Treatment guide

Facial Feminization Surgery (FFS)

Facial Feminization Surgery (FFS) is a suite of cosmetic procedures that aim to make the patient's facial features more closely resemble conventional female ones. A variety of different facial features can be included in FFS including eyebrows, noses, lips, and cheeks. The procedure is most common in individuals with gender dysphoria but may also be chosen by women who simply feel their face is excessively masculine.

The content has been reviewed for quality and accuracy to the best of our knowledge by Qunomedical and its Medical Board of Experts.

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  • Individuals who experience gender dysphoria causing the feeling of being a woman living inside a man's body, and therefore seek to change their physical appearance.

  • Women who are unhappy with their facial appearance, particularly those with prominent brows and foreheads or jawlines that are excessively wide.


  • Discharge from hospital usually takes place one to two days after surgery.

  • Full recovery commonly takes four to six weeks although patients can return to normal life almost as soon as they return home

  • Specific recovery times may vary for more or less complex feminization procedures


  • Success rates are very high for single feminization operations. Studies have found that around only 5% of patients require corrective surgery following the procedure.

  • Minor touching up procedures are more common, occurring in around half of cases.


Facial feminization operation times vary depending on the number of procedures needed, but a total duration of three to ten hours is routine.


  • As with most cosmetic procedures, FFS comes with a risk of inflammation, infection, bone injuries, and haematomas.

  • Specific risks could also include implant migration (for patients undergoing cheek implants) and hair loss near incisions made around the hairline.

  • A general anaesthetic is required, which also poses possible risks, and nerve damage can occur in rare cases.

How does it work?

What is facial feminization surgery FFS?

Facial Feminization Surgery aims to allow individuals to make their appearances match the way they feel. Conditions like gender dysphoria can lead to intense discomfort concerning an individual's physical appearance and by reshaping features like brows and cheeks, surgeons can help to alleviate those emotions. This is achieved via a mixture of plastic surgery procedures and is carried out by surgeons who are specialists in feminization procedures.

How does facial feminization surgery work?

Before an FFS procedure is carried out, it is essential to make appropriate preparation. Patients will meet with surgeons to discuss the aims of the procedure and which features of their face require attention. There may also be psychological input to ensure that individuals are ready for serious cosmetic surgery. When the time comes for feminization surgery, hospital admission usually takes place one day before surgery is scheduled, although same day admissions are possible. Surgery generally lasts a period of hours. All of the procedures required as part of the process are covered in this session, which takes place under general anaesthesia. Most procedures require work on both the upper and lower parts of the face. In some cases, there will be the option of dividing the surgery for the upper and lower sections between three surgical sessions. However, surgeons tend to prefer operating once to ensure good results.

The surgery itself varies, it may involve the following procedures (depending on your needs and current facial structure):

  • Forehead recontouring: This may require surgeons to shave the brow bone, although more extensive recontouring involves removing the frontal sinus bone, altering the bone underneath then replacing the frontal bone.

  • Rhinoplasty is also commonly part of FFS along with surgery to enhance the upper lips, ensuring a feminine appearance.

  • Genioplasty and Cheek augmentation: The jaw and chin may also undergo augmentation or reduction. In some cases, surgeons will also have to raise the cheeks (cheek augmentation). Both chin and cheek augmentation procedures require intraoral (inside-the-mouth) incisions and generally require the use of surgical implants.

  • Finally, surgeons may decide to carry out a jaw reduction to smooth out protrusions, while a tracheal shave can reshape the patient's Adam's Apple. Again, this requires an incision, this time beneath the chin.

The duration of surgery depends on which of these procedures will be required, and they are not needed in all cases. When all of the required procedures are completed, discharge usually follows within one to two days.

Are there different types of facial feminization surgery?

Yes, there are many different types of facial feminization FFS procedure. Each FFS procedure can include many smaller cosmetic operations. These can include:

  • Cheekbone augmentation

  • Forehead contouring

  • Hairline lowering

  • Rhinoplasty

  • Lip lifts

  • Tracheal shaving

  • Chin recontouring

  • Jaw reduction

  • Earlobe reduction

The exact mixture of procedures depends on the facial shape of the patient and the appearance that they desire. Some people may already have feminine features such as lips or cheeks yet desire more feminine forehead contours or nasal shape. So there is no one style or template for FFS.

What should I expect?

When you choose facial feminization surgery, it's important to talk through the process with your cosmetic surgeon. They will help you understand the benefits and limitations of cosmetic surgery as well as what the surgery involves.

After surgery, expect to feel some pain around your wound sites. Many FFS procedures require incisions inside the mouth, which can cause pain as they heal. And these incisions also have the potential to become infected.

The wounds will most likely be healed around six weeks after surgery. At this point, you can apply make-up and resume all aspects of normal life. However, this is not the end of the process. Your appearance will continue to change for a period of months after the operations as your chin, forehead, nose and lips settle down.


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