Redoing Facial Feminization Surgery

Line illustration of a former facial feminization surgery patient of Facialteam

Undergoing surgery is a difficult decision. Cases of re-operation are common in FFS due to circumstances out of your control. They include:

  • lack of skill;
  • lack of professionalism;
  • poor aftercare.

No matter the surgeon, there will be a small portion of patients that will need to redo their FFS procedures. You can reduce the chances of reoperation when you are informed and understand aftercare expectations. 

We prevent the need for re-operation with comprehensive care for you before, during and after your procedures. Preventing a botched facial feminization is about information and clear guidance during the recovery process. We care about your results and our years of experience have shown that comprehensive care is the solution.

What does redoing FFS mean?

A redo of FFS is the need to perform additional operations to correct or improve the results of a previous operation. We help you address the problems from previous operations that have been incorrectly implemented. Our solution is to help you find the most comfortable and safest path to correcting those issues.  

Our team is proud of our low revision rate of 3%. Our meticulous planning and patient satisfaction demonstrate our surgeons’ capabilities. After a detailed assessment process with your input, we plan each step of your surgery so that your results are predictable, safe and precise.

Planning and experience significantly increase the likelihood of success in FFS. 

Facialteam has over a decade of experience and pages of positive results from previous patients. Before risking a facial feminization surgery gone wrong, come meet us in Marbella for a consultation. You will see why so many patients have trusted us on their gender confirmation journey.

When do FFS surgeries need correction?

Various factors influence the need for reoperation after FFS. In our thirteen years of experience we have identified the most common reasons people redo their procedures.

The following reasons are the most problematic:

  • errors in prevention resulting from poor planning;
  • improper treatment of complications;
  • unrealistic expectations;
  • impatience when waiting for final results;
  • incomplete assessment;
  • lack of proper technique.

Below we explain how each point can affect your definitive results of FFS. Some of the points mentioned happen together. In those cases, we explain how they depend on and affect each other. 

Errors in prevention or treatment of known complications

As is the case with all surgery, complications may arise. You need to be fully aware of  the risks associated with facial feminization surgery. To help you make informed decisions we provide you with consent documents which describe the most common risks. 

When choosing a FFS surgeon you should always ask your potential surgeons about their prevention and action protocols when a problem arises. In the event of a common complication or specific risk, it will help you understand how prepared they are to serve you and keep you safe. 

Your care and results are our top priority. So, we are happy to provide information about the risks related to FFS operations. In the event of complications, you want to know your provider has a contingency plan to keep you safe. 

Unrealistic Expectations of FFS

Anyone considering FFS needs to know that there are limitations. Understanding what can realistically be achieved without compromising your health increases your chances of satisfaction. In order to help you see what are reasonable results, we explain procedures in detail and outline what is viable, and what’s not, in your specific case.

In our years of experience, people who are dissatisfied with their results were not properly informed of attainable outcomes. If you are unaware of the limits to your potential results, it can lead to misunderstandings about what will be done. 

Impatience in waiting for definitive FFS results

FFS is a set of procedures that significantly modify your bone structures and facial tissues. Final results will come with time, although you should see noticeable changes immediately. Only with time swelling and bruising can diminish completely. Transparency with timelines helps you be informed when deciding if FFS is right for you. 

After one year we assess your results. Inevitably a minority of patients who undergo FFS will not be satisfied with some aspect. So, should this be the case, we offer guidance and a plan of action. By working with you to find the best solutions, we can uphold high healthcare standards that keep you safe. 

Lack of proper assessment or technique

If a surgery was not performed correctly because of a surgeon’s low skill level or improper assessment, new or repeat procedures might need to be performed. Unfortunately, this is still a common occurrence. We offer free consultations to assess these redoing cases.

Choosing a team of surgeons specialized in FFS that stands by their results offers peace of mind for patients. 

How to avoid post-op anxiety

We understand that deciding to undergo FFS is a tremendous decision. So, we do our best to help you recover peacefully. 

Nevertheless, it is not uncommon for patients to second guess the results they see in the mirror. Some may even ask, “Do I need a redoing?” 

We take many precautions to help you minimize post-op anxiety during your recovery.

Most post-op anxiety is reduced when the following questions are defined clearly: 

  1. How do I avoid a botched FFS?
  2. How do I know a surgeon cares about my well being?
  3. What are the best practices for predictable results and controlled recovery?

Below we will provide the answers to these questions so you can feel confident when opting for FFS with Facialteam. 

How can I avoid botched FFS?

It is important to reiterate the risks involved with any surgery before you opt for a procedure. We will make you aware of any potential risks involved with the procedures needed to achieve the look you want. As these procedures are life changing, you should deliberately select the best FFS team for you. This task will take time. 

The decision has never been easy. However, taking time to choose the ideal FFS clinic for you will likely minimize complications that may lead to needing a redo later on. 

Many patients choose a FFS surgeon based on economic and geographic factors. However, this is only a partial view. Unfortunately, people that choose a FFS practice based solely on cost and location may end up unsatisfied with their results. 

Similarly, it is not advisable to choose on the basis of a single recommendation from a friend unless you conduct further research. A reference may be made in good faith, but it is important to remember that your own facial structure is unique. So the approach for you should be personalized too. The better informed you are, the higher the chance of satisfactory results. 

Basing your choice of FFS surgeons on incomplete information poses substantial health risks:

  • Physical risks: Damage that can be irreversible (nerve injury, scars, skin defects, bone atrophy, poor tissue readaptation, etc). Unfortunately we have been contacted multiple times by patients who are desperate to solve physical problems relating to post-op results. 
  • Mental Health: If surgeons fail to meet your expectations, you may be left dissatisfied with the results. An inability to integrate into society as imagined can be very disruptive to your daily life. When seeking a surgery redo you may experience feelings of despair. 
  • Financial problems: Ineffectively performed procedures mean more than double the investment. Corrective treatments and redoing procedures can cost even more and there is no guarantee that they will yield satisfactory results. 

Investigations show that the best criteria to choose a FFS clinic are safety, collective team experience, effectiveness and predictability of results. We take your safety as our number one priority and our research makes strides toward improving standards in trans healthcare. Our team of surgeons has a combined total of over 40 years of experience. 

Through careful planning and 3D technology, we offer predictability. The effectiveness of our procedures is verifiable through the number of satisfied patients willing to share their results in our testimonials. 

Before making this once-in-a-lifetime decision without sufficient contemplation, we recommend you take the time to research several alternatives. It is a good idea to discuss FFS choices with your family, if they are supportive. Also, get a second or even third opinion before mulling over the options. Visit our blog for many more resources for facial feminization research.

Our clinical evaluations are free of cost and of obligation. Here is our research that proves the influence facial gender surgery has on your quality of life. Gender confirming surgery does save trans lives when based on informed decisions, which reduce the chances of botched facial feminization surgeries. 

The pitfalls of redoing surgery

As gender confirmation surgeries are necessary, it is vital that they are performed correctly the first time. When surgeries need to be redone, the difficulty and risk of complications dramatically increase. With each redo the risk of complication rises due to tissues reacting less predictably. 

Surgeons performing redos may encounter other unexpected circumstances such as asymmetrical scarring or adhesions. They must prepare for these by planning out a redo operation in full detail. 

Trust in caring professionals

Facialteam is expressly dedicated to Facial Feminization Surgery and has some of the most extensive international experience available. Our 3% rate of minor complications is impressively low for any surgical field. 

Due to our reputation for quality, predictable results, our team is approached frequently by patients looking for their facial feminization surgery to be redone.

Here is what you can expect when choosing us for your redo procedures.

A Multidisciplinary team

Our Marbella office boasts a staff of more than 40 highly qualified professionals. They are all exclusively focused on your needs throughout the FFS process. Our comprehensive care starts at orientation and follows you through preparation, surgery up to your one year follow up. 

Our core values as gender affirming professionals guide us in supporting your FFS journey. 

Cutting-edge technology

We accurately assess your personal situation during the planning stages. To provide world-class care and healthcare standards, our techniques include the latest technology available:

3D CT scan: To diagnose bone anomalies due to your previous surgeries. The 3D scan provides accurate insight to plan for possible issues during your redo. 

3D photo camera: To study the consequences of your previous surgery in detail using precise measurements.

3D printer: To physically print a replica of your bone structures as well as 3D cutting templates used to guide bone incisions during surgery. This makes it possible to foresee the best course of action based on a simulation surgery with the replica of your bone structure.

Materials & Instruments: We spare no expense and only use the highest quality material and instruments for our surgeries. 

  • titanium rigid fixation material (no sutures or wires);
  • Endotine® for skin flap-to-bone anchoring;
  • Piezosurgery®: To perform ultrasonic osteotomies with the highest precision, extra security and avoid trauma to surrounding soft tissue for better healing;
  • customized Medpor® implants, when desirable, after 3D simulation.

Virtual Facial Feminization Surgery (VFFS): A digital simulation of your photographic results with the best gender analysts. It assists us in two ways: 

  1. Deciding whether to go ahead with procedures of marginal benefit
  2. Establishing realistic expectations and attainable results

VFFS is highly realistic when done by experts who can accurately emulate the projected changes.


We have performed more than 6500 facial feminization procedures on over 2000 patients. That makes Facialteam a world leader with extensive and proven experience. Our large body of research is published in top medical journals as well as textbook chapters on facial gender confirming surgery. 

Hundreds of our patients have written and recorded FFS testimonials of their facial gender surgery experience.

Orientation and diagnostic process

We listen to every patient because your satisfaction matters to us. We focus on your health and realistic goals when considering your case. An exhaustive evaluation is necessary to create a personalized treatment plan for FFS surgery. We will never recommend a surgical procedure that we do not think you will benefit from. 

If we feel that a desired procedure will not benefit you, we’ll discuss its advantages and drawbacks and offer alternatives if possible. Exhaustive analysis may be necessary. They include multiple conversations, be it via email or video consultations. Yet, an in-person consultation is the best assessment method we can offer. 

When you come to meet us in Marbella the consultation is free, as always. We make the process easy and provide complimentary round trip concierge service to and from the airport. We recommend taking time for the decision-making process instead of making rushed choices on skewed information.

Predictable results

In addition to our diagnostics protocol (onsite visit, 3D photography, 3D CT scan, virtual surgery, etc.), we have spent the last ten years improving our surgical protocols, followed precisely with every patient.

Surgical protocol creates a controlled environment and reduces unforeseen circumstances during surgery. Consequently, we minimize the possibility of post-op complications. Our low reoperation rate of 3 out of every 100 procedures is proof of the effectiveness of our surgical protocols.


Our postoperative protocol is an integral part of our comprehensive care, which includes:

  • Hilotherapy;
  • Acupuncture;
  • Lymphatic drainage physiotherapy;
  • Highly trained, specialized nursing;
  • Mental health support.

Psychological care and individualized nursing

Returning to an operating room after a botched FFS procedure can understandably induce anxiety. We understand how difficult the experience can be and have equipped our team with the tools needed to help you adjust. To reduce your stress level, you will have access to an on-duty nurse and specialized psychologist during your redo recovery. 

 A team of coordinators are also there for you 24-hours a day to provide postoperative care.


Marbella (Spain), the center of the Costa del Sol of Málaga, has an ideal climate in an idyllic location. Its beautiful views and peaceful nature allow you to focus on what’s most important – healing. 

Don’t let desperation to fix unsatisfactory results hasten your search for a new FFS surgeon. Take your time to get second and third opinions on how and when you may fix your results. Talk with our surgeons. We can help you determine options for redoing your procedures. 

If you have concerns at any stage of your process, we are listening. 

Book your Consultation

We offer both online as in-person consultations in our clinic in Marbella, Spain.

Our consultations are free of costs and a great aid for those patients seeking advice to start their journey.


This technique is based on several scientific articles produced by our group throughout our clinical practice. Our academic literature is a record of our dedication to the science of feminization surgery of the upper facial third since 2008.

Logo of Elsevier, a leader in information and analytics for customers across the global research and health ecosystems

Comprehensive Care of the Transgender Patient

Cecile Ferrando
From a renowned specialist at the Cleveland Clinic and medical and surgical experts in this growing field comes an up-to-date, multidisciplinary resource on transgender health care and surgery. Comprehensive Care of the Transgender Patient, by Dr. Cecile Ferrando, covers all aspects of transgender health care, beginning with epidemiology and history and progressing to an in-depth review of the complex transition for patients, including mental health services, endocrine and hormone therapy treatment, and surgical options.
Logo of PRS, Plastic and Reconstructive Surgery.

Facial Gender Confirmation Surgery: A Protocol for Diagnosis, Surgical Planning, and Postoperative Management

Luis Capitán, Javier Gutiérrez Santamaría, Daniel Simon, Devin Coon, Carlos Bailón, Raúl J Bellinga, Thiago Tenório, Fermín Capitán-Cañadas
During the past 10 years, academic publications that address facial feminization surgery have largely examined the technical aspects of the different surgical procedures involved and clinical evaluations of postoperative results. This Special Topic article focuses on aspects that are underdeveloped to date but useful with regard to taking the correct therapeutic approach to transgender patients who are candidates for facial gender confirmation surgery.
Logo of PRS, Plastic and Reconstructive Surgery.

Facial Gender Confirmation Surgery: A New Nomenclature

Luis Capitán, Daniel Simon, Jens U Berli, Carlos Bailón, Raúl J Bellinga, Javier G Santamaría, Thiago Tenório, Anabel Sánchez-García, Fermín Capitán-Cañadas
The term Facial Gender Confirmation Surgery indicates that although the surgical techniques are the same, their objective is very distinct and, moreover, they are intended for specific patients with well-defined needs.
International Journal Of Transgender Health logo

Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care

Jens U Berli, Luis Capitán, Daniel Simon, Rachel Bluebond-Langner, Eric Plemons, Shane D Morrison
Based on new studies, increasing evidence points to the need to include FGCS among medically necessary gender-confirming surgeries, though more-prospective studies are needed. Updates to the WPATH SOC 8 are proposed based on available quality of life studies.
Logo of PRS, Plastic and Reconstructive Surgery.

Prospective Quality of Life Outcomes after Facial Gender Affirmation Surgery: An International Multicenter Study

Shane D Morrison, Fermín Capitán-Cañadas, Anabel Sánchez-García, David C Ludwig, Jonathan P Massie, Ian T Nolan, Marco Swanson, Marina Rodríguez-Conesa, Jeffrey B Friedrich, Paul S Cederna, Raúl J Bellinga, Daniel Simon, Luis Capitán, Thomas Satterwhite
No data exist on the prospective outcomes of facial feminization surgery. This study set out to determine the effects of facial feminization surgery on quality-of-life outcomes for gender-diverse patients.
Aesthetic Surgery Journal logo

Social Perception of Facial Feminization Surgery Outcomes: Does Gender Identity Alter Gaze?

Shanique A Martin, Shane D Morrison, Viren Patel, Fermín Capitán-Cañadas, Anabel Sánchez-García, Marina Rodríguez-Conesa, Raúl J Bellinga, Daniel Simon, Luis Capitán, Thomas Satterwhite, Rahim Nazerali
The evaluation of gender-affirming facial feminization surgery (FFS) outcomes can be highly subjective, which has resulted in a limited understanding of the social perception of favorable gender and aesthetic facial appearance following FFS. Eye-tracking technology has introduced an objective measure of viewer subconscious gaze.