Facial feminization surgery (FFS) is reconstructive surgery on the face to reshape its contours and give it a more feminine appearance. Transsexual women are common candidates for this surgical procedure, although drag performers and other individuals may also consider facial feminization surgery, for a variety of reasons. A number of procedures for the face are available.
Before facial feminization surgery, patients will meet with their surgeons to discuss their options. Many surgeons use samples of before and after images to help women see how specific procedures work and to give them ideas for reshaping their own faces. The surgeon will work with the patient to develop an appropriate plan so she can feel confident going into surgery.
Most transsexual women go through transition after adolescence and thus transition with a male facial structure. High levels of masculine hormones cause significant changes to the facial appearance, including making the forehead heavier and more pronounced, altering the structure of the nose, and creating a more pronounced chin and jaw. The Adam's apple may also develop a protruding appearance. Women may choose facial feminization surgery because they are concerned about facial aesthetics.
Depending on the amount of work a patient decides to request, multiple surgical procedures may be necessary. The patient is placed under general anesthesia so the surgeon can do things like shaving down bone to change the shape and structure of the face, inserting implants into the cheeks, reshaping the nose, and moving the hairline. In the days immediately following surgery, the patient will have significant swelling and bruising. As these go down, her new face will emerge and the surgeon can remove any stitches.
This surgery requires advanced training. Oral and maxillofacial surgery to reconstruct facial structure require a high level of skill, including attention to detail to minimize scarring. Surgeons do things like hiding incisions in the hair line so they will not be visible after surgical recovery. They must also take care to keep surgical changes to the face even on both sides, and to protect the underlying structures in the face and skull. Specialists in this technique are relatively rare, and patients seeking facial feminization surgery may want to ask other members of the transsexual community for advice and recommendations.
Costs for facial feminization surgery can be very high, and are usually not covered through insurance and benefits programs. When included with other surgeries, women may choose during transition, including genital reconstruction surgeries and breast implants, it is possible to spend substantial sums on surgical transition.