Facial Feminization Surgery (FFS) and
Potential Risks

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 surgery:

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 after surgery

· 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 surgery.

· 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 difficult.

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 look off-center

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 and outcome.

· 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.