FFS LA
Facial feminization surgery Los Angeles

Facial Feminization Surgery Los Angeles – FFS LA

Facial feminization surgery (FFS) describes a set of procedures used to feminize the face. These are performed for both transgender (MTF FFS) and cisgender women. Women often have softer, smaller features. Facial feminization aims to soften masculine features and enhance feminine features. Dr. Mittermiller is one of only a few surgeons in the states with specialty training in craniofacial surgery and facial feminization surgery.

Table Of Contents

Facial Feminization Surgery Los Angeles – FFS LA
Facial Feminization Procedures
Frequently asked questions
Resources
Citations

Facial Feminization Procedures

Hairline modification

surgical hairline lowering, forehead reduction, forehead feminization, ffs hairline, hair transplants

Hairline modification can be an important procedure for women who have a high hairline or significant temporal recession. Hairline modification is often performed with a surgical hairline lowering (aka scalp advancement or forehead reduction) or hair transplants.

A hairline lowering surgical procedure is frequently performed at the same time as other procedures for facial feminization surgery. This type of procedure produces a thin scar at the border of the hair and the forehead. It is important for this procedure to be performed by a surgeon who has familiarity with the operation in order to optimize the final appearance of the scar.

Hair transplants can sometimes be performed at the same time as many of the other procedures for facial feminization. Most frequently, they are performed separately.

Click here for more information on hairline feminization: Hairline FFS

Brow lift

brow bone reduction, orbitl rim contouring, ffs brow, brow prominence reduction, forehead prominence ffs

Women commonly have higher eyebrows. An eyebrow lift feminizes the face by elevating the location of the eyebrows on the forehead. This is commonly performed at the same time as brow bone reduction and orbital rim contouring.

A slight brow lift is often necessary when performing brow bone reduction and orbital contouring to allow the skin and soft tissues to reattach in a natural way.

Brow bone reduction (forehead reduction, forehead setback)

FFS Los Angeles, Brow bone reduction, Brow feminization near me

Reducing the forehead prominence is a powerful surgical technique for feminizing the face. This can be performed with a type 1, type 2, or type 3 forehead reduction. Setback of the forehead reduces the brow ridge and feminizes the forehead. In many patients, this can be one of the most important procedures they undergo for feminizing their face. This is seen anecdotally and through systematic research.¹

Click here to learn more about a type 1 forehead reduction: Type 1 forehead
Click here to learn more about a type 3 forehead reduction: Type 3 forehead
Click here to see brow bone reduction before after photos: Facial Feminization Photo Gallery

Orbital rim contouring

Feminization of the face often involves setting back the forehead but also contouring the orbital rims. This brightens the eyes by removing shadows caused by the orbital rims.

Orbital rim contouring is almost always performed at the same time as reduction of the central brow bone.

For more information on orbital contouring, click here: Orbital contouring
Click here to find orbital contouring before after photos: Facial Feminization Photo Gallery

Dr. Mittermiller is a friendly, passionate individual with a deep interest in serving the transgender community and advancing the state of facial feminization surgery. He is primarily located in Los Angeles, California and offers FFS in LA.

Click here to learn more about Dr . Mittermiller

About Dr. Mittermiller

Cheek augmentation (cheek implants or fat grafting)

Facial Feminization Los Angeles, Cheek augmentation near me, cheek implants, fat grafting face, implants feminization

Enlargement or enhancement of the cheeks is performed through augmentation with fat grafts or implants. This creates additional fullness in the middle of the face that increases feminine appearance.

Cheek implants are placed through small incisions on the inside of the mouth. When placed correctly, they appear natural and discrete.

Cheek feminization with fat transfer is performed by removing fat with liposuction from one area of the body and transferring it to the desired area. The fat can be removed from areas such as underneath the chin or the abdomen (stomach area) and transferred to the chin.

Click here to learn more: Cheek augmentation

Rhinoplasty

A nose job, or rhinoplasty, can dramatically change the appearance of one’s face. These procedures can feminize the face and simultaneously improve breathing through the nose.

A feminizing rhinoplasty often involves removing the bump from the bridge of the nose, elevating the tip of the nose, and creating a more narrow nose.

Every person has a slightly different shape to their nose and slightly different preferences for the outcome of their rhinoplasty. It is important to work with your surgeon to discuss your individual preferences for a feminizing rhinoplasty, whether the results are achievable, and how best you can obtain a natural result.

Click here to learn more: Rhinoplasty
Click here to find feminizing rhinoplasty before after photos: Facial Feminization Photo Gallery

Lip feminization (lip lift or lip augmentation)

Lip feminization can involve a lip lift, lip augmentation, or both.

Lip lift

Women commonly have a shorter upper lip and more visibility of the upper teeth and red portion of the upper lip. A lip lift feminizes the face by increasing tooth show and red lip show while decreasing the amount of skin on the upper lip.

A bullhorn lip lift is the most frequently performed type of lip lift. This style of lip lift places a scar at the border between the nose and the upper lip. It is important to undergo this procedure with a surgeon who has familiarity with the technique in order to minimize visibility of the scar.

Click here for more information on lip lifts: Lip Lift

Lip augmentation

Lip augmentation is commonly performed with fat grafts or artificial filling material. This rejuvenates and feminizes the lips. Lip filler implies the use of an artificial material such as hyaluronic acid. When fat grafts are used for augmenting the lips, the fat is frequently harvested from the abdomen or thighs. It is then purified and injected into the lips through small puncture sites.

Jaw contouring and genioplasty (chin surgery)

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Jaw contouring and genioplasty are frequently performed to feminize the lower third of the face. In general, this involves reducing the size of the jaw and the size of the chin.

In a full FFS procedure, jaw contouring and genioplasty are frequently performed together. However, it is possible to reduce only the back angles of the jaw or only the chin depending on one’s individual features.

Jaw contouring

Jaw contouring is performed during facial feminization to reduce the width and angularity of the lower face and provide a more feminine jaw. Although the chin is technically also part of the lower jaw, the term “jaw contouring” frequently refers to the back section of the jaw. Jaw contouring can involve either shaving the sides of the jaw or removing the angles of the jaw to create a softer appearance.

Genioplasty (chin surgery)

Chin surgery, or genioplasty, is performed to change the shape and appearance of the chin. Women commonly have narrower, shorter chins than men. A genioplasty is a powerful technique for feminizing the lower face. Depending on one’s personal facial characteristics, a genioplasty can change any dimension of the chin for optimal feminization.

An osseous genioplasty refers to chin surgery where cuts in the bone are created in order to change the shape, position, and size of the chin. Chin implants can also be used to change the shape or size of the chin. Implants cannot be used to make the chin smaller

Click here for more information on jaw feminization surgery: Jaw FFS

Click here for more information about genioplasties: Genioplasty

Tracheal shave (chondrolaryngoplasty, Adam’s apple reduction)

FFS LA, tracheal shave, trach shave, chondrolaryngoplasty

The Adam’s apple, or laryngeal prominence of the thyroid cartilage, is frequently less prominent in women than in men. The prominence of the neck cartilage can often produce significant dysphoria for some individuals. An Adam’s apple reduction (or thyroid cartilage reduction) is a common procedure in facial feminization surgery for feminizing the neck.

A tracheal shave reduces the prominence of the thyroid cartilage, making it less noticeable from the front and from the side.

Click here for more information and before after photos on tracheal shave surgery: Tracheal Shave

Dr. Mittermiller is a plastic surgeon with specialty training in craniofacial surgery and facial feminization surgery. He is primarily located in Los Angeles, California and serves the broader Southern California area.

Frequently asked questions

Why is facial feminization surgery performed?

Facial feminization surgery is performed for cisgender women to increase feminine appearance and for transgender women, gender non-binary individuals, and gender non-conforming individuals to relieve symptoms of gender dysphoria. Additionally, it has other protective effects for gender non-normative individuals by potentially reducing harassment and increasing safety in public.² It has also been shown to decrease anxiety, anger, depression, and social isolation and to increase positive affect, meaning, purpose, and overall mental health for transfeminine individuals.³^,⁴

Am I a candidate for FFS?

Facial feminization surgery (FFS surgery) is offered to cisgender, transgender (MTF FFS), and nonbinary individuals who seek to feminize their face. It can be the correct choice for people who are hoping to remove or soften masculine features or enhance feminine features.

Candidacy for surgery depends on multiple variables. One may not be an ideal candidate if they have medical problems that can result in significant complications from anesthesia or a lengthy operation.

Insurance companies sometimes cover facial feminization for the treatment of gender dysphoria, which results when there is an incongruence between one’s physical traits and one’s gender identity.

Can cisgender women get FFS?

Yes! The same procedures performed for transgender women (MTF FFS) can be performed for cisgender women to remove masculine features or enhance feminine features.

How much does it cost to have facial feminization surgery near me in Los Angeles, California?

The cost of facial feminization can be extremely variable and it depends on multiple factors. These factors include those listed below:

Whether insurance is covering all or part of the operation
The number and types of procedures being performed during the operation
The duration of the operation
Variations in pricing between individual surgeons

The best way to get an estimate for the cost of facial feminization surgery is to contact a facial feminization surgeon to discuss your specific situation. Costs will vary between LA and other cities or states.

There are multiple insurance programs that cover facial feminization surgery in California and Los Angeles. Dr. Mittermiller and his office have experience helping patients to work with their insurance company to help them afford these procedures. Insurance coverage of facial feminization surgery can be complicated and it varies from one surgeon to the next. It is important to discuss the details of insurance coverage of FFS with your surgeon’s office to make sure you understand the process and the ultimate cost to you.

It can be possible that a patient’s insurance does not cover FFS or that a patient does not want to wait for the insurance approval process. In this scenarios, self-pay options are permitted.

Click here for more information on Dr. Mittermiller’s financing options: Financing Surgery

Click here for additional information on whether specific insurance companies cover facial feminization surgery (FFS): Insurance Coverage of FFS

Can I travel to Los Angeles, California for FFS?

Our office in Los Angeles, California is familiar with helping out of state patients find the best surgeon and the best location for their operations.

Los Angeles has multiple options for staying near the clinic and the operating suites.

Los Angeles has clear, sunny weather year-round, which makes it easy for patients to navigate to appointments and creates an enjoyable experience for patients who want to enjoy the fresh air while recovering.

There are many patients who try to take advantage of traveling to LA for surgery by adding experiences to their trip. Arriving early offers the chance to enjoy some of the many nearby sites in California.

A recent study by Hauc et al. evaluated multiple factors surrounding FFS and noticed that 50% of FFS procedures occurred in the Western Region of the United States.⁵ This is important to patients who are looking for surgeons who perform a large volume of facial feminization operations.

What happens during an FFS consultation?

During your consultation, many items will be discussed. Your surgeon will first want to know whether there any facial features that are particularly concerning to you. Your health and any medical issues will be reviewed. The possible surgical options will be discussed with you and the advantages and disadvantages of these procedures will be explained.

During the consultation, the surgical process and the recovery period will be discussed. If it is indicated, a CT scan may be performed. Photo simulations of the surgical results may also be performed to help discuss the procedures. Photo simulations can be helpful when discussing features of the nose since terminology can vary from person to person.

How is the recovery from FFS?

Recovery from FFS is based on the number and types of procedures that are performed.

The recovery can be minimal when it involves minor procedures such as lip lift, cheek augmentation, or fat grafting. The recovery becomes more involved when larger procedures are performed, such as jaw contouring and genioplasty. It is best to look at each individual procedure to see how the recovery will be after that procedure.

Many of the effects from FFS will be seen immediately after surgery. There will likely be swelling and bruising after the operation that can last for a few weeks. There is subsequently minor residual swelling of the face that can persist for over a year.

In general, after FFS, it is best to take at least 1 week off from work and in many scenarios it can be helpful to take 2 or more weeks off from work. It is important to discuss this with your surgeon prior to the operation.

Is FFS permanent?

The procedures performed during facial feminization surgery will produce results that are permanent. Your body will continue to age though and affect the areas of the face that were surgically modified.

Where can I go to see Dr. Mittermiller’s FFS before after photos?

Dr. Mittermiller FFS before after photos are found in the FFS photo gallery and on his Instagram page. Some patients prefer to keep their photographs private but they have allowed Dr. Mittermiller to show these photographs in the clinic setting. In special scenarios, Dr. Mittermiller will share these before after photographs with patients during their consultations.

How do I find the best facial feminization surgeon near me in Los Angeles?

It is important to do research on facial feminization surgery and the surgeons who offer these procedures as part of their practice. Finding the best facial feminization surgeon may require speaking with friends or other physicians. You will want a surgeon who has the appropriate training for facial feminization surgery and who is dedicated to their patients.

Dr. Mittermiller is a fellowship-trained craniofacial surgeon with experience in facial feminization surgery. He can be seen at the practice’s office in Los Angeles.

Resources

WPATH

WPATH Standards of Care

LA LGBT Center

Transgender Health Program

St John’s Community Health