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Facial Gender & FFS:
• In a Nutshell
Hair and Hairline
• Forehead
Eyebrows
Eyes
Nose
Cheeks
Lips
Chin
Jaw
Adam's Apple
• Facelifts
Hormonal Effects
• Ethnic Variations

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• Virtual FFS FAQs
• General FFS FAQs

My Facial Feminisation Thesis

My Top Tips for FFS Patients

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Body Dysmorphic Disorder and FFS

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Hormonal Effects

 

Hormones can have several effects on the face many of which I can simulate in your Virtual FFS if you want me to:

 

1. Cheeks
They make the apple of your cheeks (the soft part) fuller and rounder and this can be quite strongly feminising. It seems quite possible that the lips become slightly fuller on hormones for the same reason, but that is purely speculation at the moment.

 

2. Jaw
They can narrow the jaw - they don't affect the underlying bone but they do reduce muscle mass and when this affects the chewing muscles (also known as "masseter muscles") it can narrow the jaw a little at the back. The effect is more likely to be noticeable if you have fairly strong chewing muscles to begin with.

 

3. Skin Texture
Hormones make the skin texture softer and more feminine. This is a much more powerful effect than many people realise.

 

4. Skin Colour
Females from all ethnic groups have slightly paler skin on average than males. Some scientists think this helps women produce extra vitamin D from sunlight when they are pregnant. I can find no studies that have looked into whether estrogen makes your skin a little paler but based on my own experience and observations I suspect that it does.

 

5. Sub-cutaneous Fat
Hormones build up fat under the skin and this can help round off some of the hard edges associated with a masculine face.

 

6. Beard Reduction
Some people find that their beard becomes thinner and weaker on hormones. This also makes it easier to remove.

 

7. Muscle Moustache
The muscle moustache is a term I have come up with to describe the heavier musculature men often have in the moustache area and around the mouth. Read more on this in my page on lips. Hormones can help reduce this by reducing the muscle just as they do with the jaw, but they also fill the cheeks as I mentioned above and this creates less of a contrast between the muscle moustache and the cheeks.

 

8. Psychological Effects
We often start our transitions feeling very daunted and that we will need every FFS procedure possible to have any chance, but if you find that after some time on hormones, you pass well, you feel more physically feminine and you feel a lot happier, you may find that some of the procedures you thought were essential no longer seem so important. So it is very important to be aware that the physical effects of taking hormones can make you feel differently about yourself.

 

Some Questions:

Should I wait until I’ve been on hormones a while before I have FFS or Virtual FFS?
Waiting a year would be ideal. This allows the hormones to achieve most of their effect on the face, and if you find you start to pass reasonably well or feel a lot better about yourself, you might feel that you don't need as many procedures as you first thought. However, this is not always possible or practical, and if you have significant bone masculinities like heavy brow bossing or a big square chin, it is often clear that these will always be a problem. In that case, it might be perfectly reasonable to have FFS or Virtual FFS before you have started HRT.

The area hormones affect most is the cheeks, so it's usually a bad idea to have any cheek enhancement until hormones have had their effect. I strongly disagree with surgeons who recommend cheek augmentation before waiting to see what the hormones will do, unless you have a clear anomaly there like an under-development in the bone.

And as I mentioned above, the chewing muscles can reduce a little on hormones if they are large, so that's another area to be cautious about if your surgeon is recommending jaw narrowing.

Do I need to stop hormones before surgery?
Different surgeons have different protocols, so your particular surgeon should advise you. For genital surgery you should expect to come off hormones before the operation, but you are much less likely to need to come off them for FFS procedures.