My Top Tips for FFS Patients
1. STOP SMOKING!
All surgery has some risks associated with it but nothing will increase your risk of serious complications more than smoking. The main problem is that it shrinks the capillaries which are little blood vessels that carry blood to your surgical site and that basically means that the injury will not get a good oxygen supply. A lack of oxygen can mean that the tissue starts to die - this is called “necrosis” which can theoretically become gangrene. They also suppress the immune system which can make infections more likely. Some FFS surgeons will refuse to operate on patients who smoke and the same applies to SRS patients. I advise you stop smoking several months before undergoing any surgery. There are a couple of links here and here with more information:
2. Be healthy and get fit:
Patients who are slimmer and in good health tend to recover more quickly from operations so try to have a healthy diet and get plenty of exercise in the months leading up to surgery. If you want to check the healthy weight range for you height, look up your "Body Mass Index" (BMI) here.
3. Don't expect perfection:
People heal in unpredictable ways and surgeons are fallible so be prepared at least for minor asymmetries or similar small complications.
4. Be realistic:
FFS is not a magic wand and it is not possible to make every masculine face completely female. However, it is almost always possible to feminise a face and the gains for many TS women are worth the trauma and expense of FFS.
5. Don't assume you can achieve the same result as someone else:
Your end result depends on many things - your starting point, the way you heal, the surgeon you choose, your age and a little bit of luck. You will see some great FFS results on the internet and even in real life but that will only tell you what was achieved with that person's particular face by their particular surgeon/s. Hopefully your result will also be great but don't assume that a surgeon can achieve the same results on everyone - every face has a completely different potential.
6. Uncovering the female you:
Remember that FFS is about removing or reducing facial masculinities to uncover the female version of YOU. It's not about trying to create a different person or trying to copy the features of another woman.
7. Remember that hormones change you:
They change your face in several ways but they can also change the way you feel about yourself and that can change your ideas about what FFS procedures you actually need (see the page on hormonal effects).
8. Doing FFS more aggressively will not necessarily make you look more feminine:
For example, lifting the top lip will often have a feminising effect but if you lift it too far, it can give you a “rabbit-tooth” effect. For another example, shortening the height of the chin can often be feminising but shortening it too far can sometimes make the lip-to-nose distance look longer which can be masculinising.
9. Go to an FFS specialist for FFS:
Some of the main FFS procedures like forehead recontouring are beyond the training of most plastic surgeons. FFS surgeons are usually "maxillo-facial" surgeons which means they are trained for more complex bone work. Also, plastic surgeons often lack the specialised understanding of male/female facial differences needed for FFS.
10. Don't choose your Surgeon by location:
There are only a handful of FFS surgeons in the world and it is best to be prepared to travel for FFS (halfway round the world if necessary). So, if at all possible, choose your surgeon according to your surgical needs and not by their location.
11. Not everything a surgeon tells you is necessarily true:
Don't get me wrong - I'm not saying that FFS surgeons are all liars! However, surgeons, as a breed, are fairly self-confident people (they would have to be to do what they do). This self confidence can sometimes lead a surgeon to talk about your FFS with a great deal of certainty as if there is only one way to approach a problem and that is their way. And to be fair to surgeons, they will generally believe what they are telling you. However, you will find that different surgeons might have quite different ideas about your surgery. For example: one surgeon might say that it is “impossible” to do your forehead without also doing your nose. This can be true in some cases but not all and a different surgeon might tell you that is is very possible or even advisable to do them separately in your case. A lot of this can come down to the different types of procedures that different surgeons use - they can't all do the same things. Just be aware of this, keep an open mind and get second opinions. Which leads me to:
12. Find a reputable surgeon:
There are some questionable surgeons out there who will recommend the procedures they do rather than the procedures you need - look out for that. One way to help filter these out is by getting second opinions (see below).
13. Get second opinions:
Surgeons (and FFS advisors like me) are human beings – they don’t always make the best choices for you and they do sometimes make mistakes. If you have come to this website you may already be thinking of getting a second opinion on your needs from me but try to speak to more than one surgeon when planning your FFS - speak to all the top FFS surgeons if you can. Each opinion can bring you a clearer view of your needs. Sometimes you will be confused because you get such a range of opinions but it is better to go through this confusion and sort out what you really need rather than to just go with the first surgeon's assessment you get. One of the reasons people come to me is to help them sort out what to choose from a range of options they have been given.
14. Ask about revisions:
If something needs revision, who pays? Get the details. When the surgeon says they will do revisions free of charge, do they mean that you will also not have to pay for the anaesthetist, other operating staff, operating theatre etc? Make sure you are clear about any hidden costs and that you are happy to go ahead with their policy.
15. Virtual FFS is not the last word on your face!:
The virtual FFS pictures I create for you are never the last word on the possibilities for your face so if the pictures disappoint you, remember they are one artist's suggestions and one view of the possibilities.