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The Facial Feminization Surgery FFS Guide

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If you’re a transgender woman, you may have heard about facial feminization surgery (FFS). Others call it FFS surgery while some refer to it simply as FFS. No matter what you call it, it’s one of the most integral parts of surgical male-to-female transitioning.

If you’re interested in facial feminization, keep reading.

Please know that this guide was only created to help transgender women. It’s not claiming to be an academic resource nor an ffs glossary. However, please know that all of the information listed here comes from reliable sources.

Why Some Undergo Facial Feminization Surgery

There are many reasons as to why some people undergo this kind of plastic surgery. It’s not exclusive to transgender women. Some cisgender women undergo it too for various reasons.

A Vital Step Towards Fully Transitioning

The body is important if a transgender woman chooses to physically transition. Apart from the common popular choices for transgender surgery, the vaginoplasty, a lot of them also focus on the secondary sexual characteristic, the breasts.

However, for some, they don’t only consider s*xual characteristics important. Other transgender women want to match their bodies with the typical “feminine” face as well, hence, the choice of undergoing the surgery.

Gender Dysphoria

In connection with transitioning, a lot of transgender women have elevated levels of gender dysphoria. If they don’t feel like their faces don’t match the typical description of what a feminine face is, their mental well-being may be impacted negatively as well.

Yes, some women are considered beautiful even if they don’t measure up to the typical feminine type of beauty. However, transgender women have often been marginalized and it’s why some of them are not opening cracks towards being discriminated against for not fitting a common standard of beauty.

Body Dysmorphic Disorder

As mentioned earlier, it’s not only transgender women who undergo FFS. Some people have a mental disorder called body dysmorphic disorder (BDD). This makes them think that certain parts of their bodies are ugly (including the face).

Some famous personalities who are often tagged to have this disorder are American socialite Jocelyn Wildenstein and Ukrainian model Valeria Lukyanova.

What is the surgery Exactly?

The controversial facial feminization surgery, also known as FFS, is a surgery that involves the modification of one’s facial characteristics. It’s known to be the most effective way of demasculinizing one’s facial structure. The most common demographic that avails this type of surgery is transgender women.


Cosmetic surgeries of the nose and bone structure are what usually encompass it. Apart from the face, surgeries done on the neck and soft-tissue work may also be involved if deemed necessary by the doctor.

The ultimate goal of the FFS is to help someone achieve a soft and feminine look. A facial feminization surgery is tailor-made for every individual, some may need minimal work while others may need more.

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Common Facial Feminization Procedures

As mentioned above, not everyone who chooses to get the surgery will get the same cosmetic surgery package. Below’s a list of the most common procedures that are recommended in facial feminization surgeries.

facial surgery

Shaving of the Trachea (Adam’s Apple)

Because most ffs patients are transgender women, a tracheal shave is usually recommended. This helps in reducing the appearance of one’s adam’s apple.

Most doctors shave the adam’s apple by making an incision on its location but others slice just below the chin for the scarring to be less noticeable.

Jaw Surgery

A prominent jaw is usually considered masculine. This is why it’s one of the most common surgeries to soften one’s facial structure. The jaw surgery focuses on the corners of the jaw where the bone turns up to the ears.

However, these protrusions are risky to soften as one may end up with severed nerves.

Before considering this type of surgery, be very sure that your doctor has expertise in the area. Aggressive reductions may cause serious damage. It’s important not to push beyond the limits.

Sometimes, a neck lift is recommended as well to give the overall feminine look.

Forehead Softening

A lot of transgender women have prominent brow bones. This is why this kind of cosmetic procedure is often at the top of the list. This involves shaving down the hard angles of one’s forehead to give it a more feminine and rounder look.

However, like with the surgery, this has certain limits. If done aggressively, the patient may suffer from a hole in the sinus cavity. This can be daunting as some procedures include the temporary detachment of the brow bone.

Hairline Surgery

Hairline alterations often come with forehead softening. This happens in order to combat the effects of male pattern baldness or receding hairlines which affect transgender women.

This is done by making an incision in the scalp. Most commonly, the hairline is cut open to move the scalp and hairline forward which results in a lower hairline. This technique has been the only available method for years.

Other people opt for hair transplants instead. It’s less invasive and helps in covering the hairline which gives it a lower appearance along with addressing male pattern baldness very well.

Soft-tissue Procedures

Many transgender women go for soft-tissue procedures because plumper facial features are considered to be more feminine-looking. The common works that are involved in soft-tissue procedures are:

  • Lip and dermal fillers
  • Facelifts
  • Lip lifts
  • Eyelifts and Eyebrow lifts

Cheek Alterations

A feminine face is usually considered to be plump. Estrogen helps in distributing fat to the face to give it a rounder and softer look. However, for some, hormone replacement therapy is simply not enough to address the issue. This is why cheek procedures exist.

The most common technique is cheek augmentation but is only recommended by surgeons in certain cases. These may involve fat grafting, silicone implants (cheekbone), and dermal fillers.

Nose Alterations

Thinner and shorter noses are coveted because they are considered feminine and beautiful. The nose is the center of the face and is why it’s one of the most popular cosmetic surgery procedures. The most common practice is rhinoplasty which involves surgery and contouring of the shape of the nose.

Rhinoplasty is a technique that’s often recommended because it allows the surgeon to work freely in designing a more feminine nose. Since it’s invasive, it provides the surgeon with better implementation in giving one’s face a more harmonious and proportionate look.

Lip Alterations

The lips are considered important when it comes to physical attraction. Most men find fuller lips desirable. Biological males have thinner lips and this is why lip alterations are often offered in ffs packages.

Furthermore, there are noticeable nuances when it comes to feminine and masculine lips. Feminine lips have a shorter distance between the upper lip and the nose.

Added to that, the upper lip that’s curled upwards is considered to be a more feminine type of structure.

Is FFS Surgery Safe?

Most of the procedures that come along with FFS are usually safe. However, it’s still important to consider the possible risks especially if the doctor is not certified or an expert in this craft.

  • Chin and cheek implant infections
  • Damage of the nerves in the chin or jaw. Should this happen, a permanent loss of function or feeling in the tongue and face may be obtained.
  • Undesired results. There’s always a risk of not being satisfied with the doctor’s work.
  • Be aware that the incision in the scalp in forehead alterations may also cause severed nerves. However, most patients regain the sensation and recover well from this procedure.

Moreover, if you’re planning to go for fillers, never get permanent fillers such as silicone oils. Silicone oil, when directly injected into the skin, can cause skin infections.

Opt for other temporary fillers such as hyaluronic acid or hydrogel.

Famous Plastic Surgeons for FFS in the US

  • Dr. Jordan Deschamps Braly
  • Dr. Harrison H. Lee
  • Dr. Kathy Rumer
  • Dr. Joel Beck
  • Dr. Michelle Lee
  • Dr. Helena Guarda
  • Dr. Josef Hadeed
  • Dr. Jeffrey B. Marvel
  • Dr. Christopher Salgado
  • Dr. Ella Zara Ley
  • Dr. Jonathan Keith
  • Dr. Mark Youssef
  • Dr. Manish Champaneria
  • Dr. E. Antonio Mangubat
  • Dr. Timothy Alexander
  • Dr. Gerhard S. Mundinger
  • and more

See more here.

Please know that we are not affiliated with the doctors above. We’ve just listed them to help you better.

Facial Feminization Surgery Cost

There is no standard cost of the surgery globally. However, in the US, the cost range of FFS surgery usually starts from $20,000 to $50,000.

This rate can go higher depending on the expertise and popularity of the doctor. Furthermore, the price also highly depends on the number of procedures one’s planning to undergo.

a doctor

In Thailand, facial feminization surgery cost is a bit friendlier. It may start from $3,000 to $20,000. Again, the range may increase depending on the number of procedures and the popularity of the surgeon.

Is FFS Mandatory in Transitioning?

Facial feminization surgical plans rely on an individual’s choice. They are not necessary in order to be considered a woman.

The choice to feminize the face greatly helps in relieving symptoms of gender dysphoria but at the end of the day, one must be ready for the risks and costs.

a transgender woman

If you’re not financially ready yet, you must discover the wonders of:

  • vitamins
  • hormone replacement therapy
  • proper skincare
  • makeup

Should money not be the issue and the risks outweigh the benefits for you, there’s no need to force yourself to undergo this surgery.

Physical beauty is something, but not everything. After all, the hottest thing that a woman could possess is confidence.

Now, if you have the means and you’re ready to take the next step, go for it. Just remember not to skimp and only undergo ffs from highly reputable surgeons.

Posted in Informational
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About the author

Amanda Valentine Dela Cruz
Amanda Valentine is a transgender woman who has written about trans topics for over 10 years for My Transgender Date. She is an author who made it on Amazon’s best-seller list by writing 5 books on trans women’s relationships. Her book “Dating Transgender Women for Gentlemen” peaked at #3 in the Transgender Studies category on Amazon. She started writing at the age of 10 and won a poetry contest in 4th grade which convinced her to pursue a career in literature. Her personal experiences as a transgender woman give her a unique perspective on trans topics.

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