questions about FFS

[rodybaby]

i have been looking at FFS and had some questions about it. I have not started hormones yet but i am looking for a therapist right now but i want to get FFS. Do i need a doctors referral or can i just go in and get it. Does the surgery really change your appearance that much?? i am having trouble finding pictures of before and afters without make up. and would it be wise to do this even though i am not full time yet, like if i went out in guy mode people would really notice??

[Nicole Brown]

I have just made my final appointment to meet with my surgeon prior to my FFS in September. Here is the advice that I have been given by my surgeon, my therapist and my endocrinologist.

First, you will need a therapist's letter identifying you as having Gender Dysforia and recommending HRT as a treatment. This will allow you to begin hormone treatment as well as be eligible for FFS and BA if needed. Ensure that you have chosen a therapist and an endocrinologist who are experienced with transsexuals. If you are seriously considering FFS you should have already begun laser facial hair removal and electrolysis. No surgeon can properly perform FFS on an individual who has a face full of hair. Get rid of it now.....

Second, it is not advisable to have FFS prior to being on HRT for at least 6 months, preferably longer. Hormones are powerful stuff and effect many parts of your body. They not only encourage breast development and redistribution of fat, they also affect your skin. With hormones, in time, you will notice a softening of your skin and changes to facial appearance. This is why they recommend being on hormones prior to actually having the FFS. Likewise, if you need to loose any weight, do it before you have your FFS. Any significant weight that you loose after the FFS will cause your skin to sag and you will not fully benefit from the procedures.

Finally, be very careful in selecting the surgeon who will perform your FFS. Your face is the first thing that people see and notice about you. Get recommendations from other girls in your area who have had work done and by all means look online for reports on the doctor that you finally choose. Before you make up your mind, interview each of the doctors on your list and be just as concerned with their manor, skills and follow up as your are with their personality.

Feel free to PM me if you find this helpful and would like to discuss further.

[Michelle.M]

Nicole, I don't know who your FFS and BA surgeons will be but therapist letters for those surgeries is not necessarily a universal requirement. It probably ought to be, but it's not.

I had FFS after 9 months on HRT (and one definitely ought to let HRT do all it can to the body and face before a surgeon makes any assessment) and I had BA after 19 months HRT and 9 months RLE. Neither surgeon required any letters.


I have not started hormones yet but i am looking for a therapist right now but i want to get FFS.

You're going about this the wrong way. You're already concentrating on hormones and FFS and you haven't even found a therapist, much less even begun therapy? Surgery is a very big deal and you really want to cover this issue completely with a therapist first.

You need to get your head in the game and put first things first. Forget all of this surgery stuff and start doing the internal work first.

[Kaitlyn Michele]

Michelle is right..

your thoughts are VERY COMMON....ffs is great , HRT is important..but its jumping to the end..

Working through all the real life stuff around transition and the true realities of what day to day transitioned life means is much more important in the short term

...that can happen quickly if you are certain of your situation and motivated...the better you are at "life" the better the process will go for you.

..have you done electrolysis yet?? that's something that will hugely impact your quality of life..

[Nicole Brown]

Nicole, I don't know who your FFS and BA surgeons will be but therapist letters for those surgeries is not necessarily a universal requirement. It probably ought to be, but it's not.

Thank you Michelle for pointing that out. The surgeon I will be using for my FFS specifically asked if I had an HTR letter from my therapist and if I was already on hormones. I suppose it is possible that he just asked to determine my progress and I misunderstood and assumed that he was requiring it. Come to think of it, none of the other surgeons I interviewed even asked about a therapist's letter.

I agree with you that it might be a good idea to make a therapist's letter a requirement for FFS, but then we really have to go through enough without that extra task to consider.

Good catch, and thanks for pointing it out to me.....

[KellyJameson]

You may also want to use this time to learn about the human face in all its splendor and variation.

I personally did not aesthetically like much of what FFS does and there are "masculine" elements to a womans face that I very much preferred over the more feminine face as being "natural" to me.

I strongly resisted some of the suggestions and was very slow to act and I'm very glad of this.

I did not want to lose my strong jawline so I studied pictures of woman with this feature.

Google image search "woman with strong or square jaws" if this is important to you.

I would strongly encourage you to familarize yourself with your own concept of feminine beauty instead of having it pushed on you by a surgeon.

It is your face and you will have to live with it.

Just as I had to pull from my subconscious my true identity that I had submerged I also found that I had buried in my subconscious a deep sense of how I should look naturally as far as my face and body.

Try to discover this natural person within you and not how you think you should look for others but how your face was meant to look naturally in the absence of androgen exposure.

Be careful you do not allow those in authority to dictate to you how you should look just because they hold the degrees and skill. They are there to guide you, not to define you.

In my opinion you do not want to be turned into some kind of cookie cutter look that is considered "correct"

I studied thousands of pictures along with learning about the differences between men and womens facial structure and I strongly suggest you do your homework in this area.

The differences across the spectrum are actually very subtle in my opinion.

Remember that surgery is a business to make money so you do not want to be ground up like a piece of meat in the machinery of making money.

One of the primary differences between FFS and plastic surgery are changes to the underlying bone structure of the skull such as the supraorbital ridge, which you may not need.

Depending on your circumstances sometimes subtle changes can have dramatic results.

You will be shocked by the differences electroloysis and hormones will have on your face, particularly if you already have soft features anyway.

[tori-e]

I had FFS with Douglas Ousterhout in San Francisco in 2008. At the time his requirements where all about blood work, ECG's and large amounts of cash. No letters required. And really why does he need them? But I had been on hormones for a few years and was 6 months into RLE. I had the full spectrum of work that he typically does, except that I'd already had my trache done. My goals for FFS where to get the man out of my face. I think he did a pretty good job at that. One thing I haven't done is to have a face lift. Which is probably a good idea about six months after FFS. I didn't have all my electro done, but he wanted a substantial break before and after surgery. I'm still not done electro.

[Angela Campbell]

My therapist told me that here you only need a letter for anything below the waist and for hormones. Breast and face all you need is money.

I plan to get the electrolysis and start HRT and see how that goes before I decide on FFS. I may not need it.