A Complete Guide to FFS at FFS Institute

At FFS Institute—a Beverly Hills-based gender-affirming care center founded by Dr. Henry Chen—you’ll be cared for by highly sought-after specialists with extensive experience in FFS procedures.

We approach the face as a cohesive whole, and always aim to create results that feel natural and balanced rather than like separate, isolated procedures.

This commitment to natural facial harmony is one of the primary reasons so many patients go to us for FFS.

At FFS Institute, we understand that FFS isn’t just about changing how you look. It can be a deeply meaningful step toward feeling safer, more confident, and more at home in your own skin.

You may have lived for years with features that don’t reflect who you are—or perhaps you’ve already taken steps with hormones, makeup, or smaller treatments, but still feel that your face doesn’t fully align with your identity.

Know that you’re not alone, and we’re here to help.

Looking for specialists who offer personalized FFS care, using techniques tailored to areas such as the forehead, jawline, and nose, and a supportive experience from your first consultation through recovery?

That’s us. We’re happy to meet you where you are in your journey and guide you through each step with clarity and compassion.

If you’re ready to take the next step in becoming the woman you know yourself to be, we invite you to schedule a consultation at FFS Institute.

Call our Beverly Hills office at (310) 237-1392 to begin your transformation with confidence.

Meet the Specialists at FFS Institute

At FFS Institute, your care is led by Henry Chen, MD, MBA, FACS, a double board-certified facial plastic and reconstructive surgeon with specialized expertise in facial feminization surgery.

Throughout his nearly 20 years of clinical experience, Dr. Chen has successfully performed over 1,000 FFS procedures.

He is a proud member of the American Academy of Facial Plastic and Reconstructive Surgery and the American Academy of Otolaryngology–Head and Neck Surgery.

Today, Dr. Chen is widely recognized for his unparalleled FFS expertise and compassionate, patient-centered approach.

His attention to detail and commitment to personalized care have helped many patients feel more aligned and confident in their appearance.

At FFS Institute, this philosophy guides everything we do. Our mission is to provide a space where you feel seen, supported, and genuinely affirmed—every step of the way.

Your Care Team

Alongside Dr. Chen, you’ll also meet FFS Institute’s coordinators and support staff—people who are here to guide, reassure, and walk with you through every stage of your journey.

Meghan

Front Office Coordinator

Meghan is often the first person you’ll hear. She helps with scheduling, answers initial questions, and makes sure your experience begins smoothly and comfortably.

Emmy

Patient Care Coordinator

Emmy supports you throughout your surgical planning. She manages surgery scheduling and finances, facilitates communication with Dr. Chen, and offers additional help whenever you need it.
Together, our team works to ensure your experience feels organized, caring, and tailored to you from start to finish.

Every recovery is different, but most patients follow a similar general timeline. Here’s a clearer, more approachable sense of what to expect after facial feminization surgery at FFS Institute.

Right After Surgery (Day 0 to Week 1)

You’ll wake up from general anesthesia with bandages and sometimes splints, depending on the procedures you had.

Early bruising, swelling, and even minor bleeding are all normal at this stage. The good news is that incisions typically close within a week.

You may also feel pressure or soreness, especially if you had multiple procedures, but don’t worry—pain is usually well-managed with medication.

Most people take narcotics for the first four to five days and then switch to Advil or Tylenol.

Your face and neck will likely be puffy, and most of the swelling often settles around the jaw and neck as gravity naturally pulls fluid downward.

As part of your early post-op recovery, you’ll have to keep your head elevated while sleeping and avoid any strenuous activity.

First Month

If you’ve had a lower face procedure, Dr. Chen recommends wearing a compression garment for at least eight hours a day during the first month.

During this time, swelling usually begins to improve, although some puffiness is still typical. Many patients even start to notice early hints of their new appearance as the healing process continues.

Light work and gentle activity often resume two weeks after your FFS with your surgeon’s approval.

Many also feel comfortable being seen in public around this time, even with visible swelling. Some describe a growing sense of confidence as their features start to align with their identity.

About Three to Six Months

Facial transformation becomes more apparent between three and six months, but final results take longer.

A Year After

Final results take about one full year. By that point, most swelling has resolved, scars have softened, and both bone and soft tissue have completely settled.

This is also why surgeons usually wait at least 12 months before considering any revision procedures—your face needs time to reach its true final form.

That said, recovery can still vary from person to person. A few key factors can influence your timeline:

• Number and types of procedures: More extensive surgery usually comes with a longer recovery period.
• Bone work vs. soft tissue: Jaw and chin bone contouring may take longer to settle than soft-tissue procedures.
• Your health: Good nutrition, avoiding smoking, and keeping medical conditions well-managed all support better healing.
• Aftercare: Following post-op activity guidelines and attending follow-up visits can make recovery smoother and faster.
• Your natural physiology: Everyone heals differently. Some people experience more swelling or simply need more time—and that’s completely normal.

Each healing journey is unique, and it’s okay if yours takes a little longer. The important thing is that you’re steadily moving toward the results that feel right for you.

What Are the Risks and Complications of Facial Feminization Surgery?

FFS is generally safe when performed by a qualified specialist, but like any procedure, it still carries risks.

At FFS Institute, we believe in being open and transparent about these possibilities so you feel informed, prepared, and supported every step of the way. We also guide you through the steps you can take to help reduce your risk of complications.

Some general risks may include:

• Bleeding
• Infection
• Possible injury to structures near the area being operated on
• A potential adverse reaction to the anesthesia

Other FFS-specific risks may include:

• Scarring on the face
• Possible injury to the facial nerves
• The incision coming apart as it heals (dehiscence)
• Fluid accumulation under the skin (seroma)
• A firm swelling caused by trapped, clotted blood (hematoma)
• Voice or swallowing changes after a tracheal shave
• Prolonged swelling (especially around the jaw and neck)

We keep these risks low by having procedures performed by a double board-certified facial plastic and reconstructive surgeon with extensive FFS experience.

Thorough preoperative planning and scheduled follow-up visits also help ensure any concerns are addressed early.

That said, if you notice any warning signs, such as fever, worsening pain, unusual swelling, drainage, persistent bleeding, or changes in mental status, we advise contacting your surgeon right away.

Recovery Tips for Facial Feminization Surgery

Caring for your skin and incision sites is vital to helping your body heal comfortably and allowing your results to take shape over time.

To support a smoother recovery, here’s what Dr. Chen typically recommends:

• Applying ice to surgical sites for the first 3 days, placing it on for 3 to 5 minutes every hour while you’re awake. This helps ease swelling and keeps you more comfortable as you begin to heal.
• For incision care, a thin layer of bacitracin ointment three times a day helps keep the area clean and protected.
• You can usually shower two days after surgery, but keep the water warm (not hot) and avoid scrubbing your incisions. Just let soapy water run over them and gently pat dry.
• Use the two-medication strategy (Ibuprofen + Acetaminophen) as instructed—reserve narcotics for breakthrough pain and plan to taper as soon as comfortable.
  If you had lower-face or neck procedures, you’ll go home with a special dressing that helps control swelling.

We recommend continuing to wear a compression garment during the first month to support healing and reduce fluid buildup under the skin.

In the longer term, simple healthy habits make a big difference. Avoid smoking, stay well-nourished, and keep your skin moisturized as your healing continues. These small steps help support your recovery and your overall well-being.

Once your incisions have closed and your surgeon gives the OK, gentle scar massage or silicone gel sheets may help your scars mature more smoothly.

Beyond the physical healing, it’s also important to acknowledge the emotional side of recovery. FFS can stir up a wide range of feelings, and that’s completely normal—especially when the surgery is so closely tied to your sense of self.

Surrounding yourself with supportive people can make a meaningful difference, whether that’s close friends, a partner, or a mental-health professional familiar with gender-affirming care.

There may be days when the swelling, bruising, or early changes in your appearance feel overwhelming. Reminding yourself that these ups and downs are expected can help you move through the process with more ease.

And remember, you’re not doing this alone. Staying connected with your care team is encouraged, and FFS Institute welcomes check-ins by text or phone between visits so you always have support when you need it.

Research shows that many people experience a boost in confidence and satisfaction after facial feminization surgery.

In one international, multicenter study published in Plastic and Reconstructive Surgery, patients’ facial feminization scores rose from a median of 47.2 before surgery to 80.6 at six months or later, indicating a strong shift toward feminine facial perception.

Another study using the FACE-Q (a patient-reported outcomes tool) found that transfeminine patients who had FFS reported higher “Satisfaction with Facial Appearance Overall” than those on hormones alone.

These studies show high levels of satisfaction among FFS patients, especially compared to nonsurgical care.

That said, results and satisfaction can vary from person to person. Here’s what most patients can realistically expect:

• You’ll likely see a noticeable improvement in how feminine your face looks and how well your appearance matches your identity.
• Significant changes are often stable by six months, but your final results can take a year or more as swelling settles and tissues refine.
• FFS can create a much more feminine appearance, but it doesn’t guarantee an exact match to every cisgender reference point. Instead, the goal is to help your features align more naturally with who you are—so you feel more at home in your own skin.

Because FFS often involves several procedures across different facial regions, the more comprehensive the plan, the longer and more layered the healing process may be.

A few factors tend to influence outcomes and overall satisfaction:

• The number of areas treated: Patients who address all three facial thirds (upper, mid, lower) often report the highest satisfaction because more gendered features are corrected.
• Timing and age: Younger FFS patients and those who proceed sooner after deciding on FFS surgery reported higher satisfaction scores.
• Surgeon expertise: FFS requires a specialist who understands bone work, soft-tissue anatomy, and gender aesthetics.
• Your expectations and emotional readiness: Feeling informed, supported, and prepared for the healing timeline helps the whole experience feel smoother and more empowering.
• Your own healing biology: Swelling, tissue behavior, and scar maturation vary from person to person, especially when multiple procedures are done at once.

Will I Need More Than One Facial Feminization Procedure to Maintain My Results?

No. You won’t need additional facial feminization surgery to maintain your results. Once the bones and soft tissues have healed, your feminized features are long-lasting.

That said, aging is a natural process for everyone, which is why some patients choose optional procedures later in life to address natural age-related changes.

Others may consider a revision or minor refinement if something heals differently than expected or if they want a minor adjustment. These follow-ups aren’t routine, but they are possible and can be discussed with your surgeon if needed.

Beyond revision work, some people also choose anti-aging or maintenance treatments down the road for reasons unrelated to the original feminization.

Are Facial Feminization Surgery Results Permanent?

Yes. FFS changes the underlying facial structure, so the feminizing effects themselves don’t fade or wear off over time.

That said, the soft tissues around the bone continue to age just like anyone else’s. Skin, fat, and muscle naturally change over time, which can gradually soften or reduce volume.

All faces change as we age: fat can diminish, cheeks can descend, and tissue can gather along the jaw and neck.

Even fat transfer, while designed to be long-lasting, can slowly decrease over time as part of the natural aging process.

Because the underlying structure remains feminine while the surface tissues evolve, some patients eventually choose minor touch-ups, such as fat grafting, skin-tightening treatments, or other refinements, years later.

FFS Before and After Gallery

See how the FFS Institute has helped patients finally feel at home in their own reflection and move through the world with more comfort, confidence, and pride, one face at a time.

Patient 01

Facial feminization surgery became a turning point for her. As her facial features began to align more closely with how she had always seen herself, she felt more at ease in her own skin.

Her results show softer, more traditionally feminine contours: a smoother forehead, a more refined jawline and chin, and a nose that feels harmonious with the rest of her features.

For her, the journey included forehead and jaw/chin contouring, and a tracheal chondroplasty (tracheal shave). She also had a brow lift, an upper lip lift, and a revision rhinoplasty.

Each step contributed to changes that helped her feel more confident and more connected to the person she’s always known herself to be.

Charlotte K.

Meet our patient, Charlotte. She had long imagined feeling more at home in her facial features and chose to pursue facial feminization surgery as part of that journey.

Charlotte’s procedures included a face and neck lift, a brow lift, and an upper lip lift. She also underwent scalp advancement (hairline lowering), forehead contouring, and rhinoplasty.

We’re grateful for her trust and openness in sharing her experience, and we’re glad to share the results of her FFS journey.

We offer a range of nonsurgical and minimally invasive treatments that can gently enhance feminine features or support the results of surgical facial feminization.

These treatments don’t reshape bone the way full FFS does, but they can soften angles, add volume, and improve skin quality in ways that complement a feminized look.

Here’s how these treatments support feminization

• Fillers and fat-based volume treatments add softness and fullness to areas that typically read as feminine, such as the cheeks, lips, temples, and the under-eyes.
  Fillers aren’t permanent, but they can provide meaningful contour changes for one to two years.
• Neuromodulators like BOTOX® help relax overactive muscles, soften harsh lines, and even create a slimmer appearance in the lower face when used in specific muscle groups.
• Skin-resurfacing treatments can help brighten and smooth the skin, reduce texture, and soften fine lines—giving the overall face a more refined, traditionally feminine quality.

Note that these treatments can’t change the underlying facial structure. They won’t narrow a jaw, reduce a brow bone, move a hairline, reshape a nose, or reduce the Adam’s apple.

Fillers and neuromodulators also require repeat treatments to maintain results, and even the best skin procedures can’t replace the feminizing effects of bone or cartilage work.

They may support soft feminization and maintenance, but not full transformation.

That said, many patients use these treatments alongside their surgical journey. Some choose them before surgery to improve skin quality or soften certain areas while planning for a larger procedure.

Others use them after surgery—once healing has progressed—to fine-tune their results or maintain facial harmony over the years.

For patients who aren’t ready for full FFS yet, nonsurgical options can offer helpful, confidence-boosting changes until they’re able to move forward with a surgical plan.