How Many Procedures Can Be Done At One Time In Facial Feminization Surgery?

Q: Dr. Eppley, I am interested in facial feminization surgery. I specifically want: 1. lower forehead and brow ridge bone contouring, 2. forehead and eyebrow lift, 3. hairline restoration by scalp advancement and hair transplantation, 4. upper forehead bone augmentation, 5. frown line and crow’s feet surgical correction, 6. feminizing rhinoplasty, 7. cheek (malar or submalar) augmentation, 8. lip lifting, 9. chin contouring (reduction) & sliding genioplasty or chin augmentation by implant 10. jaw contouring (reduction). I also would like to know if possible can i have all these procedures done at the same time ?

A: All of the procedures you have listed are very common and often part of an overall facial feminization surgery (FFS) approach. When it comes to FFS surgery, most of them can be done all at the same time although some work against the others and are best deferred for a second surgery if needed.

Brow bone reduction/reshaping, upper forehead augmentation and scalp (hairline) advancement can all be combined and would need to be due to the same incision used for all of them. At the same time, a rhinoplasty, cheek implants and chin/jawline recontouring can be done.

There is no specific surgery for crow’s feet or frown lines. When doing an open rhinoplasty, a lip lift can not be done at the same time due to blood supply concerns of the intervening columellar skin.

Dr. Barry Eppley

Indianapolis, Indiana