A coordinated set of skeletal and soft-tissue procedures that bring the bony framework of the face into harmony with a feminine identity. Often performed as a single combined surgery, FFS is among the most life-changing procedures in gender-affirming care.
Facial Feminization Surgery (FFS) is not a single operation but a thoughtfully sequenced set of procedures that address the bony and soft-tissue features the brain reads as masculine—a prominent brow ridge, a wider mandibular angle, a taller chin, a fuller nasal dorsum, an exposed thyroid cartilage. By reshaping these structures, FFS aims not to create an imagined ideal but to allow your face to reflect the person you have always been.
In our practice, FFS is approached as bone surgery with soft-tissue finesse. We use thin-cut CT imaging to plan forehead, mandible, and chin work to the millimeter, and combine these foundational procedures with rhinoplasty, tracheal shave, and adjunct soft-tissue refinement when appropriate. Most patients undergo a combined operation in a single day.
“The forehead and lower jaw together account for the great majority of perceived facial gender. Address these well, and the rest is refinement.”
Your individual plan is tailored after consultation. The procedures below are the most commonly combined elements of FFS in our practice.
Reshapes the prominent supraorbital bossing and brow ridge characteristic of androgenized bone structure. Type III cranioplasty involves removing, reshaping, and replacing the anterior wall of the frontal sinus to achieve a smoother, more feminine forehead and brow line.
Reduces the height of an elevated hairline through a coronal or trichophytic incision, often combined with forehead contouring. Helps create a more proportionate upper third of the face.
Refines the nasal bridge, tip, and nostrils to create a softer, more feminine profile in proportion to the newly contoured forehead. May involve dorsal hump reduction, tip refinement, and alar base narrowing.
Enhances cheek projection through fat grafting or implants, creating heart-shaped facial proportions. Restores midface volume that may be lost or insufficient.
Reduces the squared appearance of the lower jaw through angle resection and tapering of the mandibular body. Creates the softer, more oval lower face contour associated with feminine appearance.
Reshapes a tall or wide chin by sliding, narrowing, or reducing the bony chin. Creates a softer, more pointed chin proportionate to the rest of the lower face.
Reduces the prominence of the thyroid cartilage (Adam's apple) through a small horizontal incision in a natural neck crease. Performed under general anesthesia, often as a same-day procedure.
Shortens the distance between the upper lip and base of the nose, exposing more of the upper teeth and creating a more feminine smile. May be combined with lip augmentation.
Comprehensive in-person or virtual consultation with photographic analysis and, when indicated, fine-cut CT scan of the facial skeleton to plan bony procedures with precision.
Our team prepares a detailed prior-authorization packet including your mental-health letter, photographs, and medical-necessity narrative. Surgical plan is finalized once coverage is confirmed.
Most full FFS combinations are performed in a single 6 to 10-hour session under general anesthesia at an accredited surgical facility, with one overnight stay for monitoring.
Major swelling resolves over 2 to 6 weeks. Final bony results are appreciated by 3 months; soft-tissue refinement continues to 12 months. Multiple post-op visits are included.
Days 1–3: Significant facial swelling and bruising. You will rest with your head elevated and use cool compresses. Pain is generally moderate and well-controlled with prescribed medication.
Week 1: Sutures from rhinoplasty and tracheal shave incisions are removed. Swelling shifts downward into the cheeks and jaw. Light walking encouraged.
Weeks 2–3: Bruising fades. Most patients return to desk work or virtual meetings around two weeks. Strenuous activity remains restricted.
Weeks 4–6: Major swelling resolves. The contour of the new bone work begins to emerge clearly. Light exercise can resume.
Months 3–12: Subtle soft-tissue swelling continues to settle. Final results are typically appreciated between 6 and 12 months post-operatively.
