Research & Development

Facialteam Research & Development

Our research and development team exists because we want to be the leading pioneers in FFS. Research is essential to improving procedures that create effective, natural, and long-lasting results for patients. We want to decrease recovery times and the invasivity of FFS procedures.

As pioneers, we focus on research and proclamations in the field of facial plastic surgery. So, our research and development team helps develop and train other professionals using leading technology.

Leading Technology in Facial Feminization Surgery

Facial Feminization surgery is one of the fastest-growing specializations in the field of plastic surgery. Increasingly doctors and psychologists worldwide are recognizing the necessity of FFS for gender dysphoria.

With an increase in focus on FFS, we increase concentration to improve standards.

We use technology that reduces healing times and provides superior operational planning.

Piezosurgery by Mectron

Piezosurgery is a precision instrument that allows surgeons to perform procedures with maximum accuracy at minimal risk. The piezoelectric sensor emits ultrasonic energy waves to make this possible. 

Piezosurgery improves patient experience through: 

  • superior safety;
  • reduced recovery times;
  • predictable outcomes.

Since 2001, this technology has been the benchmark for bone surgery.

Vectra H1 3D Imaging System

The Vectra H1 handheld imaging system brings clinical-quality 3D imaging to facial aesthetics. 

3D imaging provides us with unprecedented access to information previously unavailable. We can now view a full range of facial features from any angle in three dimensions in real-time.

Visualizing your facial structures is key for understanding how to design an optimal plan for your transitional journey.

3D CT-Scan

3D CT scans play a vital role in our daily practice. We use them to understand the facial structure of our patients within a millimeter of precision. 

Using this technology we document your transition and explain the changes made to your bone structure during your procedure. 

Our modern CT machine only takes 2-3 minutes to take all the scans we need. 

A part of the comprehensive care we provide 3D CT scans to all patients who will undergo a procedure with us. The scans enable us to have better communication and understanding with you throughout your transition process.

We highly recommend that you take advantage of 3D CT scans by attending an in-person consultation with us in Marbella. 

The CT scans provide valuable metrics about bone density and structure, and we cannot do this via virtual consultation. 

3D Printed Stereolithographic Models

We create a printed 3D model of your skull. The model helps us create your personalized FFS plan when needed. Having a model allows us to plan in more detail, provide the best overview of your unique facial features, and offer solutions to achieve your goals. 

The use of 3-D models in Oral and Maxillofacial Surgery significantly improves the predictability of clinical procedure outcomes. 

3D printed models reduce your stress and show real applicable results.

Scientific Publications

As one of the fastest-growing areas within plastic surgery, the dissemination of research in gender surgery is essential to improving patient outcomes and spurring on new innovations. To that end, we have published multiple scientific papers in peer-reviewed journals and medical books.

Every publication regards aspects of facial gender confirmation procedures. In English and Spanish, they include:

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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.
The Journal of the American Medical Association Logo

Ethnic Considerations for Rhinoplasty in Facial Feminization

Raúl J Bellinga, Luis Capitán, Daniel Simon
Reply on original article “Ethnic Considerations for Rhinoplasty in Facial Feminization”
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Facial Feminization Surgery: Simultaneous Hair Transplant during Forehead Reconstruction

Luis Capitán, Daniel Simon, Teresa Meyer, Antonio Alcaide, Alan Wells, Carlos Bailón, Raúl J Bellinga, Thiago Tenório, Fermín Capitán-Cañadas
After the forehead, the hairline pattern is the second most important feature of gender identification within the upper third of the face. This article describes a new surgical sequence in which reconstruction of the frontonasoorbital complex and redefinition of the hairline by means of an autologous hair transplant are carried out during the same operation.
Best Paper Award & Plastic and Reconstructive Surgery Journal logos

Facial Feminization Surgery: The Forehead. Surgical Techniques and Analysis of Results

Luis Capitán, Daniel Simon, Kai Kaye, Thiago Tenório
This article describes the main surgical techniques used in feminization of the forehead complex, sequences the different steps in forehead reconstruction, evaluates results obtained using cephalometric analysis, and includes the level of patient satisfaction.
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.
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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.
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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.
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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.
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Role of Rhinoplasty in Transsexual Patients

Luis Capitán, Daniel Simon, Teresa Meyer, Antonio Alcaide, Alan Wells, Carlos Bailón, Raúl J Bellinga, Thiago Tenório, Fermín Capitán-Cañadas
Reply on original article “Role of Rhinoplasty in Transsexual 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.
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Technical and Clinical Considerations for Facial Feminization Surgery With Rhinoplasty and Related Procedures

Raúl J Bellinga, Luis Capitán, Daniel Simon, Thiago Tenório
Together with the forehead reconstruction, feminization of the nose is one of the most common procedures in facial feminization surgery. Rhinoplasty surgical techniques, which provide correct support and stability in the mid to longterm, are essential for obtaining a predictable result.
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Facial Gender Confirmation Surgery: The Lower Jaw. Description of Surgical Techniques and Presentation of Results

Daniel Simon, Luis Capitán, Carlos Bailón, Raúl J Bellinga, Javier Gutiérrez Santamaría, Thiago Tenório, Anabel Sánchez-García, Fermín Capitán-Cañadas
This article describes the surgical techniques and material used to feminize the mentomandibular complex, including bone contouring, chin and mandibular body and angle ostectomies, and osteotomies to reposition the chin.
The Journal of Craniofacial Surgery logo

The Upper Third in Facial Gender Confirmation Surgery: Forehead and Hairline

Luis Capitán, Daniel Simon, Carlos Bailón, Raúl J Bellinga, Javier Gutiérrez-Santamaría, Thiago Tenório, Fermín Capitán-Cañadas
Surgical modification of the frontonasoorbital complex is reliable and predictable, and also delivers satisfactory results that are stable over time. A prototypical male hairline has an M-shaped pattern compared to the more rounded shape often seen in female hairlines.
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ESSM Position Statement “Sexual Wellbeing After Gender Affirming Surgery”

Müjde Özer, Sahaand Poor Toulabi, Alessandra D Fisher, Guy T’Sjoen, Marlon E Buncamper, Stan Monstrey, Marta R Bizic, Miroslav Djordjevic, Marco Falcone, Nim A Christopher, Daniel Simon, Luis Capitán, Joz Motmans
This article aims to review the impact of various GAS on sexual wellbeing in treatment seeking trans individuals, and provide a comprehensive list of clinical recommendations regarding the various surgical options of GAS on behalf of the European Society for Sexual Medicine.
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Masking Gender: The Impact of Facial Coverings on Gender Recognition

Daniel Simon, Luis Capitán, Shanique A Martin, Rahim Nazerali, Thomas Satterwhite, Shane D Morrison, Fermín Capitán-Cañadas
Video conferences and masking have increased focus on the upper facial third. In the transgender community, this increased focus on the face could have substantial effects on facial gender recognition, leading to exacerbation of facial gender dysphoria.
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Facial Gender Surgery: Systematic Review and Evidence Based Consensus Guidelines from the IFGS

Devin Coon, Jens Berli, Norah Oles, Sol Mundinger, Kate Thomas, Toby Meltzer, Carrie Houssock, Thomas Satterwhite, Shane Morrison, Carlos Bailón, Thiago Tenório, Daniel Simon, Fermín Capitán-Cañadas, Luis Capitán
Facial gender surgery aims to modify patients’ facial features to be more congruent with their physical expression of gender, reducing gender dysphoria and improving quality of life.

Research Partnerships

The surgeons at Facialteam strongly emphasize research and collaborate on projects with large academic institutions and private companies. We do this to provide you with the best standards in transgender healthcare. 

We are constantly researching the latest technology and advances in FFS. We work with several research institutions to contribute to improving transgender healthcare standards. They include: