Revision Facial Feminization Seattle

For some transgender people, gender confirmation surgery such as facial feminization (FFS) can be an important step in their gender transition. A combination surgery that looks different for each patient; the main goal of FFS is to create a more feminine appearance of the face. Depending on a patient’s existing features and goals, this can include many different procedures such as rhinoplasty, lip lift, brow lift, chin implant, and shaving down the Adam’s apple. While most patients are satisfied with their FFS results and do not experience major complications, all surgeries will have a small portion of patients who seek out revisional surgery. Allure Esthetic Plastic Surgery provides customized facial feminization revision surgery in Seattle.

An FFS revision can look very similar to the original surgery or entirely different. Ultimately, there are four primary reasons why a patient may seek a facial feminization revision.

• Under Correction of Treated Features: Sometimes, the corrections performed are not enough to create the desired feminine appearance. Other times, certain aspects of the surgery may not heal well or fail. This is a risk with all similar surgeries and many elements of this are out of the control of the patient or surgeon.
• Treatment of Previously Untreated Features: One of the more common reasons for additional FFS procedures is that features not treated during the original surgery must be addressed. Whether it was the patient’s choice initially or they opted to leave those features alone on the advice of their surgeon, or they simply did not bother them before, this version of revision facial feminization may include brand new surgeries meant to complement the original results.
• Complications: While rare, complications do occur. In even rarer cases, this may require surgery to correct. This is one of the less common reasons for facial feminization revisions.
• Aging: Some features corrected during FFS such as tracheal shave and brow bone reduction are essentially permanent. However, other enhancements may change with aging such as brow lifts and lip lifts. Therefore, after a decade or more, some transgender patients may undergo smaller revisional surgeries to upkeep the results of their original facial feminization surgery.

Some patients have more personal reasons for seeking FFS revision surgery. Dr. Sajan understands that a patient’s reasoning is likely complex and multi-faceted. During a consultation, he will holistically evaluate the patient to determine the right course of treatment.

The benefits and risks associated with a revision facial feminization surgery are similar to the original surgery. However, revision surgeries are more complex in general and can carry higher risks, but they can also have more benefits.

Benefits of facial feminization surgery revision may include:

• Enhance feminine appearance
• Correct unsightly scars
• Continue nose reshaping for a smaller, more feminine nose
• Address previously untreated facial features
• Correct complications of the original surgery
• Further define the jawline
• Improve the contour of the face and neck
• Reduce gender dysphoria
• Better aesthetic outcomes
• Customized gender affirming surgery

All surgeries have risks. The risks of revision facial feminization procedures may vary based on the specific surgeries performed and the reasons for undergoing the revision. Possible risks include:

• Prolonged swelling and bruising
• Infection
• Scarring
• Nerve damage
• Asymmetry

Major complications and risks are rare in patients who are healthy and good candidates for the procedure.

The surgeries included in revision FFS will depend on the patient and their needs. However, some procedures are more likely to be revised after the original surgery.

Rhinoplasty

A rhinoplasty—or nose job—is a surgery that many choose to revise. Whether performed during FFS or separately, sometimes a rhinoplasty is not adequately thinned, feminized, or supported. Additionally, nose job surgeries often have a functional—as well as cosmetic—purpose which can lead to revisions too. Many rhinoplasty revisions happen several years after the initial procedure to account for aging and changes in the look of the face.

Tracheal Shave

A tracheal shave is a surgery that reduces the projection of the Adam’s apple by shaving down the cartilage. This surgery is rapidly innovating and thus some patients may be able to garner even better results as technology advances. With that said, a tracheal shave is a delicate procedure that requires an experienced surgeon who can feminize the contour of the neck without risking the thyroid or other nearby structures.

Brow Lift

Brow lift surgery—whether performed for facial feminization surgery FFS or as an anti-aging measure—is still subject to aging and gravity. While younger FFS patients may be able to enjoy their brow lift results longer, they may eventually need a revision to address changes due to aging and time. A brow lift is primarily a soft tissue procedure which makes it more susceptible to aging, gravity, and the elements.

Chin/Jaw Surgery

Enhancing the chin and jaw during FFS can include various procedures including placing a silicone implant in the chin and contouring the bone. This is a highly specialized procedure and can require revision to refine it. Sometimes, patients may also want to exchange out their implant for a different shape or size. Depending on the specific revisions necessary, it is common to treat this area with filler or other non-surgical procedures as a means of revision.

Patients and surgeons cannot fully control whether or not a revision facial feminization becomes necessary. However, there are a few things patients can do to promote the best possible results and reduce the chances that revision becomes necessary.

• Choose an experienced FFS surgeon and one whose results align with your personal goals for the procedure
• Follow all post-operative instructions
• Have realistic expectations
• Consider choosing a facility that uses pre-surgery imaging to evaluate and plan facial feminization surgery (such as CT scans)
• Understand what the timeline for results and healing looks like
• Follow scar care protocols
• Practice good skincare and consider occasional non-surgical procedures to maintain results

Will A Revision Facial Feminization Surgery Be As Extensive As The First Surgery?

Potentially, but it is unlikely. Many revision facial feminization surgeries only involve one or two areas versus the entire face. However, occasionally, full revisions of FFS need to be undertaken. Dr. Sajan is a surgeon with years of experience performing gender affirming facial surgery and has trained around the world in the best techniques for FFS. He has performed facial feminization surgery and revisions.

How Long Should I Wait Before Seeking Revisional FFS Surgery?

Generally, it is recommended that patients wait at least one year before seeking out any revisional surgery. This is because residual bruising and swelling can take several months to fully dissipate. Some exceptions to this do exist and patients with concerns should seek the advice of either their original surgeon or another qualified FFS surgeon. Many concerns can be treated non-surgically like with ultrasound massage, filler injections, or temporarily taking medication.

Is Revision Facial Feminization Common?

No, facial feminization surgery has a similar revision rate to other cosmetic and gender affirming surgeries. However, because so many procedures are combined into one, this can inflate the chances that a revision may later become necessary. Picking the right surgeon who can customize your procedure to fit your facial structure, needs, and medical history helps reduce the chances of needing a revision.

Will Insurance Cover Revision FFS?

Often, yes, but coverage will differ based on company, plan, and the procedure itself. Allure Esthetic’s dedicated insurance coordinators can help you determine the coverage you have and work as a go-between between you and your insurance company. If insurance is not an option, Allure Esthetic does work with outside financing options including Care Credit, Alphaeon, and United Medical Credit to offer affordable financing for FFS.

Is FFS Revision Surgery Worth It?

In most cases, yes, revision FFS is worth it because it helps further reduce gender dysphoria and help transgender patients live safely and happily in the world. Every situation is different and Dr. Sajan can help patients evaluate if revision FFS is right for them.

Allure Esthetic Plastic Surgery is a plastic surgery practice and medical spa in Seattle, WA that has a long history of welcoming and treating the transgender and gender non-conforming community. Dr. Javad Sajan has trained with the world’s experts in facial feminization and uses pre-surgery CT imaging to customize surgery to each patient. Allure Esthetic and Dr. Sajan provide the best revision facial feminization Seattle offers.

To learn more and schedule a consultation, call us at 206-209-0988. Patients can also reach out online via chat, contact form, and Price Simulator.