated on previously.

1st Month
The follicular units will fall out and take root. They are in a resting phase.
3 Months
The follicular units begin to grow, around 20-30% growth. Hair growth may not be symmetrical.
6 Months
General growth in quantity and quality of the new hair, 40-60% growth.
9 Months
60-80% growth; there may be more growth in some cases.
12 Months
Usually, the new hair has grown in, although it may improve in terms of quality in the following months.

We recommend these instructions for our patients, if you’re in doubt, please contact your treating doctor.

Day 1
Use Saline Solution during the first 7 days, every 30 minutes, on the recipient site, wetting the area well to keep it moist. At night, do it only when you wake up anyhow. To apply the Saline Solution, spray it with a dispenser from a slight distance, without directly touching the recipient site. Doing otherwise could create a scab that will prevent the hair from growing. If you run out, you can refill the dispenser with Saline Solution or consult your coordinator if you prefer.
Days 2 to 7
Continue keeping the grafts moist with Saline Solution, every 30 minutes. Besides, from day 2, apply Betadine Shampoo directly to the recipient site using the dispenser. Apply it gently, without massaging or touching the recipient site. When rinsing the area, the water pressure should be very low or you can use a small cup of warm water. Follow these instructions once per day:
- Spray Betadine Shampoo on the hair transplant area;
- Leave it for a minute and then rinse it out;
- Repeat this process 3 times.
  Note: You should also wash the incision area with Betadine Shampoo.
- Apply rosehip oil directly over the recipient site every night before going to bed.
Days 6 – 7 after the transplant
Our nursing staff will wash your hair.
Days 7 to 8 after the transplant
Continue applying Betadine Shampoo to the transplant site (even though there were no scabs), begin to gently massage the scalp with your fingertips in a circular motion, using normal water pressure to rinse. If you wish, you can also use a gentle shampoo like Triconails Shampoo by Cosmeclinik after using the Betadine Shampoo. Continue to wash your hair 1 or 2 times a day. On the day of the final revision, the postoperative coordinator will give you further instructions.
Days 8–14 after the transplant
Continue applying Betadine Shampoo to the transplant site (even though there were no scabs), beginning to gently massage the scalp with your fingertips in a circular motion, using low to normal water pressure to rinse. If you wish, you can also use a gentle shampoo like Triconails Shampoo by Cosmeclinik after using the Betadine Shampoo. Continue to wash your hair 1 or 2 times a day. If you do not have any more scabs, one time per day is enough.
Day 15 after the transplant
If you have followed the postoperative instructions correctly, you should not have any scabs. You can use the Cosmeclinik, a baby shampoo or a normal mild shampoo to wash your hair. Be gentle when touching and avoid any hit on the area. In case of crusts, you can apply a little amount of olive oil to the area one hour before washing your hair to soften the site.
1 Month after the transplant
We recommend using a mild shampoo as long as possible unless you feel that it does not work for you. In this case you can start using your usual shampoo. Make sure that it is not aggressive or strong. Also, you can now wash your hair normally. If you have a dermatitis outbreak, please let us know and we will give you specific instructions.

Sometimes a temporary hair loss around the scar or even different areas on your head may arise during the postoperative period (from the beginning up to 4 months after surgery). Although this does not commonly happen, it can be a collateral, temporary effect of an operation, usually caused by trauma (meaning physical, chemical or both).

The hair should start recovering after 4-6 months after the surgery without any kind of treatment. Minoxidil Foam can be used to help the hair grow faster, but always make sure that the incision is closed and completely healed.

A total or partial lack of feeling (numbness) or the ability to move the eyebrows is normal and will gradually improve with time, usually between 3-6 months. In some cases, this may take up to one year.

There is no therapy that decreases this time, although mobilizing the area routinely can help restore mobility.

The itching of the skin and scalp is a consequence of the inflammatory process; after stretching, the tissues must recover their position and one of the consequences is itching and dryness. If this is accompanied by desquamation/dehydration, there are special pharmaceutical products to hydrate.

If you feel that your scalp is very dry, seborrheic dermatitis may have occurred after surgery. You can use T-Gel Shampoo from Neutrogena twice a week for a month to improve it.

These are signs of scalp reinnervation after a forehead surgery. It is called paresthesia/dysesthesia and can cause hyperalgesia/dysthermia, etc. Surely, you notice it
more in an inflamed area such as the area where the Endotines are located.

In short, the readaptation of the tissues requires plenty of time. When we speak of healing, it is not just the incision scar that is healing. All of the internal layers that have been treated and the surrounding tissue that has been detached and altered during surgery undergoes a cicatricial process of self-repair.

Symptoms such as lack of elasticity, contraction, and stiffness after FFS surgery, etc. are actually part of wound healing, which may take 2 years approximately to run its course.

Minoxidil
Minoxidil applied in non-transplanted areas, works like finasteride/dutasteride (although it is less potent than these), that is, preventing the progression of alopecia. However, applied in the transplant area after 6 weeks, it has been shown to accelerate the growth of the grafts.

Finasteride & Dutasteride
Based on your specific case (type of alopecia, medication taken etc.), the specialist may have decided to prescribe finasteride or dutasteride to prevent progression of alopecia, avoiding the need for a second transplant in the short term.

These medications can help to prevent progressions of alopecia to avoid a second transplant in the short term.

Nose Feminization Surgery

It is important to follow these instructions:

Take the medication prescribed by the doctor after meals.
Do not smoke, which increases the risk of infection and impedes healing.
Sleep with your head elevated (using 2-3 pillows) for the first week.
Avoid direct sunlight and saunas for 6-8 weeks after the surgery. The sun and extreme heat increase edemas (swelling), slowing the healing process. Use sunscreen, even on cloudy days, for at least one year.
Avoid crowds and sports where there is any risk of your face being hit for at least 6 weeks.
Avoid wetting the nose bandage (patch) during the first week. You should always wash your hair with your head tilted back to avoid direct contact between your nose and the water.
You can wash your face carefully. You should apply Thrombocid Forte 2-3 times a day to any bruised or inflamed areas until they recover. You can apply makeup one week after the surgery.
Apply Vaseline (petroleum jelly) in the area with the stitches.
Clean inside the nostrils with a sterile saline solution spray

For at least the first two weeks after nose feminization surgery, you should wear contact lenses, because the frames may be uncomfortable and leave marks that delay the final result while your nose is still swollen.

You can apply your usual makeup without any problems.

The healing process after a nose feminization surgery varies from person to person, depending on the skin type and the specific procedure performed.

In general, maximum swelling occurs within 24-48 hours after surgery, after which it gradually subsides.

Between the first and second week you will notice a significant reduction in the inflammation and 2 months after surgery, between 80-85% of the swelling will be gone, at which point you can make a preliminary assessment of the final result.

Swelling normally completely disappears around 6 months after nose surgery, although it can take up to one year.

Clean your nostrils with saline solution whenever you need. Nasal irrigation with saline solution will help to keep your nasal passages clean and moist, while also reducing nasal congestion.

You can use a syringe or squeeze bottle to squirt the solution up your nostrils. If the water runs into the back of your throat, then simply spit it out. It is fine to accidentally swallow the solution as it is harmless.

The scabs can be softened by applying a cotton swab soaked in hydrogen peroxide or warm water.

1 week after the suture removal.
Start using Rosa Mosqueta / Rosehip oil 1 week after the suture removal, apply the oil in the mornings and evenings with a gentle massage. Keep using the oil for up to 3-12 months.
2 weeks after the suture removal.
Start using Dermatix or similar Scar Gel 2 weeks after the suture removal, alternate the use of rosehip oil and scar gel.

Apply the scar gel in the mornings and rosehip oil in the evenings. Keep using the scar gel for up to 3-12 months.

Self-absorbing stitches will dissolve between 4-10 weeks after your surgery.

It is pretty normal to have swelling in the nose for a long time.

This is the last procedure to heal and needs several months to reach the results wanted. Patience is the key.

During the first weeks after a rhinoplasty you may experience a bad smell in your nose. This is nothing to worry about. It is possible some self-absorbing suture has started to reabsorb or there is scab/crust that has not fallen.

Irrigations with saline solution in both nostrils as explained above, even several times a day will reduce this issue.

However, if you notice a purulent discharge or very green/dark mucus, it is necessary to consult with the medical team.

The first few months are the most difficult due to the swelling which decreases in an asymmetric way.

You may experience swelling or a change of shape in your nostrils as well as the sides and bridge of your nose following your procedure.

It is a matter of time and patience, you are just beginning your healing process.

Tracheal Shave

: It takes time for the swelling and/or tension in the area to stabilize. The swelling is typical during the first 2 or 3 months after surgery, not only in the incision, but also in the tunnel to access the Adam’s Apple.

The results take time to show.
: Self-absorbing stitches will dissolve between 4-10 weeks after your surgery.
: Avoid sun exposure and apply a high factor sunscreen on the incision area during the first year after surgery.
: The scar of the trachea will be turning red at one point of the recovery. This is completely normal, since it is an immature scar. It will lose color from months 12-15 approximately.

It is very important to protect the incision from the sun to avoid long-term pigmentation problems.

About Facialteam

Facialteam offers free Facial Feminization Surgery consultations, both in person, or virtually online over Skype. During which, you’ll speak to an FFS specialist to discuss your objectives
and needs, and which procedures are right for you.

During our in-person consultations in Marbella or Barcelona, we also offer virtual simulations to help envision potential outcomes of your surgery.

It’s also a great opportunity to meet the team and visit the beautiful environment.

Book your free consultation here

Facialteam performs surgeries at HC Marbella International Hospital, located at:

Ventura del Mar, nº 11, 29660 Marbella, Málaga, Spain. This modern hospital features beautiful gardens, offering a tranquil environment for recovery.

Get to know our clinic

We recently also started to offer the option of FFS in Barcelona. Both consultations and surgeries in Barcelona are held at the prestigious IM Clinic, located at:

Carrer de Victor Hugo, 24, 08174 Sant Cugat del Vallès, Barcelona, Spain.

Learn more about Facialteam Barcelona

In addition to in-person and virtual consultations, we also host free international FFS orientation sessions throughout the year. Here we help educate about the entire facial feminization surgery process.

These events also include the opportunity to meet one of our
FFS specialist surgeons, discuss logistics with a patient coordinator, join or dedicated peer support group to connect with the community, and a high-definition clinical quality photo shoot for your records.

Due to the current world situation, we have adapted our international orientations to an online format, some of above-mentioned services may not be included during our virtual visits.