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Why it is Better to choose a Maxillofacial Surgeon for your FFS

FFS surgery is considered to be a very complicated type of surgery. What the patient often needs involves rather extreme changes of the face and at the same time it should be done in such a way that a person that didn’t know the patient before surgery cannot see ‘something has been done’ (a natural result). For sure not an easy task for the surgeon.

Two reasons

Facial feminization surgery in fact consists of 2 types of surgery:

• surgery to change the hard structures (bone and cartilage) of the face like forehead, jaw and chin, Adam’s apple and nose
• surgery to lift soft tissues (forehead lift, lip lift, facelift) and add volume where it is lacking (fat and prostheses)

Maxillofacial surgeons are used to work with bone from the start of their training. Plastic surgeons don’t and many are really afraid to handle a saw or a burr and do what needs to be done. You should know that the bone work really is the core of facial feminization surgery. Without this being done in a drastic way most trans women will not have a good passing.

Maxillofacial surgeons have a metric approach to facial plastic surgery. An important part of maxillofacial surgery is jaw surgery or also called orthognathic surgery. This is about bringing upper and lower jaw in a position that fits the rest of the face to create a harmonic face. It comes with lots of measurements before and during surgery and exactly this is very important in facial feminization surgery too. Plastic surgeons are lacking this metric approach in their training. They are more used to working out of the free hand and rely on their ‘the carpenters eye’ which very often means results will not be consistent as the eye sometimes fails.

Diplomas are important but certainly are no guarantee

Board certified means the surgeon has had several years (between 4 and 6) of specialised training after receiving his or her medical degree. But unfortunately it’s no guarantee the surgeon really has been trained for the surgery he or she is performing. FFS is a highly specialised type of surgery and in fact there is no official training for it. After having completed the training as a medical specialist the surgeon will need to visit colleagues that are famous for highly specialised facial plastic surgery like rhinoplasty, forehead surgery, jaw recontouring, lifting procedures etc. This will take years.

Ideally the FFS-surgeon will receive training from an elderly FFS surgeon that has been doing this for many years, but unfortunately very very few will have this privilege.

Not to speak of the necessary talent. To be able to make all transwomen pass, even the ‘difficult cases’, the surgeon will need an enormous feeling for aesthetics, continuous self-critique and evaluation and the guts to do what needs to be done. After years of learning from mistakes the surgeon will hopefully master the specialty of FFS and be able to deliver good results consistently.

So do extensive research before choosing your FFS-surgeon

The text above explains why there are so few really good FFS-surgeons. Please do extensive research before giving your confidence to a surgeon.

Beware: Those who chose wrong have lost not only their money, more importantly, many of them have lost their hope ever to have a good passing, which can have terrible consequences

Keep faith in your surgeon once you have chosen

Even in the hands of a very good FFS-surgeon results can be disappointing or things can even go really wrong. But if you did your research well before choosing this surgeon you know you’ll have to go back and have it fixed, because he/she’s the best. Keep faith in your surgeon. If he/she’s the right one he/she will fight for you until you‘ll be able to pass well.

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