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.

Facial Feminization Researchers Dr. Fermín Capitán and Dr. Miguel Perceval, specialized facial feminization scientists at Facialteam, a clinic for FFS surgery.
Facialteam surgeons and students of Facialteam Training and Education during a demonstration of Facial Feminization Surgery.

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.

Mectron's Piezosurgery device, used to perform ultrasonic bone cuts in Facial Feminization Surgery

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.

3D mapped facial structure before and after facial feminization 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.

Skulls with highlighted areas where surgery can be performed to feminize masculine features of the face

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. 

A 3d scan of a lower jaw and a replicated 3d model of the same bone structure

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:

Logo of medical journal Panamericana

Cirugía Oral y Maxilofacial: Atlas de Procedimientos y Técnicas Quirúrgicas

SECOM (Sociedad Española de Cirugía Oral y Maxilofacial), Jose Luis López-Cedrún Cembranos
This atlas is the result of the joint work of a renowned group of specialists, made up mostly of members of SECOM-CyC, together with the invaluable help of other colleagues and experts.
Book cover for 'Feminización de la Voz' with subtitle about a multidisciplinary approach to transgender women; editors listed.

Capítulo 4. Cirugía de Feminización Facial. Feminización de la voz: abordaje multidisciplinar de la mujer transgénero. Hospitales Quirón salud

Bailón C, Capitán L, et al. · In: Casado JC, Maraví E, eds. Feminización de la voz: abordaje multidisciplinar de la mujer transgénero. Hospitales Quirón Salud
Describir los procedimientos quirúrgicos y técnicos orientados a la armonización, suavización y modificación de los rasgos faciales masculinos para la confirmación de género o la suavización del rostro.
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.
Logo of PRS, Plastic and Reconstructive Surgery.

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”
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”
The Journal of the American Medical Association Logo

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.
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.

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.
Book cover for 'Gender Affirmation: Medical & Surgical Perspectives' with a framed illustration of a nude torso split down the middle, set against a blue-purple gradient background.

Chapter 8. Facial Feminization Surgery: A Global Approach

Capitán L, Simon D. · In: Salgado C, Monstrey S, Djordjevic M, eds. Gender Affirmation: Medical and Surgical Perspectives. Thieme Medical Publisher
A comprehensive analysis of Facial Feminization Surgery (FFS) or Facial Gender Confirmation Surgery, covering diagnostic evaluation, surgical techniques across facial regions, and postoperative management.
Book cover for 'La feminización de la voz de la mujer transexual' by Mariela Astudillo Ramírez, with a pink/blue butterfly and a purple sound-wave graphic.

Intervenciones quirúrgicas: la Cirugía de Feminización Facial

Capitán L, Simon D. · In: Astudillo M, ed. La feminización de la voz de la mujer transexual. Editorial Círculo Rojo
Publicada en español en 2016 y traducida al francés en 2019, esta obra introduce el método Astudillo de feminización de la voz y conceptos esenciales sobre transgeneridad. Dirigida a profesionales de la salud y pacientes, cuenta con la colaboración de los doctores Luis Capitán y Daniel Simón, de Facialteam, así como de Iván Mañero y Pablo Ruiz Voz mediano.

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

Luis Capitán, M.D., Ph.D., Daniel Simon, D.D.S., Kai Kaye, M.D., Thiago Tenório, M.D.
The team details their standardized protocol involving forehead recontouring with osteotomy of the anterior wall of the frontal sinus. They advocate maintaining this technique even in cases of frontal sinus agenesis to preserve anatomical integrity, avoid excessive bone cortex wear, and maintain natural frontonasal transitions.
Logo for the International Journal of Oral & Maxillofacial Surgery.

Facial feminization surgery: surgical techniques and analysis of results in 200 patients

L. Capitán, D. Simon, C. Bailón. International Journal of Oral & Maxillofacial Surgery
This work presents the team’s experience with 200 facial feminization surgeries performed between January 2008 and December 2012. It describes techniques used to soften facial features generally perceived as masculine, including frontonasal-orbital reconstruction, chin and jaw recontouring, mandibular angle reduction, and thyroid cartilage reduction. It also presents the team’s main surgical results.
Facialteam FFS scientist dr. Fermín Capitán during the international facial gender symposium at johns hopkins training center

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: