Your surgeon may use a laryngoscope to access your voice box. Some people who undergo this procedure experience side effects, most of which resolve in about a week, such as: To shape the facial contours, the surgeon may recommend a procedure to remove a small amount of fat from one part of the body and use it to add volume and smooth out hollowed or sunken areas. Don't submerge your incisions sites underwater (e.g., when taking a bath or swimming) for three to four weeks. To minimize swelling (which peaks two to three days after the operation), your surgeon will probably advise you to ice your face. Remember, too, that not everyone has the same understanding of femininity, so be sure to review how your surgical plan aligns with your expectations with your surgeon carefully. If you decide to proceed with surgery, various tests will be recommended for medical and anesthesia clearance. From there, you will walk on your own into the operating room or be wheeled on a gurney. Brow lift: The brow lift/forehead lift gives the most dramatic FFS results. This is often because the insurance company may deem the surgery as cosmetic or not medically necessary. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.plasticsurgery.org/reconstructive-procedures/facial-feminization-surgery). doi:10.1055/s-0040-1716440, Ferrando CU, Thomas TN. {{ filterCtrl.yearsExperienceTitle }} yrs exp, Board Certified Oral & Maxillofacial Surgeon. The surgery is usually done under general anesthesia. Even with a documented diagnosis of gender dysphoria, facial feminization surgery is not consistently covered by insurance. Dr. Totonchi knows your goals are extremely important and will listen and help you understand how these can be accomplished. The incisions used to insert cheek implants or fat grafting are made through the mouth so there is no evident scar on the surface of the face. A surgical procedure called a chondrolaryngoplasty, or tracheal shave, can reduce the size of an Adams apple and create a smoother neck profile. When adding the rhinoplasty procedure, nasal splints and stents are kept in placed for 2 weeks before removal. The price you see is the price you pay. This procedure involves making features more prominent and hence more masculine in appearance. Here, you will change into a hospital gown. The cost of the hotel stay is out-of-pocket, as insurance does not cover this expense for your surgery. Most patients can resume a normal diet after surgery; although, your surgeon may have you stick to soft foods (e.g., yogurt or scrambled eggs) in the beginning. In facial feminization surgery, our skilled surgeons bring our suite of face contouring procedures to bear with the goal of making the transgender woman appear more feminine. Dr. Amir Dorafshar. Healthcare providers usually recommend voice feminization therapy before and after surgery. First clinical follow-up: This usually occurs within five days of surgery, and will be scheduled before you leave. Living in gender role full time for minimum of 12 consecutive months. A tracheal shaving procedure involves reduction of the thyroid cartilage to reduce the size of the Adams apple. Resonance (how you pass air through your vocal folds to control the intensity of your voice). Policy. A speech-language pathologist works with you on: Your speech-language pathologist also makes sure you dont have any existing voice disorders that could prevent a successful surgery. Make sure you bring your driver's license, insurance card, and a list of your medications. Orchiectomy is a procedure done to remove the testes which alleviates genital dysphoria in some patients and eliminates the need for androgen (testosterone) suppression and optimize the effects of estrogen. FFS usually does not happen in one operation. If you are concerned about scarring, contact your surgeon. CareCredit credit card can help finance cosmetic surgery, minimally invasive procedures, dermatology expenses and more. Surgery changes the folds so they vibrate differently and make higher sounds when you speak. The highest standards of clinical care in state-of-the-art facilities, with Consultant-led treatment, spotlessly clean rooms, and a team of dedicated and experienced nurses. Determine what it is that you like or dislike about your look. Forehead contouring typically removes this ridge and softens the appearance of the forehead and facial features. The brow lift procedure moves the eyebrows to a higher set position on the forehead, giving a softer, wide eyed, feminine appearance. 9500 Euclid Ave. Since estrogen increases your risk of blood clots, your surgeon will ask you to stop estrogen therapy (if applicable) for a designated period of time before surgery. Vaginoplasty surgery involves creation of the vulva (outer female genital structures) with or without a vaginal canal. We are happy to share a list of qualified hair removal providers as well as qualified mental health providers upon request. Technical and Clinical Considerations for Facial Feminization Surgery With Rhinoplasty and Related Procedures, Preparing for Facial Feminization Surgery: Timing, Plastic and Reconstructive Surgery: Facial Feminization, Facial Feminization Surgery: What to Expect and Post-Operative Care, Recovery After Facial Feminization Surgery, Full Facial Feminization Surgery: Patient Satisfaction Assessment Based on 180 Procedures Involving 33 Consecutive Patients, Insufficient social support to move through the surgical process, No confirmed diagnosis of gender dysphoria (if applicable), Inability to provide informed consent of surgery, Infection and problems with wound healing, Nerve damage and subsequent numbness after surgery, Infected titanium plates/screws that may require removal, A reduction in gender dysphoria (if applicable), An improvement in self-esteem and quality of life, Wide-collar, zip-up, or button-up shirt to wear when leaving the hospital, Small personal or comfort items (e.g., cell phone and charger), Apply the ice to your face for no longer than 20 minutes within an hour-long period. Facial Feminization Surgery: A Review of 220 Consecutive Patients. But some procedures require incisions (cuts) on the outside of your throat. He lectures nationally and internationally on these topics. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. This type of healthcare provider specializes in surgery to change or enhance your physical appearance. Your complete postoperative recovery will be about 6-8 weeks but this varies with each individual. Letters of referral from aqualified mental professional (depending on the surgery, 1 or 2 letters may be required). Your surgeon will bandage the surgical area with a special compressive dressing around your jaw, which will remain in place for a few weeks after surgery. Have a health condition that makes surgery dangerous. Most facial plastic surgeries involve a day or so in the hospital for observation and to ensure you are healing properly before you are released to go home. Anna's Place - Trans: Facial Feminisation Surgery Recovery After Facial Feminization Surgery. Facial Feminisation Surgery | Nuffield Health After surgery, you may go home or to a hotel (if you are out of town), or your surgeon may have you stay overnight in the hospital. Am J Bioeth. Do not wear makeup, hairspray, nail polish, or deodorant. There are no time limits on your aftercare. Facial Feminization Surgery is a critical part of a transition timetable for a transgender patient who has decided to live full time as female. SUPPORT Patreon: https://www.patreon.com/jessiege. All patients are fully assessed for their safety prior to surgery. They control the pitch of your voice. Once all criteria have been met, we will be happy to schedule a formal surgical consultation. For example, a transgender woman or non-binary individual who feels uncomfortable or distressed with the gendered structure of their face may desire several procedures, including a forehead reduction, rhinoplasty, tracheal shave, chin and jaw reduction, and fat grafting. New masking guidelines are in effect starting April 24. RealSelf Tip: The average cost of FFS for cisgender . The cost of the hotel stay is out-of-pocket, as insurance does not cover this expense for your surgery. Dysphonia (difficulty speaking), such as voice breaks or tremors. Facial Feminization Surgery: What You Should Know - Healthline It is strongly suggested that all prospective clients perform their own independent research regarding Totonchi Plastic Surgery and our qualifications. Our team follows the World Professional Association for Transgender Health (WPATH) guidelines to ensure patients are appropriate surgical candidates. FFS is typically sought by the transgender population but can be performed for anyone seeking to soften their facial features. Just look for the RealSelf Verified badge. Undergoing this procedure will not interfere with the possibility of having future vaginoplasty. He welcomes patients in his hospital base and private practice offices. Pain and discomfort: Most people experience some discomfort for four or five days after surgery, but this should begin to ease, allowing you to gradually return to normal activities. FFS can include hairline lowering, jaw reduction, rhinoplasty (nose reshaping), eyelid surgery, face or neck lift, and other facial changes. Chest surgery (breast augmentation, masculinizing mastectomy) - 1 letter must be obtained. For a better experience, please enable JavaScript. 2021. In addition to treating patients with cosmetic procedures like facelift,rhinoplasty,eyelid surgery, breast augmentation,breast lift,tummy tuck,liposuction, facial feminization, or other non-surgical cosmetic surgeryprocedures at his Cleveland practice, Dr. Totonchi is also known for his treatment and care of children with issues ranging from facial deformities to cleft palates. By undergoing facial feminization surgery, a person may experience one or more of the following benefits: If you are considering facial feminization surgery, your first step will be to schedule a consultation with a plastic surgeon who specializes in this type of surgery. (415) 353-9500. Were happy to complete FMLA and STD paperwork if applicable. These techniques are tailored to fit the goals of each individual. Insurance Coverage: This procedure is covered by many insurance plans when criteria has been met. The assessment must document that an individual meets all of the following criteria: o Persistent, well-documented Gender Dysphoria For genital surgery, a written psychological assessment from at least two Qualified Behavioral Health Providers experienced in treating Gender Dysphoria*, who have independently assessed the individual, is required. These changes address the gendered differences in facial structure that occur due to testosterone exposure during various phases of development. We do not endorse non-Cleveland Clinic products or services. Your diet instructions may also vary depending on whether you had any procedures performed in or around your lips, mouth, or jaw. Comprehensive care for transgender patients involves a wide spectrum of services, ranging from routine medical visits to the physical transition process. The surgeon shaves away some of the cartilage from the front of the larynx to make it smaller and less prominent. It is the patients responsibility to disclose all medical and surgical history to the consultant or specialist nurses. Have disorders that require androgen (male sex hormone) therapy as treatment. You may need to sign one or more consent forms at this time. 2023 Totonchi Plastic Surgery | Website designed & developed by Ceatus Media Group, LLC*Disclaimer: The photos, results, and testimonials on this website are not intended to represent the results that all patients will experience. Instead, a staged approach, based on your priorities, is recommended. Voice Feminization Surgery - Cleveland Clinic They control the pitch of your voice. You will be advised to rest for a couple of days. You may go home with a surgical drain. As a professor, Dr. Totonchi understands the importance of education and he will take time to answer all of your questions, and present you with the best plan possible for your procedure, giving you full confidence as you move forward with your decision. Once your provider removes your stitches, you may be able to return to work or light activities. American Society of Plastic Surgery. Case 1 Facial Feminization Surgery: What are the risks of facial feminization surgery? Your goals are extremely important and Dr. Totonchi will help you understand how your goals can be accomplished with the proper expectations for the cosmetic or other surgical procedure you are seeking. Generally most patients are in hospital for around 2 to 3 days. Minimize sun exposure and always wear sunscreen. Out-of-pocket costs will also be discussed at this visit. While estrogen won't affect your bone structure, it will redistribute facial fat, and this may alter your surgical plan. Some surgeons recommend splitting the procedures into two surgeries, separated by seven to 10 days or longer. Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. The tracheal shave procedure performed alone does not have any downtime. The placement and size of the implant will depend on the individual patients facial anatomy. You may need a second surgery to achieve your target pitch. Facial feminization surgery (FFS) encompasses a series of surgical interventions designed to make your face appear more feminine. The use of modern technologies allows new options in the treatment of complex situations. She is an assistant professor at the Alpert Medical School of Brown University. Dubov A, Fraenkel L. Facial Feminization Surgery. We require that patients live full time as their self-affirmed gender for more than one year, that they have undergone cross-sex hormone therapy for at least one year, and that they have letters of support for surgical transition from two mental health professionals who are well-versed in transgender patient care. Depending on your priorities, the plan you agree on with your surgeon may include one or more of the following procedures: Shaping the forehead and hairline can create a more oval or heart shape to the face. Forehead lengthening is a procedure, which elongates the forehead, increasing the distance between the brow ridge and hairline. Facial Feminization Surgery: Everything You Need to Know. There will be several postoperative appointments after your surgery depending on what type of surgery you have. 2021. The procedure takes one to two hours and may not require admission to the hospital. We will equal any comparable price. Facial Feminization Surgery Before & After Pictures - RealSelf In terms of restarting estrogen therapy (if this applies to you), confirm with your healthcare provider, but patients can usually restart within two to three days after surgery. Facial feminization is a set of cosmetic procedures done to soften typical male facial features and provide more classically feminine features to the face and neck. Though the procedures are largely safe, it is important tocall your doctor right away if you develop a fever, severe pain or other signs of infection, or if you have any other concerns. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Facial Feminization Surgery (FFS). At this time, you may feel pain and nausea. These procedures include but are not limited to: rhinoplasty, forehead contouring, jaw angle reduction, chin width reduction, lowering the hairline, hair transplantation, cheek augmentation, lip augmentation and upper lip shortening. Relationship with a mental health care provider who will see you 4-6 weeks after your surgery. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Most people continue voice feminization therapy after surgery. Ohio Facial Feminization Surgery 19 Facial Feminization Surgery doctors in Ohio, USA CareCredit credit card can help finance cosmetic surgery, minimally invasive procedures, dermatology expenses and more. Cleveland Clinic is a non-profit academic medical center. Are a transgender woman (male transitioning to female). Last reviewed by a Cleveland Clinic medical professional on 09/06/2021. Since your face contains lots of blood vessels, it easily swells and bruises, and this can be quite dramatic after your surgery. Cheek augmentation: Cheek augmentation can be achieved with fat grafting and/or implants. Postoperative appointments: There will be several postoperative appointments after your surgery depending on what type of surgery you have. You may consider this surgery if youre a transgender woman (transitioning from male to female). Dr. Totonchi is not liable for any actions or decisions that may have been taken as a result of information provided on this website. Facial feminisation surgery can involve a combination of all or some of the below cosmetic procedures. Spread the cost of your treatment with a 6, 10 or 12 month 0% personal medical loan. How Much Does Facial Feminization Surgery Cost? | RealSelf Your doctor will provide instructions on returning to work and exercise and other tips on whats safe to do and when. The combination of these procedures, however, does not increase the recovery time. Hairline advancement (scalp advancement): Scalp advancement is a procedure done to move the hairline forward, decreasing the prominence of the forehead. Browseour articlesto find trusted information on training, nutrition, getting back to good health and much more. Facial feminization surgery is different for everyone. Cutting and reformatting the scalp can lower the hairline and give it a more feminine or nonbinary look. Talk to your healthcare provider or your psychologist before the procedure so you know what to expect. Advertising on our site helps support our mission. Some of these procedures are listed below: Male-to-female brow reshaping Male-to-female facelifts Male-to-female rhinoplasty (nose reshaping) Male-to-female eyelid surgery Sometimes voice feminization surgery doesnt produce the results you want. Dr. Totonchi is a Board-Certified Plastic Surgeon from the American Board of Plastic Surgery, he is proudly serving Cleveland, and its east and west side suburbs in Westlake and Lyndhurst. Bruises, including black eyes, may take four to six weeks to clear up. Several surgical techniques are available to change the length, tightness or size of your voice box. You will likely be given anopioidto start, followed byTylenol (acetaminophen)alone. Generally speaking, the recovery time is approximately 2-3 weeks when involving one of these procedures or a combination of these: forehead contouring, hairline advancement, brow lift, rhinoplasty or genioplasty. For more information about the program or to make an appointment, please contact the Transgender Surgery Program at 216.445.6308. Nonverbal communication, such as eye contact, gestures, articulation and pausing. Avoid exercise or other strenuous activities for at least four weeks after your surgery. FFS can change your hairline, forehead, nose, jaw and other parts of your face. He has also given relief to many patients who have suffered from migraine headaches with an innovative technique that has been developed by Dr. Bahman Guyuron. It is performed as an outpatient procedure. 2020 Aug; 53(2): 244253. The Adams apple is an area of cartilage around the larynx (voice box) that tends to be larger in people assigned male at birth. Technical and clinical considerations for facial feminization surgery with rhinoplasty and related procedures. Phalloplasty/metoidioplasty - 2 letters must be obtained. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024865/). Vaginoplasty (female genital reconstructive surgery) - 2letters must be obtained. Please check with your insurance provider to make sure that it is covered. Dr. Dorafshar is a highly distinguished plastic and reconstructive surgeon who specializes in gender-affirming facial surgery. Insurance Coverage:This procedure is sometimes covered by insurance plans when criteria has been met. Gender Affirming Surgery: Before and After Photos - Cleveland Clinic The recovery time remains 2-3 weeks. To ease discomfort, take your pain medication exactly as prescribed. They vibrate when you take in air. 2020. You may find it painful to chew solid food for a few days. BMI requirements are determined by your surgeon. Warning: You do not have JavaScript enabled. Several procedures can be recommended to revise the contours of the jaw and chin: FFS jaw surgeryrequires making an incision inside the mouth, which will be closed with dissolvable stitches. FFS is typically sought by the transgender population but can be performed for anyone seeking to soften their facial features. Read our, Estrogen for Transgender and Transfeminine People, Eyelid Surgery: Everything You Need to Know, Tympanoplasty Surgery: Everything You Need to Know, Trapeziectomy: Everything You Need to Know, Bunion Surgery: Everything You Need to Know, What to Know About Big Toe Bone Spur Surgery (Cheilectomy), Quintuple Bypass Surgery: Everything You Need to Know, Amblyopia Surgery: Everything You Need to Know, Sinus Surgery: Everything You Need to Know, Capsulectomy Surgery: Everything You Need to Know, Breast Reduction vs. Top Surgery: Uses, Benefits, Side Effects, and More, Facial feminization for cisgender women with masculine-looking faces, Facial Feminization Surgery. FFS addressed your forehead prominence (frontal bossing), hairline, eye socket shape, nose, cheeks, temples, lips, chin . Surgery will be carried out under general anaesthetic and can typically range from around 4 to 8 hours depending on the procedures. Various techniques may be used to perform this procedure, and they are surgeon and patient dependent. Dr. Totonchi offers a variety of leading-edge treatments to help you feel and look younger. However, facial masculinization surgery (FMS) is gaining popularity. Ask your surgeon about how to re-dress your incisions after washing them and applying ointment. Before and after photos on this website are Dr. Totonchis actual patients and all patients have given consent for use of these photos. Waltham, MA: UpToDate, Coleman E, Bockting W, Botzer M, et al. While the surgery takes place, you will be asleep under general anesthesia. Not enough pitch increase (voice is still too low). Facial Feminization Procedures Facial feminization surgery (FFS) involves several surgeries that can be done to feminize the facial features. You may be prescribed an oral antibiotic or an antibiotic ointment to apply to your incision sites, once or multiple times a day for the first week after surgery. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458845/). When you awaken from surgery, there will be a drain in place; this will likely come out before you are released to go home. Although. 2012;13(4):165-232. doi:10.1080/15532739.2011.700873. Feminizing the Face: Combination of Frontal Bone Reduction and Reduction Rhinoplasty. During your consultation, your plastic surgeon will review your goals and expectations, the recommended procedures, and all potential risks involved. doi:10.1080/15265161.2018.1531159, Salgado CJ, AlQattan H, Nugent A, et al. Your surgeon will probably give you the OK to shower around 48 hours after your operation. Denver Health. From there, you will probably see your surgeon at these time frames after surgery: Call your healthcare provider right away if you experience: Depending on the number and types of procedures you underwent, the final results of your surgery make take up to six to nine months to appear, and scars can take up to a year to heal.