The Definitive Guide to Facial Feminization Surgery

Facial feminization surgery is complex and highly individualized to each patient. When we look at a face, there are certain features we associate with classical femininity: A smooth, high brow line, full lips, round cheeks, a tapered jaw, a smaller nose and pointed chin. These are the shapes that tend to make a face look female. At our practice in Beverly Hills, we specialize in helping individuals achieve a more feminine look, whether they be females who have some masculine features or individuals who desire to change their facial gender orientation. The results are life-changing for our clients, who consistently report that they enjoy a new sense of confidence now that they look as feminine as they feel.

What is facial feminization surgery or FFS?

Facial feminization surgery is a type of cosmetic surgery that combines various bony and soft-tissue procedures at once to create the overall effect of a more feminine-looking face. As opposed to surgeries that address only one problem area for the client, facial feminization surgery is a comprehensive approach that employs multiple methods to achieve dramatic feminization results, often in a single procedure.

Good candidates for facial feminization surgery are those women who are self-conscious about facial features that society typically views as masculine, or patients who desire facial gender reassignment surgery. We work with cisgendered women all the time, who were born biologically female, but have struggled all their lives to feel beautiful because certain aspects of their face appear “manly,” such as a deep or low brow, or a prominent chin or jawline. We also work with transgendered women and non-binary clients seeking to feel more at home in their bodies. Facial feminization surgery can be an especially transformative step for these clients, as it helps them to live their gender identity with greater joy and confidence. In fact, for trans individuals, facial feminization surgery has been shown by numerous studies to have an even greater positive impact on mental health than does genital feminization surgery.

There are relatively few plastic surgeons who do full facial feminization surgery, so you may need to travel in order to get it. In any case, be sure to select a surgeon with proven experience in this highly specialized procedure. Your face is your most precious asset, so you need to work with an expert you can trust. You are not only selecting a doctor, you’re selecting a designer and artist, too. So shop around until you find the surgeon that feels right for you.

What should I expect before and after facial feminization surgery?

If you’re considering facial feminization surgery, the first step will be an initial consultation with your surgeon. At your consultation, your surgeon will examine your facial features, talk with you about your goals for surgery, and describe the various processes he or she recommends to achieve the desired effect. Your surgeon will also go over any pre- and post-op instructions, and give you an idea of what to expect following surgery. If you take hormone replacement therapy, you will need to stop taking it for at least two weeks prior to surgery, and at least two weeks after. If you smoke, your surgeon may require that you quit in order to ensure adequate blood flow for the healing process. Fasting will also be required the day before surgery.

You will be under general anesthesia for the duration of the procedure, and may or may not need to stay overnight for observation afterward. Some people who undergo facial feminization surgery opt to do it in two procedures — usually one surgery that covers the top part of the face, and another that covers the bottom. Others decide to have everything done at once. Your surgeon will advise you on the best course of action for your specific situation.

How much does facial feminization surgery cost?

The cost of facial feminization surgery varies considerably based on where you have it done, who you have it done by, and how many procedures are involved in the surgery. Unfortunately, facial feminization surgery is usually not covered by insurance, but many surgeons offer financing options. In the U.S., facial feminization surgery usually costs anywhere from $20,000 to $50,000+ out-of-pocket. Your surgeon will give you a more detailed estimate following your initial consultation, and you may choose to forgo certain suggested procedures in order to keep costs down, if necessary.

What are typical procedures in facial feminization surgery?

Hairline

Advancing the hairline by moving it further down the forehead can have a dramatically feminizing effect on the face.

Nose

Rhinoplasty to reduce the size of the nose and reshape it is a common procedure in facial feminization surgery.

Jawline

Shaving the lower jaw bone or repositioning it can reduce the width and angularity of a masculine-looking jaw. Buccal fat removal is also a great option for those seeking a slimmer and more contoured jawline.

Brow Lift

Lifting the eyebrows to a higher position on the face helps counteract the masculinizing effect of a deep or furrowed brow, and reduces telltale signs of aging like forehead wrinkles and crow’s feet.

Lip Lift

Bringing the upper lip closer to the bottom of the nose makes the lower half of the face look younger and more feminine.

Face Lift

A face lift is usually performed during facial feminization, as it makes the face appear less bottom-heavy and more heart-shaped.

What are the recovery times and phases?

Your recovery time will depend on your general health, how vigilant you are about aftercare instructions, and how many component procedures are involved in your surgery. Generally speaking, you will need complete rest for at least two weeks, and should not go back to work or lift heavy objects for about six weeks. You will likely need a friend or family member to help you care for yourself following surgery, and should avoid strenuous tasks and unnecessary stress. Be sure to attend all follow-up appointments, and call your surgeon’s office right away if you’re concerned about any potential complications. It’s always better to be safe than sorry.

Is swelling normal after facial feminization surgery?

Yes, swelling is to be expected after facial feminization surgery, and is a normal part of the healing process. This is major surgery, and complete recovery will take at least a couple of months. As with all invasive cosmetic procedures, things are likely to look worse before they look better. Your surgeon will monitor your swelling in post-operative follow-up visits, and will let you know if there is any cause for concern. He or she will also check for any signs of infection, and be with you every step of the way to make sure things are healing properly.

There are simple things you can do to reduce swelling and discomfort, like applying ice packs and keeping your head elevated. Your care team will go over all of these guidelines with you before surgery so you can be prepared.

What are the risks of facial feminization surgery?

The most serious risks of facial feminization surgery are the same as any surgical procedure requiring general anesthesia for an extended period of time. There is always a risk of an adverse reaction. This is rare, however, and your surgeon will order pre-operative tests to make sure that you are in good enough general health to undergo surgery.

The other risks of facial feminization surgery can be reduced simply by selecting the best surgeon for the procedure. Scarring, blood clots, implant infection, suture rupture, nerve damage, and facial asymmetry are less likely to occur if you choose a practitioner with plenty of experience and a proven track record of success in performing the surgery. That said, you should always feel comfortable discussing the risks and complications with your doctor so you can make an informed decision, and be aware that all surgeries contain some element of risk.

Are there non-surgical facial feminization procedures?

Yes. If you’re wary about going under the knife, talk to your practitioner about non- or minimally-invasive cosmetic options like injectable fillers, Botox, and ThreadLift procedures. There are many ways to achieve facial feminization without undergoing surgery, though most methods require repeat treatments to maintain the desired effect. Commonly, clients seeking non-surgical feminization opt for injectable fillers in the cheeks and lips, Botox to narrow the jawline, eyebrow reshaping, hair transplants, and facial hair removal. While surgery will produce more dramatic and permanent results, there are plenty of ways to achieve a more feminine look that don’t require general anesthesia or lengthy recovery times.

Do I need a facial feminization plastic surgeon near me?

Patients should expect to travel to an expert facial feminization plastic surgeon. Because there are only a handful of expert plastic surgeons in the country, patients should expect to travel to a location like Beverly Hills for their procedure.

Have questions?
Email Dr. Sykes at hello@sykesplasticsurgery.com

About Dr. Jonathan Sykes

Dr. Jonathan Sykes is a world-famous expert plastic surgeon who performs all cosmetic and functional plastic surgery procedures on the face and neck. He is a past president of The American Academy of Facial Plastic and Reconstructive Surgery, and served on their Board of Directors for over 10 years. He is also a Professor Emeritus in Facial Plastic Surgery from UC Davis Medical Center, and the former Director of Facial Plastic Surgery at that institution. He is known as the expert’s expert, and is often called to consult and advise other plastic surgeons in both Northern California and Beverly Hills. He has a special interest in eyelid and browlift surgery, facial rejuvenation surgery, including facelifts and rhinoplasty.