But we all have the same goal: to see our truest selves reflected in the mirror.
Mirrors have always been my enemy, says Caragh,* a transgender woman.
Seeing my reflection was like sticking my arm in a bear trap.
Martin Salgo
Nothing good was going to come of it.
FFS is an umbrella term for various personalized procedures that feminize facial features.
Every FFS plan is carefully tailored to each person.
Caragh before facial feminization surgery.
I didnt know what I was doingwasfacial feminization surgery, says Wanzer.
Its different for everybody.
It was an obvious choice, even for a fearful transitioner such as myself.
Caragh after facial feminization surgery.
What is facial feminization surgery?
Says Dr. Lee, Its one aspect of a male-to-female (MTF) transition.
Its unlikely that one patient would need or want every procedure under the FFS umbrella.
Arisce before facial feminization surgery.
A treatment plan depends on the individuals specific goals and anatomy, says Dr. Lee.
Depending on the combination of procedures, facial feminization surgery can happen in one operation.
Dr. Deschamps-Braly says he will make a run at keep it that way.
Arisce after facial feminization surgery.
How can patients prepare for FFS?
As with any elective procedure, preparation is key, says Dr. Lee.
This is especially true when it comes to gender-affirming surgery.
Brooke before facial feminization surgery.
Preparing for surgery is like preparing for a marathon, she adds.
Customizing your diet to incorporate specific nutrients before and after your procedure is critical for achieving optimal surgical results.
Its important to not put too much stress on the body before surgery, she notes.
Brooke after facial feminization surgery.
This can actually increase inflammation and cortisol levels.
When in doubt, she says, follow your doctors instructions.
And mental preparation is just as important as the physical.
Billie Grace before facial feminization surgery.
I think the surgery should be something patients have been thinking about for some time, Dr. Deschamps-Braly says.
In most cases, theyve been working with an endocrinologist or primary-care doctor to manage hormone therapy.
What is the recovery time for FFS?
Billie Grace after facial feminization surgery.
Generally, patients will be up and walking the same day of surgery, says Dr. Deschamps-Braly.
Dont let that discourage you, he notes.
Patients generally look really good between three and six months after their procedure.
What are the risks of FFS?
When Wanzer approached Dr. Lee about rhinoplasty, she admitted that she was terrified of not liking the result.
What if I dont like my nose?
Im not someone who can go under the knife and come back as a different person.
I still want to look like myself, I still want to look Black.
Says Wanzer, Listen to your doctor when they talk about options.
And if they only give you one option, they might not be the doctor for you.
Theres an artistry to the process and each surgeon has a different look.
Its important to find a surgeon whose style aligns with your aesthetic goals.
FFS typically involves a more drastic change in appearance.
Being on the same page as your doctor about the expected appearance desired post-operatively is key.
Beyond that, Dr. Deschamps-Braly encourages patients to find providers who are specifically trained and experienced in FFS.
What is the average cost of facial feminization surgery?
The total cost of any facial feminization surgery plan depends on the provider and the number of procedures involved.
But he urges patients not to rely on that and to come prepared with financial resources.
Some LGBTQ+ nonprofit organizations, includingPoint of PrideandGenderbands, offer grants for gender-affirming surgeries to those who are eligible.
The cost is high, but patients who have had FFS generally agree that the results are priceless.
Caragh before facial feminization surgery.
Caragh after facial feminization surgery.
FFS helped Caragh find joy in her appearance.
Now I love going out in public.
I crave being social.
The anticipation of how bad it would be was truly the hardest part of the process, she says.
I never experienced a minute of crippling pain.
She found emotional support in the form of friendsyes, the TV show, but especially real-life companions.
I dont think I could have made it through without my friends.
Caragh is still eagerly waiting to see the full results of her new face emerge.
For the first several months you feel like nothing has changed, she says.
But Im realizing that there is no time limit on recoveryyoull just keep getting better every day.
Arisce before facial feminization surgery.
Arisce after facial feminization surgery.
For Wanzer, who loved the way she looked, FFS was primarily a business decision.
Ive been a model for 20 years, and I already liked the way I looked, she says.
My old nose has been inVoguesix times.
I knew how to work my angles.
But she wanted to book more beauty campaigns.
She wanted to be able to look at the camera head-on, without leaning on angles.
I have booked several beauty campaigns since getting it done, she says.
I didnt do anything cisgender people dont do all the time.
I wasnt doing the most.
She says a strict low-sodium diet and pineapple juice (I was drinking nothing but pineapple juice!)
helped minimize swelling and quickly got her back on her feet.
Salt can cause water retention, confirms Dr. Lee, who treated Wanzer.
Its rich in bromelain, an enzyme that has been shown instudiesto alleviate pain and reduce swelling.
Says Wanzer, Its just beauty advice.
It was absolutely worth it.
My life has improved because Im getting what I wanted, she says.
I wanted beauty campaigns and I wanted to look at the camera head-on and not have to work angles.
The proof is in the pictures.
Brooke before facial feminization surgery.
Brooke after facial feminization surgery.
Brooke was motivated to get FFS to improve her relationships.
I wanted to recognize myself in the mirror, she says.
The strain was making me an awful person.
In some ways, I did it for them.
She was also deeply concerned for her safety and knew FFS would help.
I wept at my dream of walking to the grocery store and back without getting clocked.
The world isnt kind to feminine men.
My boyfriend used to wait for me outside of gas station bathrooms just in case I screamed.
A plaster cast ran from my forehead to my nose.
For Brooke, FFS unlocked a world of femininity she felt she didnt have access to before.
Its more socially acceptable for women to be vulnerable with each other in ways that men arent.
My compassion and vulnerability were ridiculed in dude culture.
Now, theyre treated as laudable characteristics.
Tech companies are more likely to offer me a position managing their social media account than writing software.
Billie Grace before facial feminization surgery.
Billie Grace after facial feminization surgery.
For Billie Grace, another of Dr. Deschamps-Bralys patients, facial feminization surgery was necessary for her safety.
I was ashamed of my looks and felt unsafe outside of New York, she says.
Getting FFS was as much a matter of survival as it was confidence.
I avoided all of it unless I had no choice.
The first night was surreal and a bit scary, she recalls.
Because of the nose job, I couldnt breathe properly.
And I thought Id suffocate in my sleep because my lips had grown so big.
In the beginning, youre on painkillers, she says.
Frankly, Ive had more discomfort from arm days at the gym.
Absolutely, says Billie Grace.
And I no longer fear traveling to see family because I fit in, she says.
I look like any other woman.
FFS is totally worth it for the incredible quality of life it supports.
*At the patients request, we are using only her first name to protect her privacy.
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