Phalloplasty involves using a skin graft to elongate the neopenis to 5-8 inches. Scan this QR code to download the app now. After requesting advice on how best to feminise her face and a careful analysis she realised that the most important issue for her was the length of her lower face. It is commonly undertaken for transsexual individuals who are transitioning from male to female or for women who wish to further feminise their facial appearance. Last medically reviewed on April 19, 2018, Forehead reduction surgery, also known as hairline lowering surgery, is a cosmetic procedure used to shorten the height of the forehead. We avoid using tertiary references. The analysis and preoperative planning is paramount in reaching a desirable goal. Cheek augmentation is a less common procedure. We personalize our recommendations for each person. I didnt want to live as a fake person., After she got divorced, in early 2018, Drake, now working in the games industry, was determined to transition as quickly as she could. This patient had prominent bossing of her forehead which required an osteotomy of the frontal sinus and recontouring together with a rhinoplasty to lengthen the nose and jaw recontouring with a genioplasty to advance the chin. Gender transition is a personal and emotive process that only the person choosing to undertake it can fully identify with. Pratt asked a colleague, the San Francisco-based maxillofacial surgeon Douglas Ousterhout, if there was anything he could do for his patient. Phalloplasty also carries the risk of rejection of the donor skin, or infection at the donor site. His knowledge and manner was reassuring and the reason I chose him as my surgeon. Also, it is why the development of FFS techniques and methods is a central pillar of our practice. But the authentic Sophia Drake she is looking for in the mirror is still several procedures away. The American Psychological Associations diagnostic and statistical manual (DSM-5) defines it as a difference between your experienced/expressed gender and assigned gender, and significant distress or problems functioning. Facial Feminisation. Sometimes the brow can simply be shaved down when the brow protrusion is smaller and when the brow bone itself is thick. This method uses donor tissue from the cheek or from the vagina to connect the urethra to the new neopenis, allowing you to urinate while standing. Risks and complications. Facial feminisation is a growing industry, with private clinics springing up across the globe over the past decade. To anyone consideringFFS, we wouldrecommendgetting as much information aspossiblefrom yoursurgeonor clinic. Drakes skin was smoothed back for a last time. Intestinal tissue has the added benefit of being mucosal, and therefore self-lubricating. People who have undergone facial procedures say they can make an equal, if not greater, difference to a trans persons life, as the face is where gender is first read. The informed consent model allows the physician to inform you of the risks of a certain decision. Facial feminisation surgery (FFS) is integral to the management of transgender adult females. He was confident about Drakes forthcoming surgery. . Dr. Gutierrez is the medical director of the Barcelona center and will always be one of the surgeons present in your surgery. The oldest and biggest NHS gender clinic in the UK is Londons Charing Cross, established in 1966. Therefore, each procedure is personalized in order to achieve the maximum in feminine contours in your case. This service is provided on News Group Newspapers' Limited's Standard Terms and Conditions in accordance with our Privacy & Cookie Policy. Next, her brow bone would be shaved, a section of her forehead would be filed, and her hairline would be moved down. Transgender men, nonbinary folks, and others assigned female at birth may consider a hysterectomy to better align their physical body with their sense. NHS England has confirmed that the 18 week referral to treatment time standard set out in the Constitution applies to gender identity services. We also offer Finance options so you can spread the cost of your treatment. DOI: Bellingua RJ, et al. Masculinized and unmasculinized faces exhibit a number of subtle differences, which in combination tip the scale toward a face being interpreted as male or female. Leading up to bottom surgery, most people require hair removal via electrolysis. Metoidioplasty is a much simpler and quicker procedure than phalloplasty. He has pioneered many of the operations used in FFS." When youve spent your whole life with dysphoria, thats massive. For further information, read our Privacy Policy. This results in a sensate vagina and labia. Yes, it can happen at any stage of onestransition. Some chins call for a chin reduction. Even when patients have more than one procedure performed at once, theydontusually experience a lot of painfollowingtheiroperation. There are no standard clinical protocols, and the 120 pages of guidelines published by the World Professional Association for Transgender Health contains a single line on FFS. WebSurgical Interests: Mr Keith Altman has an international and national reputation for facial feminization surgery in transgender females and has authored papers and book chapters on this subject. The removed bone is then contoured separately and replaced, so it lies flat. Im not trying to make a supermodel face, I just want to see the person I always saw in my head, she said. Healthline Media does not provide medical advice, diagnosis, or treatment. While there is no doubt that testosterone does change skulls in puberty, how much is up for discussion. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. They may be undertaken for several reasons including. Facial feminisation is not considered cosmetic surgery. You can do so via online forums, support groups, or mutual friends. Ops! Some people may experience a rectovaginal fistula, a serious problem that opens the intestines into the vagina. Drake sought out videos of facial feminisation surgery, in which trans women had their masculine features hairlines, jaws and brows reduced and remodelled. WebIf you want to stay in the UK or if you don't have extensive needs, use the London Transgender Clinic. On the other hand, the National Health Service in the UK Ill use my Facial Feminization Surgery as a hypothetical example of gender dysphoria since it was my first surgical procedure. I cant remember anyone whos been really upset with the outcome, he added. He has heard of several trans women who have had consultations with so-called fly-in-fly-out doctors: surgeons from overseas who might not have a licence to practise in the UK, but see prospective patients in hotel rooms and offer cut-price surgery abroad. You may be attended by another doctor who is member of the Team. Since our first procedure in 2008 we have been improving our techniques, pioneering new technologies and developing our own state-of-the-art methods. I see testosterone as a poison in my body, a poison that I had to deal with for 20 years. Nerves are also severed during the scalp incision, but most people regain most or all of the sensation in their scalp skin as they heal. See additional information. Throughout his career, Mr Inglefield has gained vast experience in a wide range of specialities, with areas of specialist interest including gender confirmation surgery, facial feminisation surgery, body feminisation surgery, masculinisation surgery and male chest reduction, breast surgery, breast implants and reconstruction, hair line lowering, eye bag surgery and facial rejuvenation, rhinoplasty and non-surgical nose job, labia reduction and labiaplasty. For vaginoplasty, hair will be removed on the skin that will eventually comprise the lining of the neovagina. Sophia Drake spent six years playing in secret with apps that make faces look more masculine or feminine, creating folders full of gender-transformed selfies and hiding them on her computer. I was very nervous for my consultation but Mr Musgrove made me feel at ease. Throughout his career, Mr Inglefield has gained vast experience in a wide range of specialities, with areas of specialist interest including gender confirmation surgery, facial feminisation surgery, body feminisation surgery, masculinisation surgery and male chest reduction, breast Microflora of the penile skin-lined neovagina in transsexual women. Part two: Plastic surgery during the COVID-19 pandemic, (Let us know you are a Top Doctors patient), By using the telephone number provided by TOP DOCTORS, you automatically agree to let us use your phone number for statistical and commercial purposes. If youre going under general anesthesia, this includes fasting. The common donor sites for the skin graft are the forearm, thigh, abdomen, and upper back. Facial feminization surgery: The forehead. WebBy Mr Christopher Inglefield Plastic surgery . Nice skin. Music on, he declared, and soon the sound of There She Goes by the Las was wafting through the room, above the gentle whirr of Altmans drill. Its like a sickening in your stomach, a pit, a crunching. It was Drakes profile that threw into relief the reality that she had been born biologically male. Youre not doing this to beautify or rejuvenate, youre doing it to feminise, he said. What happens after I get back home after surgery? Weve gathered all information you need in a Facial Feminization roadmap, to understand what is involved in Your Journey with Facialteam. Facial Gender Confirmation Surgery (FGCS) has advanced considerably since its beginnings, thanks in part to our work to revolutionize the field, from R&D to training future generations of professionals. A penile implant may be inserted in a follow-up surgery, providing the ability to maintain a full erection suitable for penetrative sex. Its only recommended by some surgeons in certain cases. In Canada and the UK, bottom surgery is covered under nationalized healthcare, with varying levels of supervision and wait times depending on the region. Facial feminisation is not considered cosmetic surgery. Which means you can go through an entire day, maybe, without having a major bout of dysphoria. Some people are on the waiting list for four years, she said. Another, above it, was shot in profile. Rhinoplasty work is particularly delicate. This method uses perforated scrotal tissue graft for the vaginal lining, and intact scrotal tissue for the labia majora (same as a penile inversion). It says only that there are no criteria for standards of care for facial surgery, but that mental health professionals can play an important role in helping their clients to make fully informed decisions about the timing and implications of such procedures. This was the most difficult part of the surgery. 679215 Registered office: 1 London Bridge Street, London, SE1 9GF. Some aspire to social transition telling others about their gender identity without medical intervention. Theyll let you know if you need to stop taking them for the procedure. This all-encompassing glossary will equip you with the knowledge to communicate effectively and respectfully [], Being misgendered can leave you feeling disrespected, invalidated, and invisible. The gatekeeper model also tends to use heteronormative, cisnormative criteria for qualifying the real-life experience. Improving facial symmetry. Im planning other surgeries.. Ten years ago, a London-based GP began referring trans women to him. Here's why this surgery is done and what to expect. FFS is commonly pursued by transgender women or assigned male at birth (AMAB) non-binary trans people. Becauseofitsincrediblefeminisingpower, it isfrequentlyone of the first surgeries transfeminine patients will request in their transition. In general, risks are low, but bruising is very common. The MRI on the lightbox showed Drake had a large sinus cavity with a thin wall; the challenge was to saw the bone down without perforating the sinus, and the best way to do this was to remove part of her forehead entirely. (2013). He sliced into it with another fine tool, then prised out the section of bone. How a trans woman found the surgery that could restore her sense of self, When the children at Sophia Drakes primary school in rural Wales used to talk about what superpower theyd like, she always told them she wanted to be a shapeshifter. Abstract Introduction Facial Feminisation Surgery (FFS) is integral to the management of transgender adult females. Surgeons typically approach the chin and jaw through incisions within the mouth, along the gum line. Each face is unique. He fixed the hairline in place with a ladder of surgical staples at her temples and blue stitching along the top of her forehead, with a practised tilt of his wrist. The outcomes Now, I dont need to worry.. Search by Country and Procedure. I find it hard to breathe. To discover that she has not passed is to be reminded that her identity may still exist only in her mind, and not the minds of other people. How should I prepare for my FFS Surgery? Her jaw looked square, and her brow jutted in a prominent ridge. As the surgeon, Keith Altman, prised back her cheek with a stainless steel retractor and peered inside her mouth, beams from the three bulbs fixed to his glasses illuminated the furthest interior reaches of her jawbone. After that, penetrative sexual activity is normally enough for upkeep. Facial Feminising Procedures commonly include an opration to reduce the prominence of the thyroid cartilage. However, it is not only transgender women who undertake this procedure. Other people spot this she cupped her hands around her jaw more than I do. The number of procedures patients decide to have at once is verymuch dependent on the patients' requests, medicalwellbeingas well associaland financialcircumstancesof the patient. First, the brow was lifted and anchored by two stitches. Our research & education team was born of our vision for a world with better trans health care services. WebBackground: Facial feminization surgery encompasses a broad range of craniomaxillofacial surgical procedures designed to change masculine facial features into feminine features. He contacted a surgeon in Antwerp who was experienced in facial feminisation surgery, and who invited Altman over to watch him at work. This patient had prominent bossing of her forehead which required an osteotomy of the frontal sinus and recontouring together with a rhinoplasty to lengthen the nose and jaw recontouring with a genioplasty to advance the chin. Learn more, Everything you want to know about genioplasty, including the procedure for sliding genioplasty and chin implants, and aftercare and complications for, Buccal fat removal is a procedure that removes the buccal fat pads in your cheeks. Consultations can be held in Antwerp or via Skype, but also in a number of European cities such as London (UK), Munich, Berlin (Germany), Stockholm, Testimonial Our website services, content, and products are for informational purposes only. Youll likely need full-time rest for two weeks. NEWS OF THE WEEK You may also pursue a Centurion procedure, wherein the ligaments underneath the major labia are repositioned to add girth to the neopenis. She could get away without having this done, he rubbed his jawbone but the forehead, she does need. Drake had no definite idea of how she would look after the surgery. Follow the Long Read on Twitter at @gdnlongread, and sign up to the long read weekly email here. Photograph: Christopher Thomond/The Guardian, 'I just want to see the person I always saw in my head': the story of a face, hen the children at Sophia Drakes primary school in rural Wales used to talk about what superpower theyd like, she always told them she wanted to be a shapeshifter. At Facialteam, we are [], Facial feminization surgery can result in a more delicate jawline, for a typically feminine facial shape. Thats what I want to hear. Find out more on our Finance page. The hairline frames my face better. This time has just been booked by another user. Hair transplants allow surgeons to target the areas of the hairline that need reinforcement without unnecessarily advancing parts that may not aesthetically need it. His knowledge and manner was reassuring and the reason I chose him as my surgeon. Mr Inglefield was born in Trinidad, West Indies, and obtained his medical degree from the University of the West Indies in Jamaica and Trinidad in 1985. One surgical element regarding male-to-female (MtF) transition that requires further examination before going ahead is facial feminisation surgery (FFS). She pays about 50 a month for her hormone treatment, and will need to continue with it for the rest of her life. All they really offer is HRT and vaginoplasty. WebRoughly speaking, Facial Feminization Surgery costs range from 5 000 to 60 000 euros. Literature detailing the conduct and outcomes of FFS is lacking. Altman is one of only a handful of British surgeons to specialise in it. I can sit and relax in ways Im not sure Ive ever been able to, she said. With total respect for your gender identity, our detail-oriented care protocol attends specifically to your emotional and physical needs during the FFS process. When choosing a surgeon, pursue in-person or skype interviews with as many surgeons as possible. In his NHS work, Altman could remake your forehead if you smashed it against a dashboard in a car accident. They are generally white, and wealthy enough to afford the typical 20,000-25,000 cost of facial feminisation surgery. The aim of this project was to review surgical practices in NHS Scotland. WebFacial feminization surgery is a series of procedures that can reshape the face and its features to achieve a more feminine appearance. . Altman has operated on the faces of more than 100 trans women in the past 10 years. Its goal is to reconstruct the face, not to improve it aesthetically. For more information, please see our Phalloplasty: The dream and the reality. Furthermore, the gender reassignment procedures involved with the physical transformation need to be carefully considered. If somebody wants to have an easy life, then boy, trans people deserve an easy life. This is a tough gig. Drains collected the fluid that was accumulating under her skin. Understand the risks, recovery, and cost. Many, however, reportfeelingdiscomfort. The point where you get the referral its taken you years, often, to get to that point.. Facial feminisation surgery (FFS) aims to feminise the face by changing masculine facial features to feminine ones. Sitemap | Each and every one who works at 2pass goes above and beyond to make your experience as positive as possible and all relationships are based on mutual trust and respect. For phalloplasty, hair is removed on the site of the donor skin. A tracheal shave reduces the appearance of the Adams apple. His other main interests are orthognathic surgery, skin cancer surgery, salivary gland surgery and jaw joint disorders. Unlike the hairline advancement procedure, a coronal incision allows for simultaneous hair transplants. Rectosigmoid vaginoplasty involves the use of intestinal tissue to form the vaginal wall. He drew back her skin in either direction from her hairline until it gathered in folds on one side at the tip of her nose, and draped back across her crown on the other. If youre considering facial feminisation surgery, Mr Inglefield is available for expert consultation via his Top Doctors profile. Im not trying to make myself beautiful, Drake said. What are the different types of cosmetic dentistry? Altman brushed sterile aqueous iodine over her face and hair, rendering her first rusty red and then yellow. If you opt for lip or brow fillers, be very cautious about permanent fillers, such as silicone. WebFacial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. You can get this cosmetic procedure in the UK, but it is very unlikely this will be offered on the NHS, so you will have to go privately. (2009). Taped to the wall above the nurses station were black-and-white portraits of the patient. She then went on to have cheek implants to highlight her cheek bones and add more volume to her face. Full metoidioplasty and phalloplasty carry the risk of urethral fistula (a hole or opening in the urethra) or a urethral stricture (a blockage). Many of his patients travel from Northern Ireland, where the procedure is covered by the NHS. And all is conducted by a team of highly-qualified practitioners, nurses, and beauticians who practice this day in and day out. Facial Feminization Surgery Annalena. They have ranged in age from 18 to almost 70, and include a barrister, several academics and three airline pilots. Drake protruding brow bone, which she had struck with the side of her index finger when she told me about the poison of testosterone, was gone. He made an incision into her hairline with a swift, steady hand. WebCosts of FFS vary greatly depending on whether you only want work done on one area of your face or several and how difficult the surgeon will envisage creating the change will The clinic also suggests you can expect moderate pain for 3-5 days, but you can go back to regular activities after 1-2 weeks. Then, you decide for yourself whether to proceed without any input from any other healthcare professional. Ask many questions, to get a sense of each surgeons variations in their technique, as well as their bedside manner. From the thick brows above their surgical masks, it was evident that the two surgeons, two anaesthetists and two doctors observing were all men. . Youll find everything under one roof: 2pass Clinic You want to choose someone that youre comfortable with, and who you believe is the best fit for you. Rashid M, et al. This model required months or years of real-life experience (RLE) in their gender identity before they could have HRT or more routine surgeries. You may also choose to do a urethral lengthening with your metoidioplasty, also known as a full metoidioplasty. Find a Surgeon. You can learn more about how we ensure our content is accurate and current by reading our. But, two months later, Drake was delighted with the results. However, some care providers argue that ethical standards dont contradict informed consent. Reddit and its partners use cookies and similar technologies to provide you with a better experience. Rest and recuperate with our team of dedicated FFS experts who put you, the patient, first. (2014). Our quotes include hospital andanaesthetistfees, pre- and post-operative care for one year, pre- and post-operative manual lymphatic drainage (MLD) and a nurseon call24/7. Forehead work is often paired with procedures to alter the hairline in order to counteract the effects of receding hairlines or male pattern baldness. Plastic surgery. On the Channel 4 programme Embarrassing Bodies, she watched the maxillofacial surgeon Keith Altman transform the face of a transgender patient. As society becomes more familiar with transgender issues, the medical establishment seems to be slowly recognizing FFS as fundamental to transgender care, rather than optional and elective. When he put it back in place, he pulled the skin over it, tilting his head to the side to check his work. When a trans woman called Candice had breast implants and genital surgery in California in 1982, she returned to her surgeon, Darrell Pratt, a few months later to say that it had had no impact on how other people perceived her in everyday life, because her face looked masculine. I had first class care at Spire Regency Hospital in Cheshire and follow up/after care all went very well, so I now feel far more confident about my appearance & swelling has almost gone so I can see the results which I am very happy with. When she finally felt ready to eat, using her jaw was agony; she lived on soups, sorbets and mushed-up jelly. After two visits to Belgium, he began operating on his own patients in the UK. It costs twice as much as genital surgery, which used to be considered the standard procedure for gender reassignment, and has been available on the NHS since 1966. A surgeon can smooth strong protrusions. But the truth is, if testosterone has shaped your face, it will have shaped your shoulders, your shoulder-to-hip ratio. Both can be repaired via minor follow-up surgery. Calmer. For this reason, our comprehensive care streamlines your FFS process with attention to detail at each stage: before, during and after surgery. 2023 London Transgender Clinic. Thanks to the scientific enquiry and investigation conducted by this team, we continue to pioneer transgender surgery methods, facial gender techniques and the FFS diagnostics for an ethical practice. For Drake, it is the removal of the changes that testosterone made to her face during puberty. She now recognises the post as a low point, triggered by the loneliness of being single for the first time in a decade and moving to a new city, and the suspicion that, despite having had facial surgery, she still wasnt always read as female. Healthline Media does not provide medical advice, diagnosis, or treatment. You have a more obtuse angle between your forehead and your nose here, he said, smoothing a finger between the middle of his brows. Most facial plastic surgery procedures are designed to correct the skin and soft tissues of the face to reverse the signs of aging. DOI: All About Buccal Fat Removal for Thinner Cheeks, Are Puberty Blockers Reversible? The sole NHS youth gender clinic in England and Wales has experienced an average 40% annual increase in referrals over the past four years, with many of their child patients asking for puberty blockers so their bodies will not go through the kinds of changes Drake has spent thousands of pounds trying to address. Improving facial harmony. WebFacial feminisation is a growing industry, with private clinics springing up across the globe over the past decade. In his private practice, he treats a different kind of trauma: the trauma of not being read as female. To date, our surgeons have performed over 6500 procedures on more than 2000 patients seeking facial feminization surgery. Please note that appointments are now held remotely. When possible, the surgeon will make the incision just below the chin so that scarring is less noticeable. At The London Transgender Clinic, we commit to ensuring you understand the cost of your treatment plan and ensure we will not introduce any hidden costs. When you are called to get on a plane and someone calls you sir thats a huge dysphoria trigger. After the surgery, Holford had moved to London to be by herself, just completely anonymous, and go stealth I hate that term, but thats what they call it, she told me. This makes a surgical procedure unnecessary. For transgender men and transmasculine folks, upper body workouts can boost overall health while altering chest tissue. He examined 1,500 male and female skulls in search of a clinical, craniofacial basis for the maleness people were apparently seeing in Candices face. Im tired of the stress and constant insecurity and I am not sure I can take it any more. She had written two lists, for and against detransitioning. It puts completely unfair pressure on cisgendered women I think its awful but for trans women its double, and youd do anything just to feel like you fit in. Many only pursue hormone replacement therapy (HRT). Please be aware that guide prices are subject to change. These before and after images of a patient who attended for advice about FFS illustrate the power of surgery on the lower face in FFS. She was on the table for seven hours. The coronal incision method is slowly being incorporated into other surgeons practices. We wont see the full effects until next year, she said. This confirmed his expertise in all aspects of plastic, reconstructive and cosmetic surgery and he was added to the UK GMC specialist register. You can learn more about how we ensure our content is accurate and current by reading our. Pratt asked a colleague, the San Francisco-based maxillofacial surgeon Douglas Ousterhout, if there was anything he could do for his patient. Other times, a chin augmentation is recommended. WebIn terms of consultations, Facial Team and Bart have London consultations. For the first couple of days, whenever she got out of bed, she would vomit the blood that had collected in her stomach from the surgery inside her mouth. I feel that Ive got a lot more expression in my eyebrows now. However, there are limits to the reductions. You have likely asked yourself, How do I find the right FFS surgeon?