Facial feminization surgery (FFS), you've may have heard about it but have no idea what it really is about. FFS is a surgery that involves the cosmetic modification of one's facial features. FFS NYC explains that the goal of this type of surgery is to soften strong male features into a shape more typically feminine. FFS is commonly done on transgender women or assigned male at birth (AMAG) non-binary trans people. Other people, like cisgender women, also pursue this type of surgery.
FFS is customized to each person and include up to every part of the face and neck. Facial feminization surgery is focused mostly on modifying the bone structure and nose shape. Soft tissue work, such as neck lifts and face lifts, can be included if necessary.
How Much Does it Cost?
The first thing people usually ask when inquiring about FFS is the cost. According to experts at FFS NYC, Facial Feminization Surgery initially wasn't included in health insurance or government healthcare. But nowadays, some insurers are starting to include FFS from select surgeons.
Out-of-pocket costs for FFS are usually between the $20,000 to $50,000 range. In some cases, it can even cost more, depending on the surgeon and the amount of component procedures that are needed to be done.
Insurance providers usually classify FFS as an elective cosmetic procedure. But, compared to genital surgeries such as phalloplasty and vaginoplasty, FFS has more impact an individual's mental health and social well-being. As our society becomes more and more aware and accepting of transgender issues nowadays, medical institutions are gradually accepting FFS as fundamental part of transgender care, rather than optional and elective.
How to Choose Your Doctor
Choosing the right surgeon to perform the FFS on you is vital to its success. You can't just choose any doctor for the job; you need to make sure they have the right experience for it.
To choose the right surgeon, you usually pursue face-to-face or Skype (or Zoom) interviews with as many surgeons as you can. Don't be afraid to ask as any questions possible. This way you'll be able to get a feel of how each surgeon works, and also get an idea of the variations in each surgeon's techniques and bedside manner.
Most surgeons provide consultations and presentations in major cities and even appear at some transgender conferences. It can also be a good idea to reach out to patients of surgeons that catch your attention. This can be done via online forums, support groups, or mutual friends.
What Procedures are Involved in FFS?
There exist several subtle differences between masculinized and unmasculanized faces. In combination, these two tip the scale to a face that can be interpreted as male or female. According to FFS NYC, in facial feminization surgery each area of the face is addressed in individual procedures such as:
Procedures to alter the hairline is often done to offset the effect of receding hairline or male pattern baldness.
This is achieved by accessing an incision from the forehead into the scalp. The most common way to do it is to cut along the hairline, which makes it possible for the scalp and hairline to physically move forwar and lower the entire hairline in return. For years, this was the only procedure available, with hairline advancement becoming the default standard, even though it often had a masculinizing effect.
Over the years, a new method of coronal incision (done along the top of the head) has been developed by the FacialTeam in Spain. The coronal incision hides the incision scar using the bulk of the individual's head hair. It faces upwards, hidden from the view of most people.
If you're planning on getting a hair transplant, consult your doctor about coronal incision. A coronal incision, allows for simultaneous hair transplants, unlike hairline advancement procedure because the incision is away from the hairline.
Forehead procedures shape the forehead by shaving down strong or hard' angles and decreasing the brow bone's prominence. Oftentimes, the brow shaved down when its protrusion is smaller and when the brow bone itself is thick.
When you shave down the brow bone, it may result in a hole in the sinus cavity. This is why people with more prominent brow protrusion require a more involved procedure.
Nose jobs or rhinoplasty shapes the nose to fit within unmasculanized norms, while keeping it naturally proportioned with the rest of the facial features.
There isn't really a significant difference with rhinoplasty for transgender individuals and standard cosmetic rhinoplasty. But a surgeon that's well versed with FFS can sometimes provide better results, especially when it involves altering multiple areas of the face at once.
When a client requests for less extreme changes, rhinoplasty can be done without external scarring. If a client demands more obvious changes to the nose, an open rhinoplasty may be the best option. This results to a small scar, which is barely noticeable, between the nostrils.
The proportions of skin above the lips and below the lips of masculinized and unmasculanized faces are different.
In most cases, there appears to be a shorter distance between the upper lip and the base of the nose for unmasculanized faces. The upper lip usually curls more upward. A musculanized face, however, can be given a lip lift. This results to a shorter distance above the lip and changes the lip orientation.
Jaw surgery is done mostly on the back corners of the jaw, where the bone turns upwards to the ears. FFS NYC surgeons can smooth strong protrusions, but there are limitations to the number of reductions done. The jawbone contains a crucial nerve, and aggressively reducing it increasis the risk of exposing or severing the nerve.
Although cheek augmentation is not really commonly done, it's recommended by some surgeons only for special cases.
Cheek augmentation involves fat grafting OR cheek implantations. For most people, when synthetic hormones start to redistribute body fat, the cheeks get bigger or fuller on their own. For this reason, a surgical procedure is often unnecessary.
Soft Tissue Procedures
Soft tissue procedures can be done together with the some of the major FFS procedures listed above. These include:
- Eye lifts
- Face lifts
- Lip injections/fillers
- Eyebrow lifts
In most cases, these procedures aren't considered necessary and don't impact how people perceive the gender of the face.