FFS Basics

Facial Feminization Surgery (FFS) is an advanced (and expensive) step of transition from male to female. FFS encompasses a range of surgical procedures that minimize and/or remove typically male characteristics from the face and neck. While not all transsexual women need FFS, this kind of surgery can help us assimilate better into society. While the surgery provides an immediate improvement, it is in the future that the payoff can be the most dramatic when aging skin shrinks to more starkly reveal the skeletal structure of the face.

The three most common areas worked on, those providing the most dramatic change, are forehead, nose and jaw. All three of these areas tend to be less pronounced, smaller and smoother in females. While soft tissue surgery can effect positive change on the nose, generally it is bone work to re-sculpt all of these features that gives the greatest change. This is highly specialized work practiced most frequently by a handful of surgeons. This is one area where the cost of surgery should be of secondary importance to the surgeon's experience with FFS. For more specific information on FFS, a good starting point is Andrea James' TS Roadmap website.

Christine's FFS

I had my FFS with Dr. Toby Meltzer in October, 2005. He did the following procedures on me. The total cost was under $24,000. Dr. Meltzer had me on the operating table about 9.5 hours. I spent two days in the hospital, though I could have been released in one. I spent two more days in Phoenix and then caught a plane home to Los Angeles.

Brow Contouring/Reduction
Also known as a "Type III" forehead, the anterior (front) wall of the nasal cavity is cut away with a bone saw, reduced and reshaped, and adhered back in place with a high-tech bone glue.

Scalp Advancement
My hairline was not only brought forward to create a smaller, more feminine forehead size, an unattractive widow's peak was also greatly reduced. This also had the effect of raising my eyebrows a little higher and eliminating forehead lines and wrinkles.

Rear Mandible Reduction
I had a massive, nearly square jawline that made me always want to keep my hair hanging over the sides of my face. Dr. Meltzer aggressively ground down the angle of my rear mandible, significantly reducing the size. When I can afford it I will get a facelift to tighten up the loose skin caused by the reduction in jaw size.

Bony Rhinoplasty
Having been fortunate to inherit the tip of my mother's nose, the only part that needed work was narrowing and smoothing out the bump in the bridge of my nose. How it has that gentle, little "skijump" swoop to it.

Christine's Before & After Photos

The Before photos were taken the day before my FFS. It was a year and a half before I returned to Dr. Meltzer's office for another procedure, which is when I had the After photos taken. I wanted to have the same camera and lighting setup take the followup photos to allow for a fair comparison. I wish I had swept my bangs back for the 2007 photos, but you can still see the effects of the scalp advance and brow contouring.