Our website services, content, and products are for informational purposes only. However, a surgeon experienced with FFS can sometimes provide better results, especially when multiple facets of the face are being altered at once. Because you dont want to keep fighting all the time. While she was growing up, Drake didnt really know what transgender was, aside from something everyone laughed about in the playground when Nadia was on Big Brother or Chandlers dad was on Friends. Facial feminization surgery, or FFS, is a surgery that involves the cosmetic modification of your facial characteristics. They also believe that RLE is a mentally traumatic, socially impractical, and physically dangerous period of time in which a transgender person must out themselves to their community without the benefit of the physical transformations that hormones or surgeries bring. The point where you get the referral its taken you years, often, to get to that point.. Others will pursue HRT as well as various degrees of surgery, including chest reconstruction or facial feminization surgery (FFS). Throughout his career, Mr Inglefield has gained vast experience in a wide range of specialities, with areas of specialist interest including gender confirmation surgery, facial feminisation surgery, body feminisation surgery, masculinisation surgery and male chest reduction, breast You have likely asked yourself, How do I find the right FFS surgeon? She was open, at ease, comfortable. She devoured whatever information she could find on Reddit pages such as asktransgender, transgenderuk and transtimelines, and specialist forums for trans women such as Susans Place. The American Psychological Associations diagnostic and statistical manual (DSM-5) defines it as a difference between your experienced/expressed gender and assigned gender, and significant distress or problems functioning. @copy; 2020 Facial Plastic Surgery Specialist, Before and after images of blepharoplasty, Jaw osteotomies/upper or lower Jaw surgery. Furthermore, the gender reassignment procedures involved with the physical transformation need to be carefully considered. We find the best specialist for your medical problem Gender euphoria is the feeling of joy in how your gender is presented and perceived. I dont walk around any more worrying that people are looking at me, and looking at my brow bone., She once feared wearing too much makeup would draw attention to her brow, but now accentuated her eyes with flicked eyeliner. In this procedure, the clitoris, already elongated to 3-8 centimeters by HRT, is released from the surrounding tissue, and repositioned to match the positioning of a penis. More about Facial Feminization Surgery Narrow *Treatment results may vary *The member who uploaded this photo has read and agreed to the RealSelf Photo Rules The neovagina develops microflora similar to a typical vagina, although the pH level leans much more alkaline. A bimaxillary osteotomy of the upper jaw was performed to shorten her face together with a lip lift. Your surgeon should discuss Its an all too common occurrence for transgender individuals, especially those who are just beginning [], As a trans or nonbinary person, body positivity can be a challenging concept to embrace. NEWS OF THE WEEK The moment Drake opened her eyes in recovery, she asked the nurse beside her to take her picture, but she fell back asleep immediately. #ltc, WHO SAID SKIN TIGHTENING TREATMENTS NEED TO BE PAI, Mr. Christopher Inglefield Specialist Transgender Surgeon, Miss Natasha Berridge Oral & Maxillofacial Surgeon, Mr. Giuseppe Di Taranto Consultant Plastic Surgeon, Chin Contouring / Chin Reduction / Shaping, Thyroid Reduction / Adams Apple Reduction, MtF Gender Confirmation Surgery Peno-Scrotal Flap Technique, High Definition Liposuction & Body Sculpting, Gender Confirmation Surgery Penile Scrotal Flat Technique, Gender Confirmation Surgery Colovaginoplasty, Top Surgery: Double Excision with Free Nipple Graft, Square jaw reduction (masseter) with botulinum toxin, 500 per session (usually 4 sessions needed), Varies depending on individual needs starting from 85 for a small tattoo. To date, our surgeons have performed over 6500 procedures on more than 2000 patients seeking facial feminization surgery. On the other hand, the National Health Service in the UK Ill use my Facial Feminization Surgery as a hypothetical example of gender dysphoria since it was my first surgical procedure. . It made me feel like I had power, for the first time in my life. In 2016, she married her girlfriend, hoping the discomfort would somehow go away. Am I sitting in the wrong way? In this case, surgeons slice the bottom part of the chin bone into a wedge. To choose the right surgeon, pursue in-person or Skype interviews with as many surgeons as possible. The nearest NHS gender identity clinic told her they had a two-year waiting list for an appointment. Facial feminisation is not considered cosmetic surgery. Hairline advancement became the default standard, despite sometimes having a masculinizing effect. Metoidioplasty is a much simpler and quicker procedure than phalloplasty. You can learn more about how we ensure our content is accurate and current by reading our. When less extreme changes are called for, rhinoplasty can be performed without external scarring. All rights reserved. Penile inversion involves using the penile skin to form the neovagina. But those codes and diagnoses are currently needed in most cases for trans people to get access to the resources they need, which is unfortunate, Plemons said. Scars tend to either be hidden in the pubic hair, along the folds of the labia majora, or simply heal so well as to not be noticeable. On 28 October 2013, a thread appeared on the Susans Place message board titled Ive stopped HRT today. In one, she looked directly into the camera with a calm determination in her eyes, bleached-blond hair, an elegant nose, full lips and dimpled cheeks. The hairline frames my face better. But I didnt want to be an animal. How does dilation work after Gender Confirmation Surgery? I didnt want to be Spider-Man or Muhammad Ali, I just wanted to change into a woman.. I see testosterone as a poison in my body, a poison that I had to deal with for 20 years. This is achieved by mandibular and mentonian basal contour [], Embark on a journey through the expansive world of transgender terminology. But she saw it as vital to her wellbeing, as mental health surgery. Some aspire to social transition telling others about their gender identity without medical intervention. See additional information. What happens after I get back home after surgery? Weve gathered all information you need in a. They may also decide that bottom surgery also known as genital surgery, sex reassignment surgery (SRS), or preferably, gender confirmation surgery (GCS) is the right choice for them. WebFacial feminisation is a growing industry, with private clinics springing up across the globe over the past decade. The aim of this project was to review surgical practices in NHS Scotland. After that, penetrative sexual activity is normally enough for upkeep. This patient had brow recontouring, a rhinoplasty, jaw recontouring and a tracheal shave to reduce the prominent "Adams Apple" Many transgender men and gender diverse folks use testosterone therapy as a form of gender affirming care. Controlling her food intake fed the fantasy that she could finally shapeshift, after all. (By comparison, Drake was having pretty light work done, which was why her surgery was cheaper than average.). She recognised how lucky she was to be able to afford a procedure that she could not get on the NHS. The effects of puberty blockers are reversible, whether the medication is being used to treat precocious puberty or as a part of gender affirming care. For other inquiries, Contact Us. For Keith Altman, the maxillofacial surgeon, it is the removal of bone, skin and cartilage. Our team of people are our core strength. Soft tissue procedures can be performed in conjunction with the core FFS procedures listed above. Pratt asked a colleague, the San Francisco-based maxillofacial surgeon Douglas Ousterhout, if there was anything he could do for his patient. The surgery may also be performed in cisgender women who desire a more feminine face or facial feature (e.g., a lower hairline). Now, I dont need to worry.. When he was satisfied with the result, Altman changed his gloves and turned his attention to her forehead. And certainly no one has ever said they want to be a man again.. Talk to your surgeon about other medications that you take regularly. Each area of the face is addressed in separate procedures: Forehead procedures contour the forehead by shaving down hard angles and reducing the prominence of the brow bone. The oldest and biggest NHS gender clinic in the UK is Londons Charing Cross, established in 1966. Not just for trans women, but for women in general. It had been posted by Joanna Holford, a trans woman who had had facial feminisation surgery with Altman the year before. However, the back scar tends to be the least visible and allows for additional penis length. Youll find everything under one roof: 2pass Clinic The labia major and minora are primarily made from scrotal tissue. Its goal is to reconstruct the face, not to improve it aesthetically. Surgeons who use this technique purport greater vaginal depth, more sensate inner labia, and improved cosmetic appearance. As the surgeon, Keith Altman, prised back her cheek with a stainless steel retractor and peered inside her mouth, beams from the three bulbs fixed to his glasses illuminated the furthest interior reaches of her jawbone. Her handheld games console lay on the walnut coffee table. Many only pursue hormone replacement therapy (HRT). For Drake, the surgery was about correcting her face so that, when she looked in the mirror, she no longer felt the profound discomfort of gender dysphoria. And then theres the female hairline, a low hairline. The focus of his work was to bring attention to the eyes. He noted differences in jaws, upper lips, foreheads and chins. Find out more on our Finance page. While there is no doubt that testosterone does change skulls in puberty, how much is up for discussion. NHS England has confirmed that the 18 week referral to treatment time standard set out in the Constitution applies to gender identity services. Archived post. The clinic also suggests you can expect moderate pain for 3-5 days, but you can go back to regular activities after 1-2 weeks. Drakes skin was smoothed back for a last time. WebFacial feminisation surgery (FFS) is integral to the management of transgender adult females. Demand remains steady. Drake had no definite idea of how she would look after the surgery. It will have shaped your hands. Facial Feminization Surgery Annalena. Full metoidioplasty and phalloplasty carry the risk of urethral fistula (a hole or opening in the urethra) or a urethral stricture (a blockage). MONTANA BANS TRANSGENDER ME, Mr Di Taranto, our Consultant Plastic Surgeon at t, For further details of our complaints policy and to make a complaint please click this link: thesun.co.uk/editorial-complaints/, Surgery on the face to make it look more feminine is a cosmetic option, The surgery can sculpt chins, brow bones, the forehead, hair, lips and varying other areas, Sir Cliff Richard admits he wants a facelift on Loose Women, London Bridge Plastic Surgery & Aesthetic Clinic, Independent Press Standards Organisation (IPSO). Facial Feminization Procedures Explained Facial Feminization Surgery (FFS) is a group of facial surgery procedures that transform male-looking facial features to bring them closer in shape, size and proportion to typical female facial features. Some do nothing at all and keep their gender identity and expression private. He contacted a surgeon in Antwerp who was experienced in facial feminisation surgery, and who invited Altman over to watch him at work. Aggressive reductions risk exposing or severing the nerve. DOI: Bellingua RJ, et al. Make sure to tell your surgeon about any other medications you regularly take. He regularly attends national and international conferences and workshops as an attendee and invited speaker. Holford has been. They blend in. She decided against, in the end. Make an appointment here. WebFacial feminisation surgery and hair transplants are not routinely available on the NHS. And we have to create safety for everyone. In general, risks are low, but bruising is very common. He considered mathematical takes on beauty, the golden ratio of pleasing proportions first theorised in ancient Greece. Its only recommended by some surgeons in certain cases. The upper lip often curls more upward. This all-encompassing glossary will equip you with the knowledge to communicate effectively and respectfully [], Being misgendered can leave you feeling disrespected, invalidated, and invisible. Search by Country and Procedure. She looks pretty good anyway. 'I just want to see the person I always saw in my head': the story of a face podcast, Get the Guardians award-winning long reads sent direct to you every Saturday morning, Original reporting and incisive analysis, direct from the Guardian every morning, 2023 Guardian News & Media Limited or its affiliated companies. But there are so many other elements to passing: the way you handle yourself, the way you speak, the clothes that you choose, the belief you have in yourself., Holford accepts that facial feminisation surgery perpetuates the idea that there is such a thing as a normal female face, that there is a standard expectation of what a woman should look like, and that any woman who falls outside of that is less feminine. To anyone consideringFFS, we wouldrecommendgetting as much information aspossiblefrom yoursurgeonor clinic. You may be attended by another doctor who is member of the Team. WebFrom what I've been told NHS England doesn't recommend or fund FFS because there's no evidence base for it's effectiveness with regards to overall quality of life. Drake had to take out a bank loan to cover two-thirds of the 14,500 cost of her facial feminisation surgery. I cant remember anyone whos been really upset with the outcome, he added. Those who can afford it can buy the capacity to pass to go through public life without being identified as trans, without everyone knowing their business. She pays about 50 a month for her hormone treatment, and will need to continue with it for the rest of her life. The quest for excellence has transformed Facialteam into a leading practice for facial gender-affirming care. A bimaxillary osteotomy of the upper jaw was performed to shorten her face together with a lip lift. The London Transgender Clinic is a trading name of C&M Health Ltd who is authorised and regulated by the Financial Conduct Authority (register number 731851) and act as a credit broker and not a lender. The aim of this WebSurgery; Initial Consultation (Face to Face) 350: Follow up (existing patient) 175: Private Prescription: 59: Facial Feminisation; Brow Lift: Starts from: 8,000: Cheek Scrotoplasty may be performed with either surgery, which modifies the major labia into a scrotum. DOI: Capitn L, et al. The common donor sites for the skin graft are the forearm, thigh, abdomen, and upper back. Altman brushed sterile aqueous iodine over her face and hair, rendering her first rusty red and then yellow. travelled to Spain earlier this year for facial feminisation surgery (FFS). How should I prepare for my FFS Surgery? Soft tissue work, such as face-lifts and neck lifts, can be incorporated when necessary. This time has just been booked by another user. View Gallery Be the first to find out about our latest procedures, research, news and offers. Outwardly I was this confused, shy, reserved young adult. I want to put my face to the way it would have been if testosterone had never been pumping through my body. The coronal incision hides the incision scar within the bulk of the persons head hair. After the surgery, Holford had moved to London to be by herself, just completely anonymous, and go stealth I hate that term, but thats what they call it, she told me. DOI: Bizic M, et al. But when I go back and look at old pictures, I see a massive difference.. In his private practice, he treats a different kind of trauma: the trauma of not being read as female. I was very nervous for my consultation but Mr Musgrove made me feel at ease. Please be aware that guide prices are subject to change. After attaining his degree, he went on to complete his specialist surgical training in the UK, passing the examinations to become a Fellow of the Royal College of Surgeons of England in 1990. I didnt want to be Spider-Man or Muhammad Ali, I just wanted to change into a woman.. It's done to create a slimmer face. However, some care providers argue that ethical standards dont contradict informed consent. The number of procedures patients decide to have at once is verymuch dependent on the patients' requests, medicalwellbeingas well associaland financialcircumstancesof the patient. Please choose an alternative time. Full metoidioplasty and phalloplasty require a catheter for up to three weeks, until the point at which you can purge the bulk of your urine through your urethra on your own. Its goal is to reconstruct the face, not to improve it aesthetically. Felici N, et al. Subscribe to our Newsletter to stay up to date on the latest news, TOP DOCTORS | 85 Tottenham Court Road, London, W1T 4TQ. WebSurgery for Facial Feminisation Brian Musgrove has been performing Facial Feminisation Surgery for over 20 years. After these procedures, the neopenis may or may not maintain an erection on its own and is unlikely to provide meaningful penetrative sex. Altman K. (2012). In 2015, while Caitlyn Jenners feminised face was on the cover of Vanity Fair, the actor Laverne Cox began using the #TransIsBeautiful hashtag, starting a movement for trans people to be accepted without surgical intervention. The history of the trans journey is a cis male, hetrosexual, often white, middle-aged, middle-class doctor saying hes going to make you look as close in proximity to a woman so that you can pass without being noticed, so you can blend into the background, Roche told me. High cheekbones, a curved jawline, pointed chin. They then slide it forward away from the jaw and reattach it in the advanced position. Where she once might have been met with stares, she told me she now gets nothing. Leading transgender healthcare providers will either follow an informed consent model or the WPATH standards of care. However, there are limits to the reductions. Each patient is different and your expectations and desired results will be Hair transplants allow surgeons to target the areas of the hairline that need reinforcement without unnecessarily advancing parts that may not aesthetically need it. It definitely helps. If you have an attractive male face, youll end up with an attractive female face. I asked what he meant by attractive symmetrical? Healthline Media does not provide medical advice, diagnosis, or treatment. and our Thats why we have a total care approach to your FFS experience. 10% discount applies for courses of 6 and 9 treatments. Things will tighten up, obviously the scar will slowly reduce over time. The goal is to soften masculinized features into a shape more typically recognized as feminine. Is my clothing really bad?, Even after more surgery, and even though her videos are shared on message boards as an example of a transition to be envied, Holford still finds passing a daily effort, a daily chore. Using maxillofacial surgery techniques it is possible to change the dimensions of upper and lower jaws, make the face shorter and more delicate, correct asymmetries, move the midface forwards if it is too flat, highlight the cheekbones and correct dental irregularities to give the face a more feminine and attractive appearance. Some chins call for a chin reduction. Is there something wrong with my hormones? I feel that Ive got a lot more expression in my eyebrows now. The WPATH standards of care requires a letter of support from a therapist to begin HRT, and multiple letters to undergo bottom surgery. Facial feminisation has allowed for the creation of a kind of two-tier system where, on the whole, the most successful trans people are beautiful people that pass, Roche continued. However, FFS can have more impact on a persons mental health and social well-being than genital surgeries such as vaginoplasty and phalloplasty. If somebody wants to have an easy life, then boy, trans people deserve an easy life. The shape of the jaw and chin is very important in making your face appear feminine.The operation most commonly used to recontour the lower jaw is called "jaw recontouring" which entails shaving the lower border of the mandible. Orchiectomy may be a first step in gender confirmation surgery for transgender women. (2013). This may include: But in most cases, these procedures arent fundamental to how people perceive the gender of a face. It puts completely unfair pressure on cisgendered women I think its awful but for trans women its double, and youd do anything just to feel like you fit in. Then Altman drew in a new hairline, a centimetre below Drakes natural one, and sliced out the excess strip of skin. As a commissioner, NHS England is investing 4.4 million more in additional gender surgery procedures in 2015/16, and will invest more again in 2016/17. Transgender men, nonbinary folks, and others assigned female at birth may consider a hysterectomy to better align their physical body with their sense. You should refrain from returning to work or lifting heavy objects for six weeks. Im planning other surgeries.. Terms & Conditions | Which means you can go through an entire day, maybe, without having a major bout of dysphoria. You can do so via online forums, support groups, or mutual friends. These before and after images of a patient who attended for advice about FFS illustrate the power of surgery on the lower face in FFS. hen a trans woman called Candice had breast implants and genital surgery in California in 1982, she returned to her surgeon, Darrell Pratt, a few months later to say that it had had no impact on how other people perceived her in everyday life, because her face looked masculine. She was on the table for seven hours. Im not trying to make myself beautiful, Drake said. The operations have been But in the long term, I expect to feel nothing. Common variations include using the remaining scrotal tissue as a graft for additional vaginal depth, and using the intact mucosal urethra recovered from the penis to line part of the vagina, creating some self-lubrication. Not Im beautiful. 679215 Registered office: 1 London Bridge Street, London, SE1 9GF. An overview of neovaginal reconstruction options in male to female transsexuals. The reduction of the prominence is done through a small incision just above the prominence in a skin crease, in order to keep the incision scar as inconspicuous as possible. Drake thinks there may always be a need for it, because there will always be people like her who understand who they are later in life. There are always risks associated with surgery, but vaginoplasty complications are rare. Search by U.S. State, Procedure and Insurance. Gender transition is a personal and emotive process that only the person choosing to undertake it can fully identify with. Each and every one who works at 2pass goes above and beyond to make your experience as positive as possible and all relationships are based on mutual trust and respect. FFS isnt the golden ticket to passing. First, the brow was lifted and anchored by two stitches. It also helps to reach out to former patients of the surgeons that interest you, via online forums, support groups, or mutual friends. Cookie Notice In addition facelifts, blepharoplasty, liposuction can all be used to enhance the appearance but the most important key is to neutralize the male gender cues which are to do with the shape of he facial skeleton. It can be done under local anaesthetic or general anaesthetic, both as a day-case. For many people, when synthetic hormones begin to redistribute body fat, the cheeks get sufficiently fuller on their own. WebFacial feminisation surgery can involve a combination of all or some of the below cosmetic procedures. In his NHS work, Altman could remake your forehead if you smashed it against a dashboard in a car accident. Learn more, Everything you want to know about genioplasty, including the procedure for sliding genioplasty and chin implants, and aftercare and complications for, Buccal fat removal is a procedure that removes the buccal fat pads in your cheeks. Its like a sickening in your stomach, a pit, a crunching. After requesting advice on how best to feminise her face and a careful analysis she realised that the most important issue for her was the length of her lower face. More commonly, people who get a vaginoplasty may experience minor urinary incontinence, similar to what one experiences after giving birth. I mean pleasing. To see all content on The Sun, please use the Site Map. FFS mostly focuses on bone structure and nose shape. A surgeon can smooth strong protrusions. Vaginoplasty is typically pursued by transgender women and AMAB (assigned male at birth) nonbinary people, while phalloplasty or metoidioplasty, is typically pursued by transgender men and AFAM (assigned female at birth) nonbinary people. When it comes to the whole inequality in transgender treatment in the UK, I think its just short of criminal, she said. All rights reserved. It says only that there are no criteria for standards of care for facial surgery, but that mental health professionals can play an important role in helping their clients to make fully informed decisions about the timing and implications of such procedures. At Facialteam, we are [], Facial feminization surgery can result in a more delicate jawline, for a typically feminine facial shape. You cannot exercise though for around six weeks. It impacts on so many people, not just trans people., Roche understands the appeal of facial surgery for so many trans women. Rashid M, et al. . Also, it is why the development of FFS techniques and methods is a central pillar of our practice. FFS is tailored to each person and can encompass up to every aspect of the face and neck. Nerves are also severed during the scalp incision, but most people regain most or all of the sensation in their scalp skin as they heal. But I didnt want to be an animal. There was no more easy chatter between the doctors when Altman returned to the theatre to operate on Drakes brow and forehead. If you receive forehead work, your surgeon will anchor the eyebrows in place. What does the everyday person think when they look in the mirror and see their face? The Sun website is regulated by the Independent Press Standards Organisation (IPSO), Our journalists strive for accuracy but on occasion we make mistakes. In general, you can expect to go home after surgery. For people in whom hormone therapy Masculinized and unmasculinized faces have different proportions of skin above the lips (up to the base of the nose) and below the lips (down to the tip of the chin). Sophia Drake spent six years playing in secret with apps that make faces look more masculine or feminine, creating folders full of gender-transformed selfies and hiding them on her computer. When the job was done, Altman flicked his green surgical glove into a bin and left the theatre for a coffee break while the anaesthetist moved the breathing tube from Drakes nose to her mouth. He examined 1,500 male and female skulls in search of a clinical, craniofacial basis for the maleness people were apparently seeing in Candices face. Facial feminisation surgery (FFS) aims to feminise the face by changing masculine facial features to feminine ones. For Drake, it is the removal of the changes that testosterone made to her face during puberty. The week before Drakes surgery, Altman operated on someone who had a thyroid shave, forehead reduction, brow lift and scalp advance (bringing the hairline forward), jaw angle shave, lip lift, cheek implants and rhinoplasty. Your surgeon will require you to stop HRT two weeks before surgery, and refrain for two weeks after surgery. This service is provided on News Group Newspapers' Limited's Standard Terms and Conditions in accordance with our Privacy & Cookie Policy. In these cases, the front of the brow bone is entirely removed, temporarily exposing the sinus cavity behind it.