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Facial Gender & FFS:
• In a Nutshell
Hair and Hairline
• Forehead
Adam's Apple
• Facelifts
Hormonal Effects
• Ethnic Variations

• Virtual FFS FAQs
• General FFS FAQs

My Facial Feminisation Thesis

My Top Tips for FFS Patients

Disclaimers, Promises and My Qualifications

Body Dysmorphic Disorder and FFS



My Top Tips for FFS Patients



All surgery has some risks associated with it, but nothing will increase your risk of serious complications more than smoking (including E-cigarettes). 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. Smoking will 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 vaginoplasty patients. I advise you stop smoking several months before undergoing any surgery. There is more information here.


2. Get yourself fit and healthy if you can:
Patients who are in good health tend to recover more quickly from surgery 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:
FFS isn't engineering, it works on bone and soft tissues which swell and flex and scar, so there is always some degree of unpredictability in the way the healing process will proceed, and in the way everything will finally settle. If the surgeon is competent, the level of unpredictability is low, but it is always there so don't expect perfection levels down to fractions of milimetres.


4. Be realistic:
FFS has limits and it is not possible to make every face completely feminine. However, it is almost always possible to feminise a face to some degree.


5. Don't assume you can achieve the same result as someone else:
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. Your own result depends on many things - your starting point, the way you heal, the surgeon you choose, your age, and a little bit of luck.


6. Remember that FFS is about you:
FFS is not about trying to create a different person or trying to copy the features of another woman - the main purpose of FFS in my opinion should be to remove the effects that testosterone had on your face at puberty. So it's about returning to your original face rather than creating a new one. I call this concept "puberty reset".


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 my 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. Similarly, 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. It's all about balance.


9. Go to an FFS specialist for FFS:
Some of the main FFS procedures like forehead reconstruction are beyond the training of most plastic surgeons. FFS surgeons are usually "maxillo-facial" or "cranio-facial" surgeons which means they are trained for the more complex bone work that FFS patients typically need. 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, so try to choose your surgeon according to your surgical needs rather than by their location, even if you have to travel thousands of miles for your surgery.


11. Get second opinions:
Surgeons are human beings – they don’t always make the best choices for you and they do sometimes make mistakes. So try to speak to more than one surgeon when planning your FFS because 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 rather than to just go with the first surgeon's assessment you get.

You can also come to me - one of the main purposes of Virtual FFS is to walk you through these kinds of complexities.


12. Ask about revisions:
Different surgeons have different rules so discuss this with them during your consultation and don't wait until you need a revision to find out. Some surgeons do charge, others don’t charge for their work but do charge for the anaesthetist and hospital facilities, and some will revise completely fee of charge. It will usually vary according to the nature of the revision - if, for example, there has been a surgical error - perhaps an asymmetry that should not have happened, then the revision should be free, but if there is no error or complication, but you would like to try a slightly different approach, then you will probably have to pay for that.