Facial Feminization Surgery (FFS) and
It’s important to remember that facial feminization surgery is elective
and permanent. Facial feminization surgery, like any surgery, has its risks.
Below is a list of possible risks to consider when exploring facial feminization
Severe Risks of Facial Feminization Surgery
- Blood loss - Patients rarely hemorrhage after surgery, but donor
blood could carry infectious diseases. To avoid this stop all
drugs that affect clotting
- Blood clots - These can lead to heart attack or stroke. Ask your
endocrinologist if you should stop taking drugs and hormones,
and stop smoking to avoid this risk.
- Infection – Improper surgical procedure or post-op care
can lead to infections and affect recovery time, surgical outcome,
and, in extreme cases, cause death.
- Pneumonia - Fluid in the lungs can build up after surgery. The
best way to avoid this is to quit smoking, get in shape, use
an incentive respirator, or walk or sit up as much as possible
- Necrosis - Death of tissue can be caused by infection, tissue
rejection or loss of blood supply to tissue.
- Paralysis – A severed nerve or stroke or blood clot can
cause mild to moderate effects on muscles around the mouth,
usually on one side or the other.
- Allergic reaction - Reactions from anesthesia or certain drugs
like penicillin can close air passages or send a patient into
shock. Non-fatal reactions include rashes and hives. Inform
the doctor of all allergies drugs taken in the month prior to
- Visual changes - Some patients have reported visual problems because
of tightened tissue and swelling. Double vision or distortion
in one or both eyes may also occur. Blindness could also occur,
but is extremely rare.
- Speech changes – Patients have reported slight to noticeable
slurring or lisping following facial feminization surgery, especially
chin work. Sometimes facial feminization surgery can affect
control of the lower lip. Pronouncing “s” can also be
Less Serious Risks of Facial Feminization Surgery
- Weakness and Fatigue - Mental and physical activities can be more
difficult for many months after facial feminization surgery.
Getting in shape prior to surgery, quitting smoking and avoiding
overexertion will help with a quicker recovery.
- Numbness - Numbness in some or all areas the face may occur after
facial feminization surgery. This can make it difficult to notice
saliva or food on the face. Less sensitivity to hot or cold
items can also be dangerous.
- Pain - Permanent pain may occur as a result of a severed nerve
or other mistake.
- Hypersensitivity – Some areas may be permanently too sensitive
to be touched.
- Bleeding - Mild bleeding may occur as incisions heal, especially
during facial feminization surgery involving the noses and mouth.
- Sore throat - Breathing tubes put in during general anesthesia
may cause a sore throat, making it difficult to eat or drink
Eat soft foods around room temperature to help.
- Shocks - Tiny nerves that have been cut or disturbed during facial
feminization surgery may send out tiny electric shocks to the
face as they regenerate and heal. This can be painful and last
for as long as a three months.
- Swelling and Bruising - Expected after surgery, but very greatly
by individual. The bruising looks worse than it feels.
- Nausea - Post-surgical nausea from anesthesia can occur ranging
from loss of appetite to severe vomiting.
- Skin problems - Rashes or bedsores can occur from not moving around
after facial feminization surgery.
Cosmetic Risks of Facial Feminization Surgery
- Scarring - Surgery will cause scars. Depending on skin type, the
surgeon's skill, and post-op maintenance, scars can be unnoticeable
or prominent. Show your surgeon incisions or scars before facial
feminization surgery so they can understand the skin’s
healing process. Follow the surgeon's post-op instructions diligently,
and ask about vitamin E oil, silicone sheets, oral vitamin B1, cortisone
creams or other topical preparations
- Grafts – Scarring may occur at the donor site as well as
the graft site
- Keloids - Raised, dark scars may occur on certain skin types,
but are more common on dark or black skin
- Shape - Unsatisfactory cosmetic results may occur including too
much or too little change, or a disproportionate looking face,
which can make it look like work has been done
- Positioning – Since a face is asymmetrical, improper work
can make adjustments more noticeable. Brows may look too high,
skin too tight, lips too high or low, or a nose or mouth can
Psychological Risks of Facial Feminization Surgery
- Depression - Almost every patient can suffer some level of post-surgical
depression because of the event’s build-up before surgery.
Some people rely on facial feminization surgery as a solution
for problems the surgery cannot solve. Keep realistic expectations
of the recovery and outcome of facial feminization surgery.
- Anxiety - Anxiousness and worried feelings can occur as patients
heal. Immediately after facial feminization surgery, patients
may feel they look horrible and worry they’ll never look
normal again. As the bruising and swelling subsides, anxiety
should also decrease. Thoroughly researching the procedure and
the surgeon will often help.
- Regret - Some patients feel they made a poor choice of surgeons
or wish they had not had the facial feminization surgery. This
is especially true when complications or poor cosmetic results
occur. It’s best to have realistic expectations of recovery
- Remember that a good surgeon will rarely have complications and
will honestly discuss the likelihood of risks during your consultation.
A Surgeon at a University medical center will often be able
to provide the safest and best surgical procedures.