They control the pitch of your voice. When adding the rhinoplasty procedure, nasal splints and stents are kept in placed for 2 weeks before removal. Since your face contains lots of blood vessels, it easily swells and bruises, and this can be quite dramatic after your surgery. Healthcare providers recommend voice feminization therapy before and after surgery. Among the various gender-affirming procedures, facial feminization surgery (FFS) is arguably the most commonly denied surgery, as insurance companies often deem the involved procedures as cosmetic and not medically necessary. The total cost will vary depending upon the procedure and the number of stages needed. If you are staying overnight, you will be moved to a hospital room once you are fully awake. Its important to have realistic expectations about the results of voice feminization surgery. Brubaker L, ed. 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. Here, you will change into a hospital gown. What are the masculine features that you would most like to soften and make more feminine? Your voice box will need several weeks to heal after voice feminization surgery. 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. Voice feminization surgery raises the pitch of your voice, making it sound higher. Facial Feminization Surgery: What are the risks of facial feminization surgery? An Adams apple that is still prominent after the procedure, Removal of too much cartilage, which can damage the vocal cords. 2020 Aug; 53(2): 244253. Financing & Support for Gender Confirmation 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. Case Rep Surg. In older patients, the eyelids may also be lifted to open the eyes and achieve a more feminine look. They may recommend certain ointments or treatments to address them sooner than later. 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. Using a highly individualized approach, the plastic surgery team works with the patient to develop a plan that best meets the individuals needs and preferences. 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. For patients who are only having a brow lift, the surgeon can make four or five small, one-centimeter incisions in the hairline or an incision around the brow line. Nuffield Health looks after your health and wellbeing in ways that go beyond getting you fit and getting you back on your feet, that's what makes us specialists in you. Facial feminization surgery has a wide range of recovery time depending on the combination of procedures that are chosen. Facial Feminizations Mastectomies Vaginoplasty Breast Augmentations This procedure involves enlargement of the breasts with an implant. YOU WILL NOTICE A DIFFERENCE IN SERVICE AND CARE THE MOMENT YOU VISIT OUR OFFICE. Incision sites may also vary with certain procedures. While not all patients require this procedure, it can be helpful in achieving a more harmonious profile with the use of cheek implants. Find out if you benefit from a discounted membership. These images help the surgeon plan your surgeries and provide a baseline for evaluating results after your procedures are finished. Your healthcare provider will probably take out the nonabsorbable stitches a week after your surgery, or they may place absorbable stitches that don't need to be removed. Use our list of health topics to reach your destination faster. The Adams apple is an area of cartilage around the larynx (voice box) that tends to be larger in people assigned male at birth. Your vocal cords (also called vocal folds) are bands of soft tissue in your larynx (voice box). Facial Feminization Surgery FFS Insurance Coverage A variety of techniques can be employed for the chin, which includes the use of a chin implant, osteotomy (cutting and shaping of the chin bone), or fat graft. 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. Facial feminization surgery is a series of procedures that can reshape the face and its features to achieve a more feminine appearance. 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. Other common post-operative instructions may include: You can expect to see your surgeon for your first follow-up visit around one to two weeks after surgery. Youll have gauze or bandages over your incisions for several days. The cost of the hotel stay is out-of-pocket, as insurance does not cover this expense for your surgery. 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. Breast augmentation is often performed as an outpatient procedure but some patients may require one night stay in the hospital. Facial Feminization Surgery: What to Expect and Post-Operative Care. 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. This means you probably wont have to stay overnight in the hospital or surgery center. The procedure is done through a 3cm incision along the scrotum. 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. The surgery may also be performed in cisgender women who desire a more feminine face or facial feature (e.g., a lower hairline). Your diet instructions may also vary depending on whether you had any procedures performed in or around your lips, mouth, or jaw. Facial surgery with him (in theatre - and they showed a great deal!) Facial feminization surgery - Mayo Clinic Facial Feminization Surgery: What are the risks of facial feminization surgery? Any specific claims or permanence length of results vary for each patient and are not guaranteed. Before the first consultation, the surgeon may schedule photographs,X-raysand a 3DCT scanthat shows your facial bones and soft tissue. He lectures nationally and internationally on these topics. Many people do voice feminization therapy before surgery. A drain is a thin, plastic tube that the surgeon places under your skin. Ask your healthcare provider when its safe for you to resume therapy. Case 1 Thank you, {{form.email}}, for signing up. FFS can change your hairline, forehead, nose, jaw and other parts of your face. Cost of Postoperative Stay: As part of your recovery, you will be staying at the Intercontinental Hotel, which is attached to the Cleveland Clinic Main Campus. If it is not, you will receive information about payment plans at the time of your consultation. Facial Feminization Surgery: Everything You Need to Know. For people in whom hormone therapy is not enough to achieve desired gender-affirming changes to the face, surgery can help. She is an assistant professor at the Alpert Medical School of Brown University. At the end of the procedure, the incision will be closed with sutures that do not need to be removed. Revealing My Post-Facial Feminization Surgery Face! - YouTube 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. All information on this site is intended for general purposes and is in no way a substitute for professional medical advice. 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. Depending on the specific procedure being performed, there may be more than one approach that a surgeon can use. 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. What is facial feminization surgery (FFS)? Before and after photos on this website are Dr. Totonchis actual patients and all patients have given consent for use of these photos. Raffaini M, Magri AS, Agostini T. Full Facial Feminization Surgery: Patient Satisfaction Assessment Based on 180 Procedures Involving 33 Consecutive Patients. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. ), and place an intravenous (IV) line into a vein in your arm. The average cost of facial feminization surgery (FFS) is $34,372, according to 217 reviews from RealSelf members. Generally most patients are in hospital for around 2 to 3 days. Transgender Surgery Ohio - Affordable Facial Feminization Surgery Do not wear makeup, hairspray, nail polish, or deodorant. Copy of your most recent primary care medical records. 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. Reviewing your current medications and any allergies you may have. The surgery softens these features, creating a face that is more oval-shaped. Male hysterectomy/vaginectomy - 2 letters must be obtained. There are no time limits on your aftercare. Browseour articlesto find trusted information on training, nutrition, getting back to good health and much more. Insurance Coverage: This procedure is covered by many insurance plans when criteria has been met. Who might need facial gender surgery? Transgender Medical Clearance Sample Letter. Verywell Health's content is for informational and educational purposes only. 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. It might involve one surgery or a series of procedures. Soft foods and nutritional shakes may be easier to manage. Have a mental health disorder that impairs your ability to make appropriate personal decisions. Vaginoplasty surgery involves creation of the vulva (outer female genital structures) with or without a vaginal canal. If it is not, you will receive information about payment plans at the time of your consultation. Please check with your insurance provider to make sure that it is covered. Facial Feminization Procedures Facial feminization surgery (FFS) involves several surgeries that can be done to feminize the facial features. 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. FFS may be part of an overall plan of gender affirmation, aligning the appearance of the face and body with a persons gender. Additionally, the forehead and brow ridge are reshaped to create a softer contour with feminine highlights. You may need a second surgery to achieve your target pitch. FFS addressed your forehead prominence (frontal bossing), hairline, eye socket shape, nose, cheeks, temples, lips, chin . Lesbian, Gay, Bisexual and Transgender Health Care, World Professional Association for Transgender Health (WPATH) guidelines, Learn more about requirements for specific gender-affirming procedures, View before and after photos of masculinizing chest surgery (mastectomy), View before and after photos of breast augmentation surgery, View before and after photos of vaginoplasty surgery, View before and after photos of facial feminization procedures, World Professional Association for Transgender Health, Transgender Health & Gender Affirming Medical Services. Deschamps-Brely J. American Society of Plastic Surgeons. The procedure takes one to two hours and may not require admission to the hospital. Facial Feminization Surgery - Cleveland Clinic Denver Health. Facial Feminization Surgery Cleveland, Ohio. To access the larynx, the surgeon makes an incision in your neck. Find a Surgeon for Gender Affirming Surgery - TransHealthCare Whatever your reason for undergoing facial feminization surgery, be sure to get recommendations for an experienced board-certified plastic surgeon. July 2020. 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. 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. Patients who have met these criteria are deemed appropriate surgical candidates. Your surgical team will review these with you as you get closer to surgery. Spread the cost of your treatment with a 6, 10 or 12 month 0% personal medical loan. Insurance Dr. Angela Rodriguez San Francisco, California 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. Hormone therapy for 12 consecutive months unless medically contraindicated or if there isdocumentation in the medical record explaining why hormone therapy isnot part of the transition journey. Facial Feminization Surgery is a critical part of a transition timetable for a transgender patient who has decided to live full time as female. Ask your surgeon about how to re-dress your incisions after washing them and applying ointment. 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. Once your provider removes your stitches, you may be able to return to work or light activities. Avoid driving until you are off all pain medication and your surgeon gives you the OK. Surgery changes the length, size or tightness of your vocal cords. Meta. doi:10.1055/s-0040-1716440, Ferrando CU, Thomas TN. The chin plays a crucial role in the proportions and balance of facial features. Before and after photos on this website are Dr. Totonchis actual patients and all patients have given consent for use of these photos. Surgery changes the length, size or tightness of your vocal cords. With the endoscopic approach, smaller incisions and special, pliable instruments are used to perform the procedure. For more information about the program or to make an appointment, please contact the Transgender Surgery Program at 216.445.6308. Brow lift: The brow lift/forehead lift gives the most dramatic FFS results. Dr. Dorafshar's research is focused on gender . FFS usually does not happen in one operation. The price you see is the price you pay. Most people can go home the same day as their procedure. Hair removal completed, free of regrowth. that meets WPATH Guidelines: WPATH Guidelines for Gender Affirming Surgeries. Masculine facial features tend to be square and sharp. Cleveland Clinic is a non-profit academic medical center. Over the last several years, we have been actively expanding the surgical services Cleveland Clinic offers to gender and sex-minority patients. Cleveland Plastic Surgery - Best Cosmetic Surgeon Cleveland Free of any non-prescribed substances including marijuana (minimum 3 months). Your healthcare provider will tell you when you can gradually start using your voice again, as well as when you can resume voice therapy. Not enough pitch increase (voice is still too low). 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. The operations usually consist of multiple procedures including those listed below . Every person's gender journey is different. The doctor may recommend a soft or liquid diet until you can swallow food comfortably. It may be uncomfortable to talk, but it is safe to do so if you can. Cheek augmentation helps to round out the face giving it a feminine appearance. This therapy helps you adapt to the changes in your voice. The procedure can involve cutting or reshaping the bones as well as the cartilage. Our prices are all-inclusive. Facial pain and tightness after surgery will vary in severity based on the procedures you underwent. American Psychiatric Association. 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. 322 Followers, 6 Following, 11 Posts - See Instagram photos and videos from FFS@totonchiplasticsurgery (@facialfeminization) 322 Followers, 6 Following, 11 Posts - See Instagram photos and videos from FFS@totonchiplasticsurgery (@facialfeminization) . If you are concerned about scarring, contact your surgeon. However, it can take months for you to see the full results of the procedure. 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. Facial feminization surgery might be done as a step in the process of treating discomfort due to a difference in gender identity and sex assigned at birth (gender dysphoria). This is done by stretching the skin of the forehead and utilizing laser hair removal in order to eliminate the previous hairline move it further up on the scalp. We are happy to share a list of qualified hair removal providers as well as qualified mental health providers upon request. Since facial feminization surgery is sometimes performed in stages, you may begin preparing for the next procedure soon after recovering from the first one. When multiple surgeries are desired, the surgeon will plan a staged approach. What is facial feminization surgery (FFS)? - Paul Mittermiller, MD 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. Forehead lengthening is a procedure, which elongates the forehead, increasing the distance between the brow ridge and hairline. Dont have realistic expectations about the results. We work with you and your insurance provider to get you the treatment you need quickly, Forehead contorting, brow lift, hairline advance, Stop smoking 8 weeks prior to surgery, including vaping and recreational drugs, Patients are not required to stop any hormone treatment before undergoing surgery. For zero-depth procedures patients should expect to be in Cleveland for 3-4 days after the surgery and for a full-depth procedure, 7-10 days after surgery. Facial feminisation surgery can involve a combination of all or some of the below cosmetic procedures. Voice feminization surgery is a procedure to increase the pitch of your voice. Facial Feminization Surgery: Everything You Need to Know - Verywell Health Cleveland Clinic is a non-profit academic medical center. Please contact our office with any questions. FFS@totonchiplasticsurgery (@facialfeminization) - Instagram This is often because the insurance company may deem the surgery as cosmetic or not medically necessary. The nasal tip is generally adjusted to give a upward feminine appearance rather than the typical male downward nasal appearance. Facial Feminization Surgery: A Review of 220 Consecutive Patients. A tracheal shaving procedure involves reduction of the thyroid cartilage to reduce the size of the Adams apple. 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 Surgery Before & After Pictures - RealSelf Bellinga RJ, Capitn L, Simon D,Tenrio T. Technical and Clinical Considerations for Facial Feminization Surgery With Rhinoplasty and Related Procedures. Facial feminization surgery is performed by a plastic surgeon who has training in craniomaxillofacial and soft tissue surgery. Hairline advancement (scalp advancement): Scalp advancement is a procedure done to move the hairline forward, decreasing the prominence of the forehead. The recovery time remains 2-3 weeks. You will be advised to rest for a couple of days. The tracheal shave procedure performed alone does not have any downtime. The techniques can help transgender women transition physically to their self-affirmed gender. On the other hand, a cisgender woman with a receding hairline may only desire a hairline advancement procedure. Please make sure that you have a driver for any postoperative visit that is within 2-4 weeks of your surgery. The procedure changes the length, tightness or size of your vocal cords. The brow lift procedure moves the eyebrows to a higher set position on the forehead, giving a softer, wide eyed, feminine appearance. Cost of Postoperative Stay:As part of your recovery, you will be staying at the Intercontinental Hotel, which is attached to the Cleveland Clinic Main Campus. The Transgender Surgery Program has a special rate for our patients with the hotel. RealSelf Tip: The average cost of FFS for cisgender . A surgical nurse will review your medication list, record yourvitals(heart rate, blood pressure, etc. The mental health professional will review your gender identity and dysphoria and help you determine how the surgery fits into your overall treatment plan. DOI: 10.1001/jamafacial.2016.1572 Capitn L, et al. In addition, while there are guidelines that exist for the specific timing of facial feminization surgery, your surgeon may recommend that you delay any procedures until you have been on estrogen therapy for at least a year (if applicable). The process depends on the facial features you choose to change. Your surgical team will review these with you as you get closer to surgery. Facial Feminisation Surgery | Nuffield Health Transgender women may choose to have voice change surgery as part of their male-to-female (MTF) transition. Looking for a non-invasive treatment to help reduce the signs of aging? This is a thin, lighted tube that goes into your mouth and reaches back to your larynx. Staging surgery is safer than attempting to perform too many procedures at the same time, which can keep you under anesthesia for a prolonged period. Your surgeon will also take photographs of your face during this visit. Your surgeon will likely ask that you avoid any facial treatments (for example, electrolysis or chemical peels) two weeks before your surgery date. FFS can include hairline lowering, jaw reduction, rhinoplasty (nose reshaping), eyelid surgery, face or neck lift, and other facial changes. Examples include chin and nose augmentation, cheek augmentation, jaw contouring, and lowering of the eyebrow ridge/forehead lengthening. I just had facial feminization surgery. Dr. Totonchi is also an Associate Professor at Case Western Reserve Universitys School of Medicine. Parts of this website will not display or function properly. You may experience some throat pain or discomfort. Swelling, warmth, or foul-smelling drainage from the incision site(s). Dr. Totonchi knows your goals are extremely important and will listen and help you understand how these can be accomplished. Make sure you bring your driver's license, insurance card, and a list of your medications. Patients must have a support person to bring them home from the hospital. Although. They will ask you about your goals for surgery and explain what you can expect during your recovery after the procedure. Place a cloth between the ice pack (frozen peas or crushed ice in a zipper bag also works) on your skin. By Elizabeth Boskey, PhD In extreme cases, a tissue expansion is used to achieve the desired effect. Your consultation can be scheduled once 50% of hair removal is completed.