At Another Johns Hopkins Member Hospital: The Center for Transgender and Gender Expansive Health Team at Johns Hopkins, More about the Center for Transgender and Gender Expansive Health, Center for Transgender and Gender Expansive Health. The surgeon may simply shave or grind down the bony ridge or cut a piece of existing bone (osteotomy) and replace it with a bone graft with a smoother surface. Relationship with a mental health care provider who will see you 4-6 weeks after your surgery. The World Professional Association for Transgender Health promotes the highest standards of health care for individuals through the articulation of Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People. 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. The most important thing to us is getting you fit and healthy with our network of fitness experts and cutting-edge facilities. Patients who have met these criteria are deemed appropriate surgical candidates. 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. Various techniques may be used to perform this procedure, and they are surgeon and patient dependent. Contraindications to facial feminization (which are surgeon dependent) may include: The risks associated with facial feminization surgery depend on the specific procedure being performed. The procedure is done through a 3cm incision along the scrotum. Many people do voice feminization therapy before surgery. The Latest in Non-Invasive and Minimally Invasive Face & Body Contouring. *Exceptions made for adolescents seeking masculinizing chest surgery; decisions made on a case-by-case basis. Please check with your insurance provider to make sure that it is covered. When icing, be sure to stick to these tips: Your surgeon may also ask that you keep your head elevated for at least two weeks after your surgery. Dont have realistic expectations about the results. 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. Dubov A, Fraenkel L. Facial Feminization Surgery. In facial masculinization, the nose and chin are augmented and widened to create a more masculine appearance. He welcomes patients in his hospital base and private practice offices. The procedure may include reducing the prominence of the bony ridge above your eyes and reshaping the hairline. Facial feminization surgery (FFS) involves several surgeries that can be done to feminize the facial features. A drain is a thin, plastic tube that the surgeon places under your skin. 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. 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. Instead, a staged approach, based on your priorities, is recommended. Even though transgender or non-binary patients undergoing breast augmentation ("top surgery") or vaginoplasty ("bottom surgery") need to meet certain criteria set forth by the World Professional Association for Transgender Health (WPATH) before being approved for surgery, there are no specific criteria for patients undergoing a facial feminization procedure. University of California, Sam Francisco. Brubaker L, ed. Bathing and showering: Avoid showering, and gently sponge bathe instead until you return for your first post-surgery appointment and your doctor says it is OK to resume showering. Your provider may use steroid injections or Botox injections after surgery. BMI requirements are determined by your surgeon. 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. 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. The surgeon may use this method to shape various areas of the face and may include a silicone implant to sculpt the cheeks into a rounder, more feminine shape. A surgeon can reconstruct the forehead by thoroughly measuring the existing bone structure and carefully working around the frontal sinuses behind the bone of your forehead. Facial feminization surgery (FFS) describes a group of procedures that are performed to feminize the face. Over the last several years, we have been actively expanding the surgical services Cleveland Clinic offers to gender and sex-minority patients. The Ethics of Gatekeeping in Transgender Health. The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with safe and effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment. This procedure includes removal of breast tissue with masculinizing chest contouring and nipple grafting in some cases. While facial feminization surgery has many potential benefits, the decision to proceed with it requires careful thought and preparation, especially given the surgery's psychological and social implications. 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. It helps drain blood and fluid to prevent swelling. Cutting and reformatting the scalp can lower the hairline and give it a more feminine or nonbinary look. To optimize your wound healing and surgical results, it's important to follow post-operative instructions carefully. Please check with your insurance provider to make sure that it is covered. Living in gender role full time for minimum of 12 consecutive months. Voice feminization surgery raises the pitch of your voice, making it sound higher. 9500 Euclid Ave. 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. Facial feminization surgery is different for everyone. RealSelf Tip: The average cost of FFS for cisgender . Genioplasty: Transgender genioplasty is performed to transform a wider, flatter, longer, and more squared masculine chin to a narrower, shorter, more rounded female chin. Kaiser Permanente. The Adams apple is an area of cartilage around the larynx (voice box) that tends to be larger in people assigned male at birth. Cleveland Clinic is a non-profit academic medical center. Many people who are transitioning from male to female consider this an important step in their transition process. Were happy to complete FMLA and STD paperwork if applicable. 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 Any specific claims or permanence length of results vary for each patient and are not guaranteed. The mental health professional will review your gender identity and dysphoria and help you determine how the surgery fits into your overall treatment plan. Transportation After Surgery: You must have a family member, friend or caregiver drive you home from surgery as medical transportation cannot be used upon hospital discharge. Deschamps-Brely J. American Society of Plastic Surgeons. But some procedures require incisions (cuts) on the outside of your throat. Some surgeons recommend splitting the procedures into two surgeries, separated by seven to 10 days or longer. The cost of the hotel stay is out-of-pocket, as insurance does not cover this expense for your surgery. doi:10.1001/jamafacial.2016.1572, Pittman TA, Economides JM. The operations usually consist of multiple procedures including those listed below . You will be advised to rest for a couple of days. Comprehensive care for transgender patients involves a wide spectrum of services, ranging from routine medical visits to the physical transition process. Thank you, {{form.email}}, for signing up. Dr. Dorafshar's research is focused on gender . Indian J Plast Surg. However, the cost can range from $1,847 to $62,000, depending on a few key factors. 2020. The surgeon can perform a nose-reshaping operation called arhinoplasty(sometimes called a nose job) to reduce the width and shape of the nose. Dr. Dorafshar is a highly distinguished plastic and reconstructive surgeon who specializes in gender-affirming facial surgery. Risks of facial feminization surgery include: Face feminization surgery can help give you the physical appearance of the gender you identify with. The techniques can help transgender women transition physically to their self-affirmed gender. Am J Bioeth. The precise steps of your surgery will depend on the type of procedure(s) you are having. Some of the most popular procedures performed by Dr. Totonchi include: Tracheal Shave: A tracheal shave reduces the size of the Adams apple to achieve a smoother, more elongated appearance of the neck. The tracheal shave procedure performed alone does not have any downtime. Each patient is different and your expectations and desired results will be discussed fully in your consultation. Facial feminization surgery has a wide range of recovery time depending on the combination of procedures that are chosen. Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. This IV will be used for administering fluids and medications during and after surgery. Dr. Totonchi is also an Associate Professor at Case Western Reserve Universitys School of Medicine. 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. More people (about 14%) choose to have nonsurgical voice feminization therapy instead. Lauren Schlanger, MD, is a board-certified primary care physician. He lectures nationally and internationally on these topics. American Psychiatric Association. The entire of scope of jaw contouring procedures are done from incisions made inside the mouth. Our providers specialize in head and neck surgery and oncology; facial plastic and reconstructive surgery; comprehensive otolaryngology; laryngology; otology, neurotology and lateral skull base disorders; pediatric otolaryngology; rhinology, sinus and skull base surgery; surgical sleep; dentistry and oral and maxillofacial surgery; and allied hearing, speech and balance services. Vocal Feminization for Transgender Women: Current Strategies and Patient Perspectives. They control the pitch of your voice. About. Your surgeon andanesthesiologistwill come to greet you and review the operation with you. In extreme cases, a tissue expansion is used to achieve the desired effect. The male nose, like the masculine chin, is typically longer, wider, and larger than the female nose which is generally shorter, narrower, and smaller in relation to female features. How long it takes: This depends on what you are having done. By Elizabeth Boskey, PhD FFS is typically sought by the transgender population but can be performed for anyone seeking to soften their facial features. He will assist you in choosing the best surgical plan to attain your desired outcome. Your surgical team will review these with you as you get closer to surgery. They may recommend certain ointments or treatments to address them sooner than later. Dr. Amir Dorafshar. This type of healthcare provider specializes in surgery to change or enhance your physical appearance. Intonation (adapting the sound of your voice to express emotions). The combination of these procedures, however, does not increase the recovery time. Depending on the specific procedure being performed, there may be more than one approach that a surgeon can use. Your surgeon will also take photographs of your face during this visit. He has now performed over 200 feminizing bottom surgeries and his practice is fully dedicated to providing gender-affirming surgical care. Double-check with your surgeon, but taking an over-the-counter herbal product called Arnica may also be recommended to further ease any bruising and swelling on your face. All patients are fully assessed for their safety prior to surgery. Avoid driving until you are off all pain medication and your surgeon gives you the OK. Rates are subject to change each year, but please plan for a minimum of $2,000 for the hotel stay. Have a mental health disorder that impairs your ability to make appropriate personal decisions. After surgery, you may feel more confident and secure in your gender expression. Those looking to soften and feminise their facial features such as their jaw, cheeks, forehead and nose. 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. Make sure you bring your driver's license, insurance card, and a list of your medications. However, it can take months for you to see the full results of the procedure. If you experience symptoms ofdepressionor anxiety before or after surgery, be sure to talk with your healthcare provider, therapist, or other mental health professional. Cleveland Clinic requires that all patients seeking the following gender affirming surgical services, must obtain a letter from a licensed mental health professional (counselor, social worker, etc.) 2021. 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. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.plasticsurgery.org/reconstructive-procedures/facial-feminization-surgery). In FMS, the cheeks can be made more angular and prominent in order to mimic a masculine facial bone structure. At this appointment, your surgeon will check your incision sites, remove any non-dissolvable stitches, and monitor you for complications. He offers Facial Feminization and Masculinization Surgery as part of the Gender Affirmation Surgery Program at Rush university Medical Center. Nicotine/nicotine-related product free (minimum 3 months). In preparation for facial feminization surgery of the jaw and chin, the surgeon may request an evaluation by a dentist or orthodontist to ensure your teeth and jaw bones are healthy and that you do not have any infected teeth, cavities or third molars (wisdom teeth) that have not yet emerged or been extracted. Facial feminization surgery is a series of procedures that can reshape the face and its features to achieve a more feminine appearance. We recognize that you have many options when it comes to your cosmetic or plastic surgery needs. Various techniques may be used to perform this procedure, and they are surgeon and patient dependent. Facial feminization surgery may be part of the treatment approach for a person who desires a more feminine facial appearance. Facial Plast Surg Clin North Am. Parts of this website will not display or function properly. Facial pain and tightness after surgery will vary in severity based on the procedures you underwent. Plastic and Reconstructive Surgery: Facial Feminization. Surgical manipulation of the bone and soft tissues of the face create a feminine appearance. Patient Checklist for Vaginoplasty & Phalloplasty/Metoidioplasty. Your vocal cords (also called vocal folds) are bands of soft tissue in your larynx (voice box). 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. That said, general risks of this surgery include: The purpose of facial feminization surgery is to change masculine facial features into feminine ones. Before and after photos on this website are Dr. Totonchis actual patients and all patients have given consent for use of these photos. Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. Reviewed November 2020. Technical and clinical considerations for facial feminization surgery with rhinoplasty and related procedures. Whether you want to minimize signs of aging or improve a life-long aesthetic concern, Dr. Totonchi offers both surgical and non-surgical facial procedures to help you achieve your desired look. Have a health condition that makes surgery dangerous. The assessment must document that an individual meets all of the following criteria: o Persistent, well-documented Gender Dysphoria The most common features that FFS addresses are the hairline, forehead, nose and jaw. 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. 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. That said, if you are seeking facial feminization surgery as a component of your gender transition, your surgeon may recommend that you receive clearance from a qualified mental health professional. Facial feminization surgery (FFS) includes a series of plastic and craniofacial surgical procedures designed to feminize the face. Dr. Totonchi offers a variety of leading-edge treatments to help you feel and look younger. Risks of voice feminization surgery include: The major benefit of voice feminization surgery is that you can achieve a pitch that more closely matches your gender identity. 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. Transgender women may choose the surgery as part gender confirmation process. Forehead contouring (frontal bossing): Forehead contouring involves shaving down the frontal bone and altering its pronounced shape. Minimize sun exposure and always wear sunscreen. The brow lift procedure moves the eyebrows to a higher set position on the forehead, giving a softer, wide eyed, feminine appearance. Scarring inside your voice box or on the outside of your throat. Healthcare providers recommend voice feminization therapy before and after surgery. He is also one of the few plastic surgeons in the area who performs surgical treatment of migraine headaches and also facial feminization surgery. You may go home with a surgical drain. Out of state residents: You may want to include your pre-operative day as well as the days you will be in the hospital in your hotel reservation if you are traveling from afar; this will allow a safe and comfortable place for you to perform your peri-operative preparations as well as provide your guest with a place to stay nearby while you are in the hospital. All of this information helps your surgeon plan your treatment. JAMA Facial Plast Surg. Your consultation can be scheduled once 50% of hair removal is completed. The course of recovery for the different procedures can vary, and it can be influenced by your general state of health and your self-care after surgery. Plast Reconstr Surg 2016 Feb;137(2):438-448.doi:10.1097/01.prs.0000475754.71333.f6. Voice feminization surgery includes the following steps: Depending on the type of surgery you have, your surgeon does the following: Voice feminization surgery is usually an outpatient procedure. While estrogen won't affect your bone structure, it will redistribute facial fat, and this may alter your surgical plan. This procedure is often done in conjunction with chin reshaping. FFS can change your hairline, forehead, nose, jaw and other parts of your face. Contact your healthcare provider right away if you experience any of these complications after your surgery: Facial feminization surgery (FFS) is a procedure to make your face appear more feminine instead of masculine. 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. Preparing for Surgery: Checklist. Before the first consultation, the surgeon may schedule photographs,X-raysand a 3DCT scanthat shows your facial bones and soft tissue. In the case of patients with more narrow mandible angles, jaw implants are used to create a more defined jaw structure. SUPPORT Patreon: https://www.patreon.com/jessiege. Browseour articlesto find trusted information on training, nutrition, getting back to good health and much more. You may need to sign one or more consent forms at this time. Meta. Do not eat or drink anything after midnight on the eve of your surgery. drtotonchi.com. The procedure changes the length, tightness or size of your vocal cords. Male hysterectomy/vaginectomy - 2 letters must be obtained. They control the pitch of your voice. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 2018; 2018: 1947807.doi:10.1155/2018/1947807, Telang PS. Chest surgery is sometimes performed as an outpatient procedure but some patients may require one night stay in the hospital. Avoid exercise or other strenuous activities for at least four weeks after your surgery. If you have decided to pursue surgery, be sure to reach out to friends and loved ones who can provide support for you during this time. Chest surgery (breast augmentation, masculinizing mastectomy) - 1 letter must be obtained. Insurance Dr. Angela Rodriguez San Francisco, California University of California, San Francisco. The use of modern technologies allows new options in the treatment of complex situations. Dr. McClung is a board-certified urologist in Columbus, Ohio who specializes in gender-affirming Vaginoplasty. This is typically only needed if you are undergoing surgery as a gender-affirming operation. Additionally, the forehead and brow ridge are reshaped to create a softer contour with feminine highlights. 2018 Dec; 18(12): 39. Facial feminization surgery is most commonly performed as a treatment for gender dysphoria, which is when an individual experiences significant distress related to a strong desire to be of another gender. 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. American Society of Anesthesiologists. (415) 353-9500. The incision is closed with sutures (stitches). The Ethics of Gatekeeping in Transgender Health, Feminizing the Face: Combination of Frontal Bone Reduction and Reduction Rhinoplasty, Facial Feminization Surgery: A Review of 220 Consecutive Patients, Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7, Transgender Medical Clearance Sample Letter. The average cost of facial feminization surgery (FFS) is $34,372, according to 217 reviews from RealSelf members. Hysterectomy is often performed as an outpatient procedure, but some patients may require one night stay in the hospital. New masking guidelines are in effect starting April 24. Your vocal cords (also called vocal folds) are bands of soft tissue in your larynx (voice box). Facial Feminization Surgery Cleveland, Ohio. Once your provider removes your stitches, you may be able to return to work or light activities. Waltham, MA: UpToDate, Coleman E, Bockting W, Botzer M, et al. Nonverbal communication, such as eye contact, gestures, articulation and pausing. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. On the other hand, a cisgender woman with a receding hairline may only desire a hairline advancement procedure. Facial Feminization Surgery is a critical part of a transition timetable for a transgender patient who has decided to live full time as female. For patients having forehead and hairline contouring, the brow can be lifted through the same incision made in the scalp. There will be several postoperative appointments after your surgery depending on what type of surgery you have. That said, whether you are recovering from one or multiple procedures, you can generally expect swelling, pain, and tightness. In addition to adjusting the pitch of your voice, a speech-language pathologist helps you feminize: About 1% of transgender women have voice feminization surgery. The total cost will vary depending upon the procedure and the number of stages needed. (2014). {{ filterCtrl.yearsExperienceTitle }} yrs exp, Board Certified Oral & Maxillofacial Surgeon. Please make sure that you have a driver for any postoperative visit that is within 2-4 weeks of your surgery. Use our list of health topics to reach your destination faster. X-rays or CT scans take pictures of the bones and soft tissues of your face and skull. Rates are subject to change each year, but please plan for a minimum of $2,000 for the hotel stay, however, depending upon your personalized plan, the overall cost may be higher. 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. Each patient is different and your expectations and desired results will be discussed fully in your consultation. The procedure is often performed laparoscopically using three 5mm incisions on the lower abdomen. Facial feminization surgery is most commonly performed as a treatment for gender dysphoria, which is when an individual experiences significant distress related to a strong desire to be of another gender. 2019 May;27(2):191-197.doi:10.1016/j.fsc.2018.12.002. Case Rep Surg. A rhinoplasty can also shape the bridge and the tip of the nose to give them a more delicate appearance. A cartilage graft is used to change the size and shape of the nose.
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