Facial feminisation surgery, often referred to as FFS, is a group of surgical procedures that work on the bones and soft tissues of the face. The goal is to alter facial features in ways that are more consistent with a feminine appearance. It’s a significant surgical procedure, and for patients who undergo it, the decision often follows a long period of careful thought, medical assessment, and consultation with a qualified medical professional.
What Does FFS Actually Involve?
FFS is not a single procedure. It’s a collective term for a range of surgical techniques that target different areas of the face. Your facial anatomy will be assessed during a detailed consultation, and the procedures that may be appropriate for your individual goals and circumstances will be discussed at that time.
The face has many structures that can differ between individuals, and surgery in this area is complex. Because FFS can involve both bone and soft tissue, the surgical approach will vary considerably from patient to patient, depending on which areas are being addressed.
Not every patient will have, or will want, every procedure. What’s discussed and agreed upon will depend on your specific anatomy, your health, and your individual goals.
Which Procedures Are Commonly Part of FFS?
Forehead contouring addresses the bone structure of the upper face and is often performed together with a brow lift (browplasty) and hairline lowering, where the scalp is repositioned to reduce the height of the forehead. This is one of the more involved aspects of FFS, as it requires reshaping the bones of the forehead and skull.
Rhinoplasty is the clinical term for surgical reshaping of the nose and may also form part of an FFS plan. It can address the size, width, and shape of the nasal bridge and tip. Jaw reduction surgery and chin surgery (genioplasty) address the lower face and may involve reshaping the lower jaw (mandible) or the chin bone (mentum) to alter the overall proportions of that area.
Surgery to the cheeks, lips, and surrounding facial muscles may also be discussed as part of your consultation. Each procedure carries its own considerations, recovery requirements, and risks, and not all of them will be appropriate or necessary for every patient.
Who Is Eligible for This Type of Surgery?
Eligibility is assessed on an individual basis. As a general principle, patients need to be in good overall health to safely undergo surgery and general anaesthesia. Age is also a factor, as facial bone development is not fully complete until early adulthood, and surgery is not appropriate for patients under 18.
Beyond physical health, a key part of the assessment is understanding your goals and whether your expectations of what surgery can achieve are realistic. Surgery can alter the appearance of facial features, but outcomes will vary from patient to patient depending on individual anatomy, healing, and a range of other factors.
A medical and psychological assessment forms part of the overall planning for surgery. Some patients also work with other healthcare providers for gender-affirming care, and the medical practitioner responsible for the surgery may request reports or referrals from them as part of the pre-operative assessment.
What Happens at a Consultation?
A consultation is the starting point for any discussion about this type of surgery. During a consultation, your facial structure will be reviewed alongside your medical history, and you’ll have the opportunity to discuss your goals and concerns.
This is also your opportunity to ask questions. You should feel comfortable asking about the experience with FFS, what procedures would be recommended based on your anatomy, what risks apply in your case, and what recovery involves. Asking questions and sharing your concerns openly is an important part of the consultation process.
Consultations are conducted on a one-on-one basis, with adequate time allocated to review your options thoroughly and address any questions you may have.
What Are the Risks?
Like all surgeries, FFS carries risks. These include the general risks associated with any procedure under general anaesthesia, such as bleeding, infection, adverse reactions, and blood clots, as well as risks specific to the procedures performed on the face.
More specific risks can include nerve damage, changes in sensation, asymmetry, scarring, and, in some cases, the need for revision surgery. The extent and likelihood of these risks will depend on which procedures are performed and on your individual health profile.
Before consenting to any procedure, all relevant risks will be discussed with you clearly. Taking time to consider all of the information before moving forward is an important part of making an informed decision.
What Does the Recovery Period Involve?
Recovery varies considerably depending on which procedures have been performed, the extent of the surgical work involved, and how your body heals. It is not a short process, and it’s important to have a realistic understanding of what recovery involves before committing to surgery.
In the days and weeks after surgery, swelling and bruising are expected. These are a normal part of the healing process and will settle over time, though the timeline differs for each patient. Discomfort is also expected, and guidance on pain management will be provided as part of your post-operative care.
You will likely need to arrange time away from work and regular activities, and there will be restrictions on physical exertion during the healing period. For procedures involving the bones of the face, full recovery and the settling of swelling can take several months. Post-operative care and follow-up appointments are an important part of the process, and clear instructions will be provided for how to care for yourself at home.
Why Choose Dr Hunt for Facial Feminisation Surgery in Sydney
Dr Jeremy Hunt is a registered specialist plastic surgeon with more than 20 years of surgical experience. He holds a Bachelor of Medicine and Bachelor of Surgery from the University of Sydney (MBBS), is a Fellow of the Royal Australasian College of Surgeons (FRACS), and is a Member of the Australian Society of Plastic Surgeons (ASPS), the Australian Society of Aesthetic Plastic Surgeons (ASAPS), and the International Society of Plastic Surgeons (ISAPS). He completed a Craniofacial Fellowship at the University of Texas, where he received advanced training in the bones and soft tissues of the face, skull, and jaw. He also serves as a Consultant Surgeon at Sydney Children’s Hospital and the Prince of Wales Hospital.
His Craniofacial Fellowship training is directly relevant to facial feminisation surgery, as many of the procedures involved require a detailed understanding of facial bone structure and surgical techniques specific to the craniofacial region. This includes forehead contouring, jaw reduction, chin surgery (genioplasty), and hairline lowering, all of which Dr Hunt performs as part of his FFS practice.
If you are considering facial feminisation surgery, your situation is assessed on an individual basis. During a consultation, Dr Hunt reviews your facial structure, explains which procedures may be considered in your case, and outlines the possible risks and recovery aspects so you can make an informed decision.