FFS: A Guide to Facial Feminization Surgery and What It Means

If you’ve been researching facial feminization surgery (FFS), you’ve likely noticed how much expertise and precision the procedure requires.

Facial feminization involves a high level of specialization, combining detailed knowledge of facial anatomy, gender-related aesthetics, and thoughtful, individualized surgical planning.

Because of this level of complexity, choosing a team with focused experience in FFS is especially important. At FFS Institute, founded by double board-certified surgeon Dr. Henry Chen, your care is led by specialists with extensive experience performing FFS procedures.

We approach the face as an integrated whole, aiming for results that look natural, balanced, and harmonious, not simply a series of isolated changes.

This emphasis on overall facial balance is one of the key reasons many patients choose to work with our team.

We also understand that FFS isn’t just about changing how you look. For many, it can be a deeply meaningful step toward feeling safer, more confident, and more at home in their own skin.

Many people come to us after years of living with facial features that don’t reflect their identity, or after finding that hormones and other treatments haven’t fully addressed facial concerns. If that experience feels familiar, you’re not alone, and we’re here to help.

We offer specialized techniques for the forehead, jawline, nose, and other key areas, supported by a structured and attentive care experience from your first consultation through recovery. We focus on clarity, communication, and professionalism at every stage.

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

If you’d like to learn more, we invite you to schedule a consultation at FFS Institute. You can call us at (310) 237-1392 to take the next step forward with confidence.

Key Takeaways

• In gender-affirming care, FFS stands for facial feminization surgery, a set of procedures used to create more feminine facial features.
• At FFS Institute, facial feminization is led by Dr. Henry Chen, an award-winning double-certified facial plastic and reconstructive surgeon.
• Throughout Dr. Chen’s nearly 20 years of clinical experience, he has successfully performed over 1,000 FFS procedures. He has been honored with Top Doctor awards from 2019 to 2026 for his compassionate approach to care.
• Recovery after FFS looks a little different for everyone, and that’s completely normal. That said, final results may take about 12 months to develop.
• FFS pricing varies based on the extent of surgery. Out-of-pocket costs at FFS Institute can exceed six figures.

What Does FFS Actually Stand for?

In gender-affirming care, FFS stands for facial feminization surgery. It refers to a group of plastic surgery procedures for male-to-female (MTF) patients within the broader framework of gender-affirming surgery (GAS), encompassing both genital and non-genital care.

What Is Facial Feminization Surgery (FFS)?

FFS refers to a group of procedures designed to reshape facial features to make them appear more traditionally feminine.

These procedures may address areas such as the hairline, forehead, brows, nose, cheeks, lips, jaw, chin, and Adam’s apple.

FFS is grounded in sexual dimorphism, which refers to biological differences in observable traits (such as facial features) between the sexes.

Because of this, successful facial feminization requires a detailed understanding of the anatomical differences between typically male and female facial structures.

Who Might Need Facial Gender Surgery? Who Is a Good Candidate for Facial Feminization Surgery?

If you’re considering FFS, it’s natural to wonder whether you’re an ideal candidate. In reality, eligibility isn’t about fitting into a specific label, but about how your facial features impact your sense of self and how you move through the world.

FFS can support a wide range of people who want their facial appearance to better align with their internal self, including:

• Transgender women whose masculine facial features continue to cause gender incongruence, even after living as women or undergoing hormone therapy.
• Gender-nonbinary individuals who want their features to appear more feminine.
• Cisgender women seeking to refine or enhance specific feminine facial features.
• Anyone experiencing gender dysphoria (distress associated with a perceived mismatch between the sex assigned at birth and gender identity).

From a medical standpoint, FFS may be considered if you are healthy enough for surgery, have stable mental well-being, and have goals that align with what these procedures can realistically achieve.

Who Shouldn’t Have Facial Feminization Surgery?

Not everyone is ready for FFS, and that’s completely okay.

FFS can be a life-changing step, and part of responsible care is ensuring you’re physically and emotionally prepared before moving forward.

You may hear surgeons use the term “contraindications,” which refers to factors that make surgery unsafe or not advisable at a given time.

Below are some situations where FFS may not be the right option at this time:

• Medical conditions that increase surgical risk
  If you have a health issue that raises the risk of surgery, your surgeon may recommend waiting or addressing those concerns first.
  
  These conditions may include heart disease, bleeding disorders, or complications related to general anesthesia.
• Significant or unstable mental health concerns
  You don’t need perfect mental health to pursue FFS. However, if you’re currently experiencing a mental health crisis or symptoms that aren’t yet stable, it’s safer to reconsider your options.
  
  This approach is consistent with the WPATH (World Professional Association for Transgender Health) Standards of Care, which emphasize mental readiness for transformative procedures and the recovery process that follows.
• Expectations that exceed what surgery can realistically provide
  If you’re hoping FFS will solve every challenge in your life, guarantee social acceptance, or completely eliminate dysphoria immediately, more time and reflection may be helpful.
  
  FFS can be profoundly supportive, but it cannot address every aspect of a person’s lived experience.
• Being underage or not developmentally ready
  FFS is generally performed on adults, often those over 18. Current guidance emphasizes legal adulthood and informed decision-making.
  
  Beyond that, there is no single “ideal” age. Readiness depends on your health, goals, and timing.

Procedures Included in Facial Feminization Surgery: What Is Done in Facial Feminization Surgery?

When it comes to FFS, the most impactful procedures are those that address the facial features that most strongly communicate gender.

For many people, these include the forehead and hairline, brows and eyes, nose, midface volume, jawline, chin, and, in some cases, the trachea.

Rather than focusing on dramatic changes to a single feature, our approach centers on the face as a whole.

At FFS Institute, our specialists evaluate how each area works together and prioritize feminizing the features that matter most, while keeping results soft, natural, and balanced.

The goal is never to look “overdone,” but to help you look like yourself in a way that better aligns with your gender identity.

• Upper Face Procedures
  • Forehead contouring: This helps soften a prominent brow ridge and gently reshapes the bone for a smoother, more relaxed look.
  • Hairline advancement: This brings the hairline forward and smooths out an“M-shaped” hairline pattern to create a softer, more feminine shape for your face.
  • Brow lift and upper eyelid surgery (blepharoplasty): These procedures lift the brows and open up the eyes, helping create a brighter, more feminine expression.
• Midface Procedures
  • Cheek augmentation: This may involve fat transfer or implants to add gentle fullness and definition to the cheeks.
  • Feminizing rhinoplasty: This reshapes the size, width, and tip of the nose to better match feminine proportions, while still supporting healthy breathing.
  • Lip lifts and lip augmentation: These procedures can shorten the upper lip or add fullness for a softer look.
  • Fat grafting: This helps soften hollows in areas such as the cheeks, under eyes, temples, and around the mouth
• Lower Face and Neck Procedures
  • Jaw contouring: This reduces width and sharp angles to help transition a square jawline into a more tapered, heart-shaped contour.
  • Chin contouring (genioplasty): This reshapes or reduces the chin to create a shorter, narrower, and more oval or gently pointed profile.
  • Tracheal shave (tracheal chondroplasty or chondrolaryngoplasty): This reduces the prominence of the Adam’s apple to create a smoother, more refined neck profile.

Forehead and Hairline Procedures

The upper third of the face, including the hairline, brows, upper eyelids, and forehead, tends to show some of the most noticeable gender-related differences. That’s why this area is often a key focus in FFS.

To give you a clearer picture of what’s involved, below is an overview of upper-face FFS procedures and how each one can support facial feminization.

Forehead Contouring

A masculine forehead has frontal bossing or prominence that casts the eyes in shadow. With forehead contouring, the strong ridge of bone that can make the eyes look deep-set or more closed is removed, creating a forehead that feels rounder, lighter, and more naturally feminine.

Forehead contouring is sometimes performed by shaving the bone, but most commonly, it involves cutting out the anterior wall of the frontal sinus and setting it back in a more posterior position to achieve a feminine contour.

Brow Lift and Eyelid Surgery

The brows and upper eyelids play a significant role in how the eyes are perceived, and they often look different in typically masculine and feminine facial anatomy.

Feminine brows tend to sit higher with a softer arch, while masculine brows are usually lower and straighter.

A brow lift (sometimes referred to as a forehead lift) can help restore balance to the upper third of the face.

Over time, gravity and everyday facial movement can cause the brows and forehead to settle lower, which may lead to wrinkles, heaviness, or a tired look.

When the brows droop enough, excess skin can start to rest on the upper eyelids. A brow lift helps by gently lifting the brows and smoothing the forehead.

Upper eyelid surgery (blepharoplasty) can be performed alongside a brow lift to further refresh the eye area.

By removing excess skin and reshaping fat around the eyes, this procedure can help you look more rested and, when heavy eyelid skin interferes with vision, may also improve your field of view.

Hairline Lowering and Scalp Advancement

Many people assigned male at birth have a hairline that forms an “M” shape, often with some recession at the temples.

In contrast, a traditionally feminine hairline tends to look softer and more rounded, almost like an upside-down “U.”

If your goal is to soften or lower the hairline, a scalp-advancement procedure can move it forward, creating a more traditionally feminine contour.

Nose Surgery for Facial Feminization (Feminizing Rhinoplasty)

Feminizing rhinoplasty is a specialized type of nasal surgery that helps the nose function well while also fitting more naturally within a feminine facial framework.

Rather than reshaping the nose on its own, the goal is to achieve a result that looks refined, balanced, and in harmony with the rest of the face.

At FFS Institute, feminizing rhinoplasty may include subtle changes such as reducing overall size and refining the shape of the nose, usually with a slightly more delicate or gently upturned tip.

Many patients also choose to smooth the bridge by reducing a dorsal hump. In some cases, the nostrils can be reshaped or resized to add definition where the nasal structure feels heavy or droopy.

Because the nose plays such a central role in facial balance, feminizing rhinoplasty is often a part of a broader FFS approach.

Features such as the chin or jaw can also influence how the nose is perceived. That’s why many patients choose to combine rhinoplasty with other facial procedures to achieve the most balanced overall result.

Jaw Contouring and Chin Procedures

The jawline impacts how a face is read at first glance. A wider, more angular jaw is often associated with a masculine facial structure, while a slimmer, smoother jawline is perceived as more feminine.

Reducing jaw width and softening sharp angles can help the face appear more balanced and delicate overall.

A narrower gonial angle (the angle at the corner of the jaw) and a reduced jaw width contribute to a softer, more traditionally feminine appearance.

Jaw contouring, sometimes referred to as feminizing mandibuloplasty, focuses on reshaping the mandible (lower jawbone) to create a more rounded, egg-shaped facial outline.

Depending on your anatomy and goals, your surgeon may recommend combining jaw contouring with chin reshaping:

• Chin reduction
  During chin reduction, your surgeon can narrow or soften the chin by shaving a small wedge of bone and repositioning the chin segment.
• Chin augmentation
  For some patients, chin augmentation, rather than chin reduction, creates better overall balance and proportion.
  Augmentation can be done with implants, subtle bone reshaping, or a combination of techniques.

Recovery After Jaw or Chin Surgery for Facial Feminization

The jaw and chin area usually has the most noticeable swelling after surgery and often takes the longest to settle.

Because this region is gravity-dependent, swelling tends to collect there during the healing process.

After surgery, you may need to wear a specialized dressing to help reduce swelling. We usually advise patients to continue wearing a compression garment for the first month.

While early healing occurs within the first few weeks, the more noticeable changes from jaw or chin surgery usually start to show around three to six months.

Final results can take up to a year to fully develop as the swelling goes down and the tissues gradually settle.

Tracheal Shave (Adam’s Apple Reduction): What Happens During Tracheal Shave?

If the appearance of your Adam’s apple makes you feel self-conscious or feels at odds with a feminine appearance, a tracheal shave may help create a smoother, more refined neck contour.

This procedure reduces the prominence of the thyroid cartilage, allowing the neck to appear softer and more in line with a feminine profile.

During surgery, your surgeon makes a small incision in a natural neck crease to minimize scarring.

Through this opening, the visible portion of the cartilage is carefully reduced to soften the contour while preserving normal structure and function.

Risks and Complications of Tracheal Shave

Complications following a chondrolaryngoplasty are rare and typically mild. Here are the most common risks associated with tracheal shave:

• Voice-related changes
  In rare cases, voice changes may occur if the surgical technique does not adequately identify and protect the vocal fold level during the procedure.
• Pain and swallowing discomfort
  Some patients may experience short-term difficulty swallowing as postoperative swelling settles down.

Recovering From a Tracheal Shave Procedure

Most people recover relatively quickly after a tracheal shave. Mild discomfort is common in the first few days, and some patients may notice temporary hoarseness or mild difficulty swallowing solid foods while swelling subsides.

The Adam’s apple is a delicate area of the neck, so it’s important to work with a surgeon who has extensive experience operating around the larynx.

At FFS Institute, our specialists routinely perform procedures in this region so you can be confident about both your safety and your natural-looking results.

Cheek Augmentation and Fat Grafting

Cheek augmentation and fat grafting focus on the midface, adding volume and a subtle lift to the cheeks, under eyes, temples, and the area around the mouth.

Enhancing these areas can help create the softer, rounder contours often associated with feminine facial features.

With fat grafting, your surgeon carefully harvests fat from another area of the body (commonly the abdomen, thighs, or flanks) and transfers it to areas of the face that would benefit from added volume.

The goal is to create a smoother, more feminine contour. While transferred fat can be long-lasting, some volume loss may occur over time as part of the natural aging process.

Cheek fillers offer another way to enhance midface volume and lift.

Injectable fillers such as Juvederm or Restylane can add fullness to the cheeks and refine their overall shape, helping create a more balanced, refreshed appearance.

Lip Procedures for Feminization

Lip procedures in facial feminization focus on two features that often differ between masculine and feminine facial anatomy: the length of the upper lip and the overall fullness and shape of the lips.

In cisgender women, the distance from the base of the nose to the upper lip is shorter, whereas in cisgender men, it’s usually longer.

A lip lift can help shorten this distance, creating a gently elevated, more feminine-looking upper lip.

Lip volume can also be enhanced through options such as implants, injectable fillers, or fat transfer from another area of the body.

Additional Facial Feminization Procedures

Many FFS plans also include soft-tissue procedures that help fine-tune facial balance and expression.

These additional techniques offer subtle but meaningful refinements. They smoothen transitions, enhance contours, and ensure the final result feels cohesive and intentional rather than piecemeal:

• Facelift and neck lift
  In some FFS plans, particularly when aging or fullness has softened a previously tapered jawline, a facelift or neck lift may be recommended.
  
  These procedures can further refine the lower face and neck, helping restore definition and support overall facial harmony.
• Liposuction and fat grafting (under the chin and along the jawline)
  Liposuction and fat grafting are commonly used in gender-affirming body contouring for transfeminine, transmasculine, and nonbinary individuals.
  
  In facial feminization, liposuction under the chin or along the jawline can help reduce excess submental fat and improve definition.
  
  How effective this approach is depends on factors such as the amount of fat present and your skin’s elasticity.
  
  Fat removed through liposuction can also be processed and reinjected into other areas when additional volume is desired.
  
  This procedure often involves restoring softness to the cheeks or midface to enhance fullness and gentle curvature.

What Should You Look for in a Facial Feminization Plastic Surgeon?

Choosing the right surgeon is one of the most important decisions you’ll make when you’re considering FFS.

The checklist below can help you evaluate whether a surgeon has the training, experience, and approach needed to provide high-quality, gender-affirming care.

• Board Certification in a Relevant Specialty
  Look for board certification in a field closely related to facial surgery, such as facial plastic surgery or otolaryngology–head and neck surgery.
  
  Membership in reputable professional organizations, such as the American Academy of Facial Plastic and Reconstructive Surgery, the
  American Academy of Otolaryngology–Head and Neck Surgery, or the American College of Surgeons, can also show adherence to established standards of care.
• FFS-Specific Training and Clinical Experience
  Prioritize surgeons who specialize in facial feminization rather than those who only offer it occasionally as part of general cosmetic surgery.
  
  Experience matters, and a high volume of FFS procedures across all facial regions is a strong sign of real-world expertise.
• Expertise in Facial and Craniofacial Anatomy
  Qualified FFS surgeons should have formal training in facial plastic, craniofacial, or oral and maxillofacial surgery. They should also have proven experience operating on facial bones, soft tissues, and complex structures such as the frontal sinus, jaw, or larynx
• Before-and-After Galleries and Patient Stories
  Review consistent before-and-after photos from actual FFS patients, not just isolated results.
  
  Patient reviews and testimonials can also offer insight into the surgeon’s communication style, surgical skill, and sensitivity throughout the process.
• Alignment With Gender-Affirming Standards
  Look for a surgeon who listens carefully, demonstrates empathy, and understands how gender dysphoria can affect quality of life.
  
  A clearly stated practice philosophy that supports transgender and nonbinary patients is also a strong sign of affirming care.
• Accredited Facilities and Hospital Privileges
  Your surgeon should operate in accredited surgical centers or hospitals and ideally hold privileges at respected medical institutions, reflecting a commitment to safety and quality standards.
• Ongoing Education and Professional Leadership
  Surgeons who actively participate in research, conferences, publications, or teaching roles demonstrate ongoing engagement with their field.

Why Choose Our Award-Winning Surgeon for Your FFS Transformation

At FFS Institute, we understand that facial feminization surgery is a deeply personal journey.

It’s natural to want reassurance that the person to whom you’re entrusting your care has the experience, expertise, and empathy to understand your goals and provide the care you deserve.

Henry Chen, MD, our founder, is an award-winning, double board-certified plastic and reconstructive surgeon with nearly two decades of experience performing natural-looking, life-enhancing procedures on the face and neck.

His work is known for its attention to detail, balance, and results that look refined rather than overdone.

Dr. Chen holds board certifications from leading U.S. organizations, including the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery.

His commitment to high-quality, patient-centered care has earned him wide recognition within the field, including:

• Gordon Award for Exceptional Customer Service and Patient Satisfaction
• Vitals Preferred Provider
• Los Angeles Magazine Top Doctor (2019–2026)
• Southern California Super Doctor (2020–2026)

After nearly 12 years at Cedars-Sinai Medical Center, Dr. Chen opened his private practice in January 2024.

He remains actively involved in academic medicine as an assistant professor in the Otolaryngology Residency Program at Cedars-Sinai and is an invited lecturer at national meetings focused on facial feminization surgery.

Throughout his nearly 20-year career, Dr. Chen has built a reputation for delivering consistent, compassionate care:

• Five-year ENT (ear, nose, and throat) residency
• One-year facial plastics fellowship
• Thirteen-year clinical practice

Patient reviews across platforms such as Google, Healthgrades, Vitals, and RateMDs reflect this commitment to exceptional results.

Down to Earth Surgeon

“Great surgeon and communicates well. Having my FFS (Facial Feminization Surgery) with him has been great.

Aside from having to wait for insurance approval letters (not his fault), it has been a great experience overall.

Dr. Henry Chen is the most down-to-earth when talking to him. I have social anxiety, so talking to people is scary, let alone trying to ask or say anything about surgery. However, he makes you feel safe that you have no problem conveying what you need.”

Valerie Vielmas

All our facial feminization procedures are performed at K & B Surgical Center, a fully accredited, state-of-the-art surgical center that meets rigorous safety and quality standards.

K & B Surgical Center, located in Beverly Hills, is a freestanding, multi-specialty outpatient facility accredited by the Accreditation Association for Ambulatory Health Care(AAAHC).

Who Performs Facial Feminization Surgery?

FFS lies at the intersection of plastic and craniofacial surgery and is performed by surgeons with advanced training in facial and skull anatomy.

Several surgical backgrounds can prepare a physician for this work, including those of facial plastic surgeons (often trained in ear, nose, and throat procedures), craniofacial surgeons, and oral and maxillofacial surgeons.

That said, a surgeon’s title alone does not guarantee expertise in FFS. What matters most is formal training in facial bone and soft-tissue surgery, along with specific experience applying those skills to achieve gender-affirming, feminine outcomes.

The World Professional Association for Transgender Health Standards of Care, Version 8, emphasizes that clinicians providing gender-affirming procedures should have appropriate training, demonstrated competence, and ongoing education in this specialized area of care.

How Can FFS Impact Someone’s Gender Transition and Transgender Individuals’ Lives?

FFS can play a profound role in a person’s gender-affirming journey by helping align facial appearance with internal identity, reducing distress related to gender incongruence, and enhancing emotional and social well-being:

• Alleviating Gender Dysphoria
  FFS helps affirm transgender and gender-diverse individuals whose facial features do not align with their gender identity.
  
  That mismatch between what you see in the mirror and who you are can be a significant source of ongoing distress, commonly referred to as gender dysphoria.
  
  A recent study published in Plastic and Reconstructive Surgery–Global Open showed that FFS is associated with a reduction in gender dysphoria and an increase in feminine self-perception among transgender patients.
• Boosting Self-Confidence and Psychological Well-Being
  When someone’s facial appearance more closely aligns with their gender identity, they often experience meaningful improvements in self-confidence and overall psychological well-being.
  
  Research has found that people who undergo facial feminization surgery often report greater satisfaction with their facial appearance and improved psychological functioning, especially when compared with individuals who receive only hormone therapy.
  
  These benefits often include increased self-esteem, reduced anxiety about appearance, and a stronger alignment between one’s internal identity and outward presentation.
• Improved Social Integration and Reduced Misgendering
  FFS may also help reduce misgendering by softening facial features that are commonly perceived as masculine.
  
  Patients often report feeling more comfortable in public spaces and noticing that others more consistently see their gender as intended.
  That change can make social and work situations easier and help build a stronger sense of belonging.
  
  When others read their gender correctly more often, many patients describe feeling less guarded in everyday situations, with reduced stress and
  diminished social vigilance related to gender presentation.
• Quality of Life Improvements
  Clinical studies have found that FFS is linked to significant improvements in quality of life.
  
  Many patients report feeling better emotionally, psychologically, and socially after surgery.
  
  Prospective research suggests that these benefits often appear early in the recovery process and remain stable over time, meaning they have a
  lasting positive effect on overall well-being.

What Are the Benefits of Face Feminization Surgery?

At FFS Institute, we take great care to ensure your treatment plan supports not only your aesthetic goals but your overall well-being.

Our FFS care offers a range of benefits, both aesthetic and gender-affirming:

• Softer, more traditionally feminine features
  FFS can reshape or soften facial characteristics that are often read as masculine.
• Closer alignment with gender identity
  For many people seeking gender-affirming care, FFS helps bring their facial appearance into closer alignment with their gender identity, reducing the disconnect between how they feel and how they are perceived.
• Natural-looking results
  Rather than making isolated changes, our FFS care focuses on the face as a whole. The goal is to create results that feel natural, integrated, and authentically yours.
• A refreshed overall appearance
  Some FFS plans include rejuvenation procedures such as facelifts or skin-tightening. As a result, patients may notice not only more feminine facial features, but also a smoother, more rested, and refreshed overall appearance.
• Personalized surgical planning
  No two transition journeys are the same. Your surgeon takes the time to understand your story, your goals, and how you want your face to evolve.
  
  Together, you’ll decide which areas to focus on and whether you’re looking for very subtle refinement or a more noticeable transformation.
• Long-lasting change
  FFS is designed to create structural changes, not temporary adjustments. Once healing is complete, the refinements made to your facial features are typically expected to last a lifetime.
  
  For many people, that permanence can bring a deep sense of reassurance and stability moving forward.
• Improved psychological well-being
  When your outward appearance better reflects who you are internally, it can be easier to move through the world with confidence, ease, and a stronger sense of self.
  
  While every experience is unique, the emotional impact of finally being seen as you truly are can be incredibly meaningful.

Preparing for Your FFS Journey: How to Prepare for Facial Feminization Surgery

Preparing for facial feminization surgery involves more than just scheduling a date. It’s a combination of medical readiness, practical planning, and setting yourself up for a smooth recovery.

Here are some steps to take in preparation for your FFS:

• Medical Clearance and Medication Review
  Before surgery, you’ll need clearance from your primary care provider to confirm it’s safe for you to undergo anesthesia. This process includes routine testing such as bloodwork and an electrocardiogram (ECG).
  
  You’ll also be asked to take a few important preparation steps, such as:
  
  
  • Complete all required medical clearance and laboratory tests.
  • Review every prescription medication, over-the-counter drug, and supplement with your surgeon.
  • Support your body with good nutrition (things like protein-rich foods, leafy greens, and fruits), staying well-hydrated, and keeping any chronic conditions well-managed.
• Preparing Your Body and Daily Routine
  Certain lifestyle adjustments before surgery can make a real difference in both safety and healing.
  
  Your surgeon may ask you to pause some medications, avoid smoking and alcohol, and keep your weight relatively stable in the weeks leading up to surgery. These steps help your body recover more smoothly and lower the risk of complications.
  
  If your plan includes multiple procedures, especially those involving the jaw, chin, or neck, it’s helpful to know that swelling can be more noticeable and may last longer.
  
  Planning your schedule with this in mind can give you time to rest, heal, and move through recovery at a pace that feels manageable.
• Setting Up Support and Recovery at Home
  You won’t be on your own after surgery, and that’s important. You’ll need a responsible adult with you for at least the first 24 to 48 hours to help you rest safely and comfortably.
  
  Preparing your recovery space ahead of time can make a big difference in how calm and supported you feel once you’re home. It’s helpful to plan for things like:
  
  
  • A support person
  • A dedicated recovery area at home or in your hotel
  • Essentials within reach, such as medications, water, soft foods, and extra pillows
  • Time away from work
  • Assistance with meals, transportation, errands, or pet care, as needed.
    
    If you’re traveling for surgery, you won’t have to figure everything out alone. Our team can help coordinate arrangements for out-of-town patients to make the process as smooth and stress-free as possible.

First Assessment for FFS

Your first FFS assessment is designed to feel structured, welcoming, and easy to navigate right from the start.

From your very first contact with us, our priority is to help you feel informed, comfortable, and confident about each step ahead.

• After you reach out, Meghan, our front office coordinator, will contact you to schedule your consultation and send a welcome email introducing you to the team and outlining what to expect next.
• Before your visit, you’ll connect with Emmy, our patient care coordinator, who will guide you through a pre-consultation call.
• She’ll explain the process, answer your questions, and remain your main point of contact throughout planning, surgery, and recovery.
• During your consultation, you’ll meet directly with your surgeon for an in-depth discussion about your goals, concerns, and priorities.
• Standardized photographs will be taken, and relevant before-and-after cases may be reviewed.
• In some cases, morphing software is used to explore potential outcomes together and help align expectations.
• Once your personalized surgical plan is in place, Emmy will walk you through scheduling options, logistics, and financial details so everything feels clear and manageable.
  There’s no rush—when you’re ready, you can reserve your surgery date.
• Before surgery, you’ll return for a dedicated preoperative visit. This appointment is all about preparation and reassurance. We’ll review the procedure, recovery timeline, and final details, and address any remaining questions so you feel fully supported moving forward.

What to Expect During Your FFS Procedure: What Happens During Facial Feminization Surgery?

Pursuing FFS, especially for the first time, can feel like a lot to take in. At FFS Institute, we walk beside you through every stage so you’re never left guessing what comes next.

Here’s what our FFS care process usually looks like.

When You Arrive

On the day of surgery, you’ll check in at our Beverly Hills surgical center at your scheduled time. Our team will verify your identity and surgical plan, take your vital signs, review consent forms, and answer any remaining questions.

You’ll meet with the anesthesia team for a final preoperative check-in before heading to the operating room. After changing into surgical attire, your face, scalp, and neck will be carefully prepared.

During Surgery

Facial feminization surgery is usually performed under general anesthesia, so you’ll be fully asleep and comfortable throughout the procedure.

Dr. Chen and his surgical team carefully follow the treatment plan you’ve created together. This may include procedures such as forehead contouring, hairline advancement, brow lifting, rhinoplasty, cheek augmentation or fat transfer, jaw or chin contouring, lip feminization, and tracheal shave.

Bone work is performed with meticulous precision, and incisions are thoughtfully placed to remain discreet (often hidden within the hairline, inside the mouth, or along natural neck creases).

After Surgery

Once surgery is complete, you’ll be transferred to the recovery area, where the team will keep a close eye on you as you wake up from anesthesia. If your procedure included work on the lower face or neck, you may wake up wearing a compression garment for added support.

It’s also completely normal to experience swelling, bruising, and a sense of facial fullness at this stage. These are expected parts of healing and tend to improve gradually over time.

As you wake from anesthesia, the recovery team will monitor you closely, manage your comfort, and ensure you’re stable as your healing journey begins.

How Long Does Facial Feminization Surgery Take?

There isn’t a single set timeline for facial feminization surgery because each treatment plan is completely individualized.

Some patients have shorter, more focused procedures that take just a few hours, while more comprehensive surgeries addressing the upper, mid, and lower face can last longer.

Your surgeon will review the expected timing with you ahead of time so you know exactly what to expect and can plan comfortably around your surgery day.

FFS Recovery: What Is the Facial Feminization Surgery Recovery Process? What Happens After Facial Feminization Surgery?

No two recoveries look exactly the same, but most patients move through a familiar pattern of healing.

Here’s a stage-by-stage overview of what recovery may look like after facial feminization surgery at FFS Institute.

First Few Days After Surgery (Day 0 to Week 1)

Patients stay at an aftercare facility with round-the-clock nursing for the first few days.

When you wake up from general anesthesia, you’ll have bandages (and in some cases, splints) depending on which procedures were performed.

At this early stage, bruising and swelling are expected, and minor bleeding can occur. The good news is that incisions seal within the first week.

You may also notice a sense of tightness, pressure, or soreness, especially if multiple areas were treated. Pain is often moderate to severe at first, but it’s managed with a structured medication plan.

Many patients use prescription pain medication for the first few days, often alongside arnica to help with bruising and swelling.

As discomfort steadily decreases, patients then taper off prescription medication and transition to over-the-counter options such as Advil or Tylenol within the first week.

Swelling is often most noticeable in the face and neck and settles along the jawline and lower face due to gravity.

During this initial recovery period, you’ll be asked to sleep with your head elevated and avoid strenuous activity to help reduce swelling and support proper healing.

First Month

If your surgery included work on the lower face, Dr. Chen typically recommends wearing a compression garment for at least 8 hours per day during the first month. This added support helps manage swelling as healing progresses.

Throughout this time, swelling gradually improves, though some puffiness remains normal.

As the weeks pass, many patients begin to notice early changes in their facial shape and recognize aspects of their new appearance.

With your surgeon’s approval, light work and gentle activity often resume around the four-week mark. Many patients are comfortable returning to public settings at this point, even with some swelling remaining.

For some, this stage brings a growing sense of confidence as their features increasingly align with their identity.

Three to Six Months

More noticeable refinements in facial shape usually appear between three and six months. Healing continues beneath the surface, and your results become progressively clearer.

A Year After

The healing process continues for a few more months, with final results becoming apparent around the one-year mark. By then, most residual swelling has resolved, scars have matured, and both bone and soft tissue have fully stabilized.

This is why some surgeons wait at least 12 months before assessing the need for revision.

How Long Does Facial Feminization Surgery Take to Heal?

Healing takes time, and everyone moves through the process at their own pace. While full recovery may take up to a year, your experience will be uniquely your own.

A few factors can influence how long healing takes:

• Number and type of procedures: More extensive surgical plans generally require a longer recovery period.
• Overall health: Good nutrition, avoiding smoking, and keeping medical conditions well-controlled can all support smoother healing.
• Bone work versus soft-tissue procedures: Jaw and chin bone contouring often takes longer to fully settle than soft-tissue treatments.
• Postoperative care: Following activity guidelines and attending scheduled follow-up visits can help promote a more efficient recovery.

How Painful Is Facial Feminization Surgery?

As with any surgical procedure, moderate to severe pain is expected.

Clinical research offers some helpful context: In one study of 74 FFS patients, the average early postoperative pain score was 4.3 out of 10. There was no meaningful difference between patients who had only a few procedures and those who had more comprehensive, full-face surgery.

This data suggests that more comprehensive surgical plans do not necessarily lead to greater pain.

Managing Discomfort After FFS: How Much Discomfort Follows After FFS?

You won’t feel pain during surgery because facial feminization procedures are performed under general anesthesia. Once you wake up, it’s normal to experience some discomfort as swelling and inflammation begin.

Most patients describe this sensation as pressure, tightness, fullness, or a headache-like feeling rather than sharp pain.

If incisions were made inside the mouth, some tenderness is also expected, but this typically improves steadily over time.

The good news is that postoperative discomfort is usually very manageable. Many patients do well with medications like Tylenol or Advil and only require prescription pain medication for the first few days.

By around day four or five, most people notice consistent improvement and feel significantly more comfortable.

At FFS Institute, all procedures are performed in accredited surgical centers by a dedicated surgical and recovery team following a structured postoperative care plan.

From the moment you wake up, you’re closely monitored, supported, and guided through each step of recovery, so you never have to navigate the healing process on your own.

Results From Facial Feminization Surgery: Are FFS Results Permanent?

FFS reshapes the underlying facial structure, so the core feminizing changes do not fade or “wear off” over time.

The bone work itself is permanent. However, the soft tissues that sit over the bone, such as skin, fat, and muscle, continue to age naturally, just as they do for everyone.

Over time, all faces change. Facial fat may gradually decrease, cheeks can settle, and tissue can collect along the jawline or neck.

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

If you’d like to see what FFS Institute can offer, here’s a patient story that shares how our team has helped individuals feel more at home in their own skin and move through life with greater comfort, confidence, and pride.

Patient 08

Meet Sherilyn. She’s 73, transgender, and someone who decided it was finally time to make her outer reflection match who she’s always been inside.

She chose to undergo FFS procedures, including forehead contouring, a brow lift, reshaping her jaw and chin, and a tracheal shave to soften her profile.

Piece by piece, those changes came together and gently transformed her face, giving her a softer, more traditionally feminine look that feels right for her. What stands out most is how much more comfortable and confident she seems in herself now.

We’re grateful to have supported her through this process and appreciate the trust she placed in our team.

Sherilyn’s story is a reminder that it’s never too late to make choices that align with who you are, and it may offer encouragement to others considering the same path.

How Much Does Facial Feminization Surgery (FFS) Cost?

The cost of FFS can vary widely, depending mainly on the number of facial areas addressed and the extent of your surgical plan. In some cases, a comprehensive facial feminization surgery plan at FFS Institute may exceed six figures.

To provide general context, here’s an overview of typical non-insurance costs by facial region:

• Upper third (hairline, forehead contouring, brow procedures): $10,000 to $50,000
• Middle third (nose, cheeks): $6,000 to $18,000
• Lower third (lips, jaw, chin, neck): $4,500 to $50,000

While the overall investment can feel significant, it doesn’t necessarily have to stand in the way of your goals.

PPO (Preferred Provider Organization) insurance acceptance may help make the path forward feel more accessible for some patients.

What Are the Costs Associated With FFS Surgery?

Pricing depends on the complexity of your surgical plan, your surgeon’s experience, and the resources required to deliver safe, high-quality care.

Understanding how these elements fit together can help you plan realistically and feel more informed about your investment.

Your total cost can vary based on several key factors:

• Surgeon experience: Board-certified surgeons with focused, gender-affirming expertise often charge more due to their specialized training and level of skill.
• Facility fees: These cover essential elements, including nursing staff, medications, surgical supplies, and the operation of a safe, accredited surgical environment.
• Facility quality: Centers that operate with accredited surgical suites, hospital-grade equipment, and enhanced patient services may have higher fees, which are reflected in overall pricing.
• Anesthesia: Comprehensive FFS procedures are performed under general anesthesia. Working with a dedicated anesthesia provider may increase the total cost.
• Number and type of procedures: Each additional procedure, such as forehead contouring, rhinoplasty, jaw or chin reshaping, tracheal shave, or lip procedures, adds surgical time and increases facility and anesthesia costs, resulting in a higher overall total.
• Geographic location: In major markets like Beverly Hills, the cost of FFS procedures is often higher because there’s strong demand for specialized expertise and a high standard of care from experienced facial plastic surgeons.

How to Pay for FFS Surgery

Thinking about how to pay for facial feminization surgery can feel overwhelming at first, but there are several options to consider, and you don’t have to navigate them alone.

Some health insurance plans provide coverage for FFS, although the approval process can take time and may not include every procedure. In many cases, coverage is partial rather than comprehensive.

Because insurers often require separate documentation for each procedure, navigating insurance approval can feel complex. In practical terms, the process may involve:

• Working with a medical or mental health provider to obtain referral or support letters
• Submitting those letters alongside your surgeon’s treatment plan
• Confirming whether your specific policy includes exclusions for gender-affirming care
• Preparing for some back-and-forth with your insurer before you make a final decision

If insurance does not cover FFS, or covers part of it, the remaining balance becomes an out-of-pocket expense.

For patients who prefer not to pay the full amount upfront, we offer flexible financing options such as CareCredit, which allows you to spread the cost of surgery over time.

There’s no single “right” way to plan financially. Many patients choose an approach that feels sustainable for their situation, such as saving toward part of the cost while financing the remainder to keep monthly payments manageable.

Others build a flexible timeline that allows time to save while gathering insurance documentation.

If you’re traveling from out of town, it can also be helpful to account for additional expenses such as travel, time off work, and follow-up visits.

Risks and Safety of Facial Feminization Surgery: What Are the Risks of Facial Feminization Surgery?

FFS is generally considered safe when performed by a qualified, experienced specialist. However, like any surgical procedure, it carries risks.

At FFS Institute, we believe in being open and transparent about these possibilities so you feel informed, prepared, and supported throughout your care.

We also provide clear, practical guidance before and after surgery to help minimize risk and support a smooth recovery.

• General Surgical Risks
  As with most surgeries, potential risks may include:
  
  
  • Infection
  • Bleeding
  • Adverse reactions to anesthesia
  • Injury to nearby structures in the surgical area
    
    Your surgical team takes extensive precautions to reduce these risks, including thorough preoperative screening, careful surgical technique, and close postoperative monitoring.
    
    Open communication and meticulous planning are central to maintaining safety at every stage of care.
• FFS-Specific Complications
  Some risks are specific to facial feminization surgery and vary depending on the procedures performed.
  
  While these complications are rare, understanding them can help you feel more informed and prepared. They may include:
  
  
  • Visible scarring, depending on incision placement and individual healing
  • Wound dehiscence (incisions reopening during healing)
  • Short-term or, rarely, lasting nerve changes, affecting facial movement or sensation
  • Seroma (fluid accumulation under the skin)
  • Temporary voice changes or swallowing difficulties after a tracheal shave
  • Hematoma (localized swelling caused by trapped blood)
  • Prolonged swelling, particularly around the neck and jawline, after bone contouring
    
    While these risks are uncommon, discussing them openly allows us to take appropriate steps together to reduce their likelihood and support a safe, well-managed recovery.

Frequently Asked Questions About FFS

1. When should I see my healthcare provider after FFS?

FFS is generally safe, and most patients recover smoothly with routine follow-ups as scheduled by their surgical team. That said, it’s important to trust your body and seek care right away if something doesn’t feel right.

Contact your surgical team immediately if you experience any of the following after surgery:

• Arrhythmia (irregular heartbeats)
• Breathing difficulties
• Chest pain
• Signs of infection, including drainage, pain, redness, or swelling

2. How long does facial feminization surgery last?

The length of facial feminization surgery primarily depends on how many procedures are included in your plan.

At FFS Institute, surgery duration varies based on the number of procedures performed.

When multiple areas of the face need to be addressed, Dr. Chen often recommends staging the surgery into two separate operations.

This approach helps keep anesthesia time and recovery more manageable while still allowing for thorough, thoughtful treatment.

3. Does facial feminization surgery hurt?

As with any surgical procedure, moderate to severe pain is expected after facial feminization surgery. That said, most patients find it much more manageable than they initially anticipate.

In many cases, more potent pain medication is needed only for the first few days.

Nonsurgical Procedures for Facial Gender Affirmation

We also offer nonsurgical, minimally invasive options for those seeking a more conservative approach to soften certain features or complement FFS results.

While these treatments do not reshape the bone the way comprehensive FFS does, they can add softness, balance, and refinement that support a more traditionally feminine overall appearance.

Nonsurgical options may include:

• Fillers and fat-based volume treatments
  These treatments can restore or enhance fullness in areas commonly associated with feminine contours, including the cheeks, lips, temples, and under-eye area.
  
  While fillers are not permanent, they can provide noticeable contouring effects that may last one to two years.
• Neuromodulators such as BOTOX®
  By relaxing targeted facial muscles, neuromodulators can soften strong expressions, smooth dynamic lines, and, when used in the masseter muscles, help create a slimmer-appearing lower face.
• Skin-resurfacing treatments
  Skin-resurfacing procedures can brighten the complexion, improve texture, soften fine lines, and create a smoother, more polished appearance that often aligns with a feminine aesthetic.

Taking the Next Step Toward Your FFS Journey

If you’re ready to take the next step toward your transition goals and work with a team that truly understands your hopes and expectations, we invite you to meet with Dr. Chen.

Call us at (310) 237-1392 to book your consultation and begin planning your FFS journey with a team dedicated to your comfort, vision, and goals.