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. was also featured in a documentary (badly) titled "Sex Change" shown by Channel 4 (a terrestrial TV station in the UK). 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. 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. Typically, with female-to-male transitioning, hormone therapy is the most effective way to change secondary sex characteristics and achieve a more masculine facial appearance. ), and place an intravenous (IV) line into a vein in your arm. Ask your surgeon about how to re-dress your incisions after washing them and applying ointment. This means you probably wont have to stay overnight in the hospital or surgery center. 2023 Dotdash Media, Inc. All rights reserved. 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. Find out if you benefit from a discounted membership. American Psychiatric Association. When you awaken from surgery, there will be a drain in place; this will likely come out before you are released to go home. 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. The techniques can help transgender women transition physically to their self-affirmed gender. A nurse will administer medications, as needed, to ease your symptoms. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.plasticsurgery.org/reconstructive-procedures/facial-feminization-surgery). Most people continue voice feminization therapy after surgery. Reviewing your current medications and any allergies you may have. On the other hand, a cisgender woman with a receding hairline may only desire a hairline advancement procedure. The surgery softens these features, creating a face that is more oval-shaped. While estrogen won't affect your bone structure, it will redistribute facial fat, and this may alter your surgical plan. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://alahns.org/wp-content/uploads/CLC/56-Transgender-surgery.pdf), (https://leader.pubs.asha.org/doi/10.1044/leader.FTR2.24022019.54). Nonverbal communication, such as eye contact, gestures, articulation and pausing. Most people need several weeks or months to fully recover from FFS. Your surgeon will probably give you the OK to shower around 48 hours after your operation. Your complete postoperative recovery will be about 6-8 weeks but this varies with each individual. In addition to treating patients with cosmetic procedures like breast augmentation, breast lift, tummy tuck, liposuction, facelift, rhinoplasty, eyelid surgery or other non-surgical cosmetic surgery procedures at his Cleveland practice, Dr. Totonchi is also well known for his treatment and care of children with issues ranging from facial deformities to cleft palates. Our team follows the World Professional Association for Transgender Health (WPATH) guidelines to ensure patients are appropriate surgical candidates. Dont have realistic expectations about the results. Plast Reconstr Surg 2016 Feb;137(2):438-448.doi:10.1097/01.prs.0000475754.71333.f6. SUPPORT Patreon: https://www.patreon.com/jessiege. It helps drain blood and fluid to prevent swelling. The brow may be elevated to give the eyes a feminine appearance. During your consultation your Consultant will be able to advise you in detail about your personal recovery. Avoid bending over or lifting anything heavier than 20 lbs for two weeks after your surgery. This type of healthcare provider specializes in surgery for the voice box and throat. They may recommend certain ointments or treatments to address them sooner than later. Forehead contouring typically removes this ridge and softens the appearance of the forehead and facial features. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. Information on Estrogen Hormone Therapy. RealSelf Verified doctors complete our multistep verification process and meet rigorous requirements to become our most trusted plastic surgeons and cosmetic procedure providers. For people in whom hormone therapy is not enough to achieve desired gender-affirming changes to theface, surgery can help. 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. Cheek augmentation helps to round out the face giving it a feminine appearance. This IV will be used for administering fluids and medications during and after 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. FFS is ideal for trans women and non-transgender women who want a more feminine facial appearance. In FMS, the cheeks can be made more angular and prominent in order to mimic a masculine facial bone structure. Postoperative appointments: There will be several postoperative appointments after your surgery depending on what type of surgery you have. American Society of Anesthesiologists. X-rays or CT scans take pictures of the bones and soft tissues of your face and skull. Please be sure to inform your surgeon of all the drugs you take, including prescription and over-the-counter medications, herbal products, dietary supplements, vitamins, and recreational drugs. Cleveland, Ohio 44195, Director of Transgender Surgical Services; Program Director, Transgender Surgery & Medicine Fellowship, Emeritus Chair & Section Head of Cosmetic Surgery, Director of Plastic Surgery Research & Co-Director of Craniofacial Program, Facial Plastic and Reconstructive Surgeon, 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. At the end of the procedure, the incision will be closed with sutures that do not need to be removed. Who might need facial gender surgery? It is strongly suggested that all prospective clients perform their own independent research regarding Totonchi Plastic Surgery and our qualifications. 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. BMI requirements are determined by your surgeon. Cleveland Clinic Main Campus Facial feminization surgery, or FFS, is a series of plastic surgery procedures designed to create a more feminine appearance of the face for patients undergoing gender affirmation treatment. Transgender surgery: Male to female. doi:10.1080/15265161.2018.1531159, Salgado CJ, AlQattan H, Nugent A, et al. A rhinoplasty can also shape the bridge and the tip of the nose to give them a more delicate appearance. The procedure can involve cutting or reshaping the bones as well as the cartilage. Facial Feminization Surgery: Everything You Need to Know. Your surgical team will review these with you as you get closer to surgery. There are no time limits on your aftercare. *Your results may vary. Facial feminization surgery has a wide range of recovery time depending on the combination of procedures that are chosen. This procedure includes removal of the uterus and cervix as well as the fallopian tubes and ovaries in those patients who do not desire future fertility. Surgery will be carried out under general anaesthetic and can typically range from around 4 to 8 hours depending on the procedures. UpToDate. When multiple surgeries are desired, the surgeon will plan a staged approach. Transgender patients transitioning from male to female and non-binary. 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. If you are staying overnight in the hospital, be sure to pack the following items in your bag or suitcase: Avoid smoking or tobacco use four to twelve weeks before surgery. 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. 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. At this appointment, your surgeon will check your incision sites, remove any non-dissolvable stitches, and monitor you for complications. If you are planning to undergo facial feminization surgery, it's reasonable to ask your surgeon about the specific techniques or approaches they will use. Our volume of patients increases each month, and with this growth, we continue to expand our caregiver team to be able to accommodate our patients needs. You will likely be given anopioidto start, followed byTylenol (acetaminophen)alone. 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. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7.International Journal of Transgenderism. 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. Decreasing the distance between the nose and upper lip gives a more feminine balance to the face. The surgeon will attempt to minimize the appearance of the scar by placing it in a less obvious area or within the natural skin folds of the neck. All patients are fully assessed for their safety prior to surgery. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024865/). Facial Feminization Surgery: What are the risks of facial feminization surgery? 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. You may have temporary restrictions on heavy lifting, vigorous exercise or other activities. That said, general risks of this surgery include: The purpose of facial feminization surgery is to change masculine facial features into feminine ones. Since you will be changing into a hospital gown upon arrival, wear loose-fitting clothes on the day of your surgery. In the case of patients with more narrow mandible angles, jaw implants are used to create a more defined jaw structure. 2019 May;27(2):191-197.doi:10.1016/j.fsc.2018.12.002. 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. 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. We take quality and safety seriously. Vaginoplasty (female genital reconstructive surgery) - 2letters must be obtained. The placement and size of the implant will depend on the individual patients facial anatomy. Have a mental health disorder that impairs your ability to make appropriate personal decisions. If you are concerned about scarring, contact your surgeon. Products & Services Book: Mayo Clinic Family Health Book, 5th Edition 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. Facial feminization surgery may be part of the treatment approach for a person who desires a more feminine facial appearance. Healthcare providers usually recommend voice feminization therapy before and after surgery. Facial Feminization Procedures Facial feminization surgery (FFS) involves several surgeries that can be done to feminize the facial features. 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. From there, you will walk on your own into the operating room or be wheeled on a gurney. The total cost will vary depending upon the procedure and the number of stages needed. 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. The average cost of facial feminization surgery (FFS) is $34,372, according to 217 reviews from RealSelf members. 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. You will be advised to rest for a couple of days. Youll have gauze or bandages over your incisions for several days. Facial feminization surgery (FFS) encompasses a series of surgical interventions designed to make your face appear more feminine. University of California, Sam Francisco. Facial Feminization Surgery (FFS). A tracheal shaving procedure involves reduction of the thyroid cartilage to reduce the size of the Adams apple. There are different approaches to voice feminization surgery, including: You may choose to have voice feminization surgery if you: Many people choose to have voice feminization therapy before and after surgery. All information on this site is intended for general purposes and is in no way a substitute for professional medical advice. The specifics of recovery from facial feminization surgery depend on the procedures used and whether all the procedures are done at once or the surgery is performed in stages. As with all surgeries there are risks involved with being under general anaesthetic. The Adams apple is an area of cartilage around the larynx (voice box) that tends to be larger in people assigned male at birth. Doing two surgeries gives your face more time to heal between surgeries and allows more flexibility for patients. 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. 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. Talk to your healthcare provider or your psychologist before the procedure so you know what to expect. The surgery is usually done under general anesthesia. How long it takes: This depends on what you are having done. Facial Feminization Surgery: What are the risks of facial feminization surgery? BMI requirements are determined by your surgeon. Many people who are transitioning from male to female consider this an important step in their transition process. Comprehensive care for transgender patients involves a wide spectrum of services, ranging from routine medical visits to the physical transition process. They control the pitch of your voice. Signs of symptoms of infection, including increased redness, pain, drainage or swelling. Dr. Totonchi is also an Associate Professor at Case Western Reserve Universitys School of Medicine. These images help the surgeon plan your surgeries and provide a baseline for evaluating results after your procedures are finished. For trans patients, gender confirmation surgery might include removing breast tissue and reconstructing the chest, facial masculinization surgery (FMS) to make their facial features appear more masculine, removing and reconstructing the external genitalia, and removing internal reproductive organs. Facial Feminization Surgery: A Review of 220 Consecutive Patients. Even fewer hospitals offer surgical care for patients wishing to undergo gender affirmation surgery. 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. However, facial masculinization surgery (FMS) is gaining popularity. Doing a physical exam, including lab tests. That said, the physical and emotional challenges that go along with surgery are very real. 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. Voice feminization surgery is a procedure to raise the pitch of your voice or make it sound higher. Facial feminisation surgery can involve a combination of all or some of the below cosmetic procedures. The brow lift procedure moves the eyebrows to a higher set position on the forehead, giving a softer, wide eyed, feminine appearance. The process depends on the facial features you choose to change. Patients who have met these criteria are deemed appropriate surgical candidates. Your surgeon will also take photographs of your face during this visit. Various techniques may be used to perform this procedure, and they are surgeon and patient dependent. In addition to plastic surgery, facial feminization procedures include nonsurgical treatments such as cosmetic fillers, botulinum toxin, fat grafting and liposuction. Your healthcare provider will tell you when you can gradually start using your voice again, as well as when you can resume voice therapy. Companion to accompany you for postoperative stay. Parts of this website will not display or function properly. Bandages and dressings: Do not remove tape, gauze, drains, splints or compression dressings: The doctor will take off these items and examine the surgical area at your first clinical appointment after your procedure. Males tend to have wider and longer foreheads than females. First clinical follow-up: This usually occurs within five days of surgery, and will be scheduled before you leave. Surgery changes the length, size or tightness of your vocal cords. Any non-disclosure could result in your surgery being cancelled. A small incision is made under the nose to lift the upper lip and decrease the distance between the nose and the upper lip. While some individuals may feel that facial feminization surgery is necessary to feel affirmed in their gender, others may not. 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. Waltham, MA: UpToDate, Coleman E, Bockting W, Botzer M, et al. After surgery, you may feel more confident and secure in your gender expression. 2017 May; 19(3): 175181. 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. The price you see is the price you pay. To access the larynx, the surgeon makes an incision in your neck. Chest surgery is sometimes performed as an outpatient procedure but some patients may require one night stay in the hospital. This is typically only needed if you are undergoing surgery as a gender-affirming operation. Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. 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. Hysterectomy is often performed as an outpatient procedure, but some patients may require one night stay in the hospital. 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. Voice feminization surgery raises the pitch of your voice, making it sound higher. Please contact our office with any questions. University of California, San Francisco. 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. The incisions for an eyelid lift can either be hidden in the crease of the eyelid or placed behind it to minimize visible incisions. 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 voice box will need several weeks to heal after voice feminization surgery. Avoid hot beverages for one or two weeks or until your incisions heal. Genioplasty: Transgender genioplasty is performed to transform a wider, flatter, longer, and more squared masculine chin to a narrower, shorter, more rounded female chin. At your consultation, Dr. Totonchi will meet with you and discuss your aesthetic goals openly and honestly, and explain what is possible and attainable for you. 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. (2021). Patient Checklist for Vaginoplasty & Phalloplasty/Metoidioplasty. They control the pitch of your voice. Patients may opt to have a zero depth vaginoplasty procedure which involves creation of the outer genitals (labia, clitoral hood, urethral opening) only without a vagina. 2021. For example, a forehead reduction may be performed using an open or endoscopic approach. Dysphonia (difficulty speaking), such as voice breaks or tremors. 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. Upon arrival at the hospital or surgical center, you will be led into a small pre-operative/holding room. Two letters of support from qualified mental health providers dated within the past 12 months. 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. She is an assistant professor at the Alpert Medical School of Brown University. Insurance Coverage: This procedure is very specialized and often not covered by insurance plans. Get useful, helpful and relevant health + wellness information. Several surgical techniques are available to change the length, tightness or size of your voice box. Whatever your reason for undergoing facial feminization surgery, be sure to get recommendations for an experienced board-certified plastic surgeon. Were happy to complete FMLA and STD paperwork if applicable. 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. Its important to have realistic expectations about the results of voice feminization surgery. Masculine foreheads have a heavy bony ridge above the eyes, just below the eyebrows. 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. Sometimes voice feminization surgery doesnt produce the results you want. Indian J Plast Surg. The most common features that FFS addresses are the hairline, forehead, nose and jaw. What Is Gender Dysphoria? 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 operations usually consist of multiple procedures including those listed below . 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.
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