What Are the Risks of Facial Feminization Surgery?
Considering FFS but Nervous About Risks?
Every surgery comes with risks, but when it is your face, those risks can feel more personal. Today, we will talk about the risks of facial feminization surgery and, more importantly, what you can do to lower your chances of complications.
At CMF Surgeons, we help patients understand FFS risks, recovery, and what to expect before moving forward.
Book a consultation with us today, or visit our FFS playlist on YouTube for more videos about facial feminization surgery.
When You Undergo Surgery, There Is Always Some Amount of Risk Involved
Any surgery you may have will always carry risks. The most common risks of any surgery are pain, swelling, bleeding, and the risk of infection. There are also risks of anesthesia, including having a reaction to medication.
Any surgery is also likely to have a risk of scarring that goes along with it. In the anatomy of where we are working, there are always nerves, blood vessels, and other structures that you need to be aware of in order to reduce your risk of complications.
Also, if you have risks like diabetes or are an active smoker, you may have additional risks of wound healing and other issues that others may not. Most of these risks are manageable and avoidable, but it is very important for you to understand what those risks are for you.
What Risks Are Specific to Facial Feminization Surgery?
All of the risks associated with facial feminization surgery are short-term, and they are things that we can treat, mitigate, and resolve over time.
Neurologic Risks
The most common risks are the neurologic risks around the nerves that we are working on. If we do forehead contouring, we are working around the nerves that innervate the forehead.
Anytime we make an incision up in the hairline itself, there are nerves just behind the hairline that are going to go completely numb for a period of time. These nerves can regenerate, but most patients do notice a short-term loss of sensation in some areas of their forehead.
If we are doing jaw contouring, working around the chin, or working around the neck, there is always a risk of numbness in those areas as well.
Scarring Risks
Other risks include scarring in the areas where we make incisions. Anytime we move a hairline or make an incision on the skin, our goal is to hide where the scar will be. But there is always a risk of excessive scarring, especially when we are moving a hairline because we are creating tension across that wound.
When tension is created, wounds have a tendency to widen. We mitigate that risk using a number of techniques that we will always discuss during your consultation.
Shock Hair Loss After Surgery
One of the very common risks when we do forehead contouring, brow lifts, and hairline advancement is short-term loss of hair in the entirety of the scalp, but more specifically around the incision line itself. This is most commonly known as shock hair loss.
It is essentially your body’s physiologic response to the changes in blood flow and to changes in the tension and pressure in the wound itself.
We expect some degree of hair loss, usually starting around the second week, and it generally does not go past the sixth week. The entire scalp can be affected.
One of the things that we will always talk to patients about is that you are going to see yourself losing hair. It is okay. It is expected.
What is actually happening is that your body is ejecting the hair shaft itself, but the hair follicle is still viable and doing what we need it to do. The hard part is that it makes the scar more visible.
Obviously, seeing hair going down a drain or pulling out hair is very unsettling, which is a big part of why we make sure we have the discussion about what we expect, what we do to mitigate it, and the fact that it is actually okay.
The hair will grow back because the follicle itself is okay.
How Can Your Results Change Over Time?
It is also important to think long-term. Facial feminization surgery does not stop the natural aging process. Your skin will change over time. Weight changes and fluctuations can have an impact on how your skin heals and how your skin looks over time.
Some patients do get revision procedures down the line for fine-tuning or further optimization of healing and overall outcome. That does not mean that something went wrong. It is just a part of your personalized journey.
Can You Lower Your Risk Before Surgery?
The good news is that there is a lot you can do to reduce your risk. You want to choose an experienced, board-certified surgeon. Make sure you are completely honest about your medical history.
How Your Choices Can Support a Safer Recovery
One of the things you can do is stop smoking if you are an active smoker. Ideally, you should stop six weeks before surgery, whether that means cigarettes, nicotine-containing products, or marijuana. The ideal is to stop six weeks before and continue that through six weeks after.
It is also very important to follow all preoperative and postoperative instructions from your surgeon.
You also want to make sure that you protect any healing areas from sun exposure. Cover them up and put on sunscreen. Basically, you want to block any fresh, open, or visible wounds from sun exposure.
The best thing that you can do is always take care of your general and overall health.
Why Your Provider’s Experience Matters
Another way to reduce risk is to understand what the risks are. Talk to your surgeon about what these risks may be. Ask, “What are you as a provider going to do to help me decrease the risk of these things? What is your surgical plan?”
It requires a lot of open dialogue and a real understanding of the risks, how we are going to combat them, and what we are going to do if they do come up.
Generally, taking good care of yourself before surgery is important. Understand your postoperative and preoperative plans. Discuss it with your provider. That is the way to be the most successful in both your preoperative and postoperative recovery.
Should You Be Worried About Serious Complications?
When performed by an experienced surgeon, FFS is considered very, very safe. Serious complications occur in fewer than 0.5% of patients.
General satisfaction rates from FFS are very high, and it allows you to get back to your regular life with confidence, with your new face, and express yourself as you see fit.
You’re Not on Your Own During Recovery
If something does come up, the most important thing is communication. Stay in very close contact with your surgeon.
Here are some of the things that we might do if you experience a complication. The most common complications are infection and wound healing issues. Part of our postoperative process is a very regular follow-up, especially during the first seven days in particular.
If an infection or wound healing issue is happening, medication is generally going to be able to treat it as long as we know about it in time.
Occasionally, additional procedures are needed to get a wound to heal, drain an infection, or optimize a wound bed in order to facilitate good long-term healing. But that is the least likely outcome from an infection or wound healing issue.
Thankfully, for most people, nothing ever needs to happen.
Book a consultation with me to talk through your risks and recovery plan, or watch another FFS video on our YouTube channel to learn more about what to expect.