Reddit reviews Facial Feminization Surgery: A Guide for the Transgendered Woman

I wouldn't say any of them are the best. Some, like the facial team in Spain, are known for being conservative. Others are might not do chin work like Dr. Toby G. Mayer (I think he can't do type III forehead as well if you have a prominent brow ridge). They can also be hit or miss like Dr. Spiegel. They also all tend to have a certain style with how they make the nose, which can be a big deal if you want a certain nose. One surgeon may be perfect for you while another transwomen worst nightmare. So you have to think about what you want or need more specifically than "I want to look like a woman" and who you will trust with your face.

If you haven't read it, I would recommend checking out Facial Feminization Surgery: A Guide for the Transgendered Woman by Dr. Ousterhout (who is consider the father of facial feminization surgery). He goes over all the different types of procedures, who usually would benefit from them, and possible pros/cons. I think it's a pretty good start for evaluating what you need although I believe the book is a little dated (from what I have heard from other people).

https://www.amazon.com/Facial-Feminization-Surgery-Guide-Transgendered/dp/1886039933

First, I would encourage you to get on the yahoo FFS group. There's a lot of very experienced people on there who can offer you some very good advice.

Ultimately, it's about what YOU want. You need to be happy with your own face.

If you want to learn more about FFS, check out this book. It's by one of the pioneers of FFS and offers very comprehensive explanation, descriptions, and tons and tons of pictures of different procedures. http://www.amazon.com/Facial-Feminization-Surgery-Guide-Transgendered/dp/1886039933

I'm not any kind of expert. If you want my opinion, I'll share it. Realize it's worth everything you're paying for it, but here it is.

I read your face as pretty female already. Still, if you were going to get FFS, you would probably want to focus on the brow. It's easily the most masculine feature of your face. If you want to change it, go to a doc who dose actual bone re-movement. Some docs just grind down bone. For bringing a brow like that back down flush, you need to break bone, move it back, and let it heal back up. It's a pretty brutal procedure. Don't go into it lightly.

I myself have the same issue. Ultimately I decided to get FFS. I meet Dr. DiMaggio's operating table on April 19th. Eeep!

Oh look, it's me lol

Here are some more for context: https://imgur.com/a/prdKf

Scalp advancement alone usually won't fix a typical 'M' hairline; the main purpose of scalp advancement is to reduce the length of the forehead. Hair transplants are the solution for recession, though the advancement did help reduce the area I would need to cover.

When I consulted with Dr. D, I brought this up, and we both agreed that having him spend his time in the OR doing hair transplants – which often don't survive when done in conjunction with an advancement – would be a poor use of time and money since someone who doesn't have rigorous craniofacial training could do it at a later date, for less money, and with better results.

I'm not sure if I'll end up doing it, as some hair was removed to make the incision and will fill back in a bit, but I wanted him to have as much time as possible to do the difficult stuff; my surgery was still 11 hours.

I know we all just want transition to happen overnight, but it is a long and expensive process. All of the bone and soft tissue work I had done was $60k, so I needed to make some decisions. I'm thrilled with the results, and with my hair down, that's not even an issue.

Feel free to look through my old posts if you want more info, and I'm happy to answer any questions.

If you have an unlimited budget, and you insist, he'll do the transplants too, though you might have to split the procedures up over two days depending on how much you are having done.

Lastly, if you are really concerned, I'd speak with Dr. D, but if you want to go to Facial Team, I'm sure you'll have a good result; I looked at them, but I felt their results were a little too subtle.

You also might want to read this book that Dr. Ousterhout wrote for patients considering FFS: Facial Feminization Surgery: A Guide for the Transgendered Woman https://www.amazon.com/dp/1886039933/ref=cm_sw_r_cp_api_.yGczbBMGKHXC

I don't have any specific advice for questions, but I would recommend reading Dr. Ousterhouts book before you go so you are familiar with a lot of the procedures - https://www.amazon.com/Facial-Feminization-Surgery-Guide-Transgendered/dp/1886039933

If I had the money, and he wasn't retir(ing/ed), I would have loved to go to Dr. Ousterhout for FFS. After all, he (quite literally) wrote the book on it.

Buy this kindle book now.

This one by Deschamps-Bailey

Edit: Hold up let me fix the link

Edit 2: fixed

I need to go back and read it more in depth, but the book that Dr. Ousterhout wrote about FFS talks about the different types of forehead techniques. He has statistics in the back of the book about the surgeries he's done and a large majority of people who saw him had type 3 forehead reconstruction. His book also has photos of before/after.

Excellent post, and I hope you don't mind if I riff off a couple of your points.

> they have too high expectation for what the procedures can do. expecting to look like Angelina Jolie.

A good surgeon's duties include making sure that their patients go in with realistic expectations. A surgeon who does not talk about the limits of what they can do is usually giving a big warning sign. Dr. O. has a line in his book that goes something like he would tell his patients that he could make them attractive but not beautiful. [Note here that attractive is meant in a different sense than the OP has above.]

> studying the Techniques

I found it extremely helpful to read through Dr. O.'s book, Facial Feminization Surgery: A Guide for the Transgendered Woman (https://www.amazon.com/gp/product/1886039933/). It is a little outdated (as you can tell from the title) and some surgeons prefer some different approaches, but it provides a good comprehensive and accessible resource for the procedures in each major area. Though Dr. O. pretty much invented FFS, most of the techniques are taken from craniofacial surgery.

> While it can increase your feminine charm because more feminine normally equals slightly more attractive.

Feeling more secure about your appearance (and especially not really insecure) is a big factor in attractiveness, as quite a bit of it boils down to confidence. It's an argument that is overused by plastic surgeons, but there is truth behind it.

> That goes for doctors too. We have so many experiences now to learn about docs.

I'd love to hear about what steps you've taken to be informed (other than the obvious ones like getting in touch with former patients and looking at past examples of surgeons' work).

When I was looking around for FFS, I discounted him because of the lack of before and afters, including from himself, and what there was, wasn't anything to write home about. I also didn't like the hairline incision and a couple of other little bits and bobs.

He's competent, and for what he does, he does well, and if you're getting it on the NHS, then take it.

If you were paying for it, i'd be saying "Look around, because what you think is cheap isn't actually that cheap".

Regarding your hairline though, cause a ton of people think "lower hairlines = feminine" when in a lot of cases, that isn't so, have a read of this, and while you're also reading, get a copy of the "FFS Bible". That book goes through all the types of surgery the father of FFS developed, the reasons why things are done that way, and even where other surgeons have fucked up peoples skulls because they had no idea what they were doing.

That way you can walk in being a lay-expert in it and know exactly what's happening and why.

I scheduled my first consult when I was about 6 months on hormones. Never too soon.

It takes months to book a consult, months to get a date, years to save or months to plan for insurance, and then after surgery, months of recovery (including a solid week of being jacked up, another week of being uncomfortable, and then 6 more months for the healing to slowly go down)

Costs depend on who the doctor is, where they are, what travel/lodging costs where they are, and what procedures you get done. Some people just go for a nose and a chin job. Some do the whole thang. You can be looking at $15k-$60k USD, not including travel and lodging.

Some doctors need a therapists note though probably a note from your PCP would suffice. Great question to ask each individual office. It is not stringent as it is for SRS.

I suggest you read Dr. Ousterhouts book: https://www.amazon.com/Facial-Feminization-Surgery-Guide-Transgendered/dp/1886039933

Any questions LMK!

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I mean basically it means the surgeon will have to skillfully be able to work with the sinus plate in the type 3 area. The risk is the surgeon does not address this and if you go in for consultations, some surgeons can show the repair they did for the surgeons who didnt.

If you want to read into it, you can try reading into this book or do more research online.
https://www.amazon.com/Facial-Feminization-Surgery-Guide-Transgendered/dp/1886039933

Plenty in this book, and the kindle version is quite cheap.

https://www.amazon.com/Facial-Feminization-Surgery-Guide-Transgendered/dp/1886039933