What Are Some Of the Procedure Considerations That I Need To Know for Facial Feminization Surgery (FFS)?

Q: I am interested in Female Feminization Surgery which would encompass brow bossing reduction, hairline lowering, rhinoplasty, chin and jaw shaving and breast augmentation. I am considering doing the FFS either all at once or in two parts. I am male to female transgender. Can you provide me some details or specifics about what I need to consider for each of these procedures.

A: All of those Facial Feminization Surgery (FFS) procedures certainly can all be done as a single procedure and are not too excessive for one operation. If you were to do them in stages, I would separate them into the facial procedures as one set of procedure and the breast augmentation as a separate procedure.

A few comments about your proposed FFS procedures:

Hairline lowering – Whether that is possible would depend on your hairline now and where it is located. Some FFS patients have to consider hair transplants instead if their hair density is very thin or too far back.

Brow Bone Bossing – There are two methods based on the degree of bossing, burring reduction (tail of brow only) or frontal sinus wall setback (if the whole brow is very prominent) It is impossible to know which is best for you without seeing a picture. The relevance to this difference is prinarily a cost issue. Frontal sinus wall setback requires some tiny plates and screws to hold the reshaped bone and takes a little longer to do.

Rhinoplasty – There are two different types of rhinoplasty, limited and full. The full rhinoplasty requires more work and is almost always needed when there is a hump reduction needed. Limited rhinoplasty is where only the tip is manipulated/changed.

Chin and Jaw Shaving – For most FFS patients, this is largely burring reduction or saw shaving of the inferior border although sometimes the chin bone may need to be shortened vertically as well as setback.

Adam’s Apple – Any issues here? I am supposing not since you didn’t mention it.

Breast Augmentation – The only issue here is saline vs silicone gel breast implants. That is just a cost difference issue

Dr. Barry Eppley

Indianapolis Indiana