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Personalized Care for Gender Affirmation in San Antonio

At Micallef Plastic Surgery, we understand that facial appearance plays a crucial role in self-expression, personal confidence, and affirmation. Our team, led by renowned surgeons Dr. Christopher J. Micallef, FACS, and Dr. Alexandra S. Ortiz, MD, provides personalized, compassionate care for patients undergoing gender-affirming procedures. Contact us today to learn more about what we can do for you.

What Is Facial Feminization Surgery?

Facial Feminization Surgery in San Antonio is a series of procedures designed to soften masculine facial features and create a more traditionally feminine appearance. Each patient’s facial structure and goals are unique, and we customize every aspect of the FFS plan to suit individual needs.

Our comprehensive approach to facial feminization may include the following procedures:

Forehead Contouring

Reshaping the brow bone to reduce the prominence of a masculine forehead and create a more delicate appearance.

Rhinoplasty

Refining the size, shape, and profile of the nose to achieve a softer, feminine look.

Jawline and Chin Contouring

Sculpting the jawline and chin to be smoother, rounder, and less angular.

Lip Lift and Augmentation

Elevating the upper lip to reveal more of the pink lip, enhancing both shape and fullness.

Cheek Augmentation

Enhancing cheekbone prominence for a fuller, more traditionally feminine contour.

Tracheal Shave (Adam’s Apple Reduction)

Reducing the size of the Adam’s apple for a smoother neckline.

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Who Is a Candidate for Facial Feminization Surgery?

  • Transgender Women: FFS is a vital step in aligning physical appearance with gender identity for transgender women. It can help reduce gender dysphoria by softening masculine features and creating a more traditionally feminine appearance.
  • Non-Binary Individuals: Those who identify as non-binary may also seek FFS to achieve facial features that align with their individual sense of gender expression, whether softening masculine features or creating a balance between masculine and feminine traits.
  • Cisgender Individuals: Some cisgender women or men may desire specific facial procedures to enhance femininity or reduce certain masculine characteristics, making FFS a viable option for them as well.
  • Those Seeking Gender-Affirming Care: Anyone who feels that their facial features do not reflect their true identity or personal aesthetic can benefit from the procedures included in FFS. This may involve reshaping the nose, jawline, or forehead for a more balanced, harmonious look.
      

Additional Candidate Considerations

  • Good General Health: As with any surgical procedure, candidates for FFS must be in good overall health. This helps to reduce the risk of complications and ensures a smoother recovery process. Patients with certain health conditions should consult our team to determine whether they are suitable for surgery.
  • Age and Facial Maturity: While FFS has no upper age limit, candidates should have fully matured facial bones and structures. Most candidates are adults, and younger individuals should be evaluated to ensure their bone development is complete.
  • Clear Aesthetic Goals: Ideal candidates have specific, realistic goals for feminizing their facial features. During your consultation, Dr. Micallef and Dr. Ortiz will discuss your goals and create a customized plan to achieve your desired look.
  • Non-Smokers: Smoking can interfere with the healing process, so candidates for FFS should be non-smokers or willing to quit for a period before and after the surgery.
  • Hormone Therapy: While not always mandatory, hormone therapy can significantly impact the results of Facial Feminization Surgery. We generally recommend that patients undergo hormone therapy for at least 12 months before considering FFS. This period allows hormonal changes to stabilize, providing a clearer picture of which surgical interventions will be most beneficial. However, we understand that hormone therapy is a personal choice and may not be suitable for everyone. During your consultation, we will discuss your unique situation to develop a personalized surgical plan that aligns with your goals.

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Mental Health Evaluation

To ensure you are fully prepared for this transformative process, we require a mental health evaluation before proceeding with surgery. A qualified mental health professional can provide valuable support, assess your readiness, and help you navigate any emotional challenges that may arise. This evaluation aligns with the standards of care recommended by professional organizations specializing in transgender health. The mental health assessment aims to confirm that:

  • You have a comprehensive understanding of the surgical procedures, potential risks, and realistic expectations regarding the outcomes.
  • You are mentally and emotionally prepared for the changes and the recovery process associated with FFS.
  • Any existing mental health conditions are well-managed to optimize surgical results and facilitate a smoother recovery.

The Importance of Emotional and Psychological Support

Undergoing FFS is not just a physical transformation but also an emotional one. We recommend that candidates have a strong support network in place, including friends, family, or professional counseling, to help navigate the emotional aspects of surgery and recovery. 

At Micallef Plastic Surgery, we understand that facial feminization is about more than aesthetics—it’s about helping you feel more like yourself. Our experienced team is here to guide you every step of the way, ensuring you are prepared for the physical and emotional aspects of this transformative process.

If you meet these criteria and are ready to begin your journey, schedule a consultation with Dr. Micallef or Dr. Ortiz to discuss how FFS can help you achieve your goals.

Facial Feminization Surgery Benefits

  • Increased Self-Confidence: FFS allows you to see yourself reflected accurately in the mirror, enhancing self-esteem.
  • Gender Affirmation: By aligning your facial features with your gender identity, FFS can significantly reduce feelings of gender dysphoria.
  • Natural-Looking Results: Our surgeons focus on delivering soft, harmonious outcomes that look natural and reflect your unique beauty.
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What to Expect Before and During Facial Feminization Surgery

It all starts with a consultation, during which we will thoroughly evaluate your facial structure and discuss the procedures that best suit your goals. Our priority is understanding your vision for femininity and how we can help you achieve it. We encourage open and honest communication to ensure your expectations align with your results.

Facial Feminization Surgery in San Antonio is highly personalized and can involve one or multiple procedures depending on your specific goals. The length of surgery varies based on the extent of the procedures but generally lasts several hours.

However, you can generally expect the following:

  • FFS is performed under general anesthesia, ensuring you are comfortable and pain-free throughout the surgery.
  • Depending on the procedures involved, your surgeon will carefully reshape or augment various areas of your face.
  • Your surgeon will place incisions strategically to minimize visible scarring, often hidden in natural creases or inside the mouth where possible.
  • Once the necessary changes are made, the incisions are closed, and you will be moved to a recovery room.
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Recovery and Results

Immediate Post-Surgery Recovery

After the surgery, you will spend time in a recovery area where you’ll be closely monitored. You may feel groggy as the anesthesia wears off, and some discomfort is standard in the initial stages.
Pain medications will be provided to manage any discomfort. Swelling and bruising are common in the first few days, and cold compresses can help reduce inflammation.

You will return to Micallef Plastic Surgery for follow-up appointments so your surgeon can check your healing progress. These appointments are crucial to ensure that everything is healing as expected.

Long-Term Recovery

Most swelling and bruising will begin to subside after a couple of weeks, but it may take several months for all residual swelling to disappear. Full results typically become visible within six months to a year.
Depending on the procedures performed, you may have stitches, bandages, or surgical drains in place. Your surgeon will provide guidance on when these will be removed and how to care for incisions.
You should take at least two weeks off work and avoid strenuous activities for several weeks to allow your body time to heal. Light walking is encouraged to promote circulation.

Results and Final Outcome

As swelling subsides, you’ll begin to see the initial results of your surgery. Your facial features will gradually soften, and your overall appearance will align with the feminization goals discussed in your consultation.
The results of FFS are permanent, but they will continue to evolve as your face heals and swelling fully resolves. Scars will fade over time, and your new facial contours appear natural and balanced.
Many patients report a significant improvement in their emotional well-being and self-confidence following FFS. The alignment of your facial features with your gender identity can help reduce feelings of gender dysphoria and improve your overall quality of life.

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Trust Us to Guide Your Journey to Feminization
Contact Micallef Plastic Surgery Today

At Micallef Plastic Surgery, we take pride in offering expert, compassionate care for transgender and non-binary individuals seeking gender-affirming facial surgery. Whether you are just beginning to explore the possibility of surgery or are ready to take the next step, our experienced team is here to help you achieve your goals and feel confident in your skin. 

Dr. Christopher J. Micallef, FACS, is a double board-certified plastic and reconstructive surgeon with over 15 years of experience in the United States Air Force as a Special Operations medical officer. His military background has shaped his disciplined, patient-centered approach, allowing him to deliver both aesthetic and reconstructive procedures with precision and care. At Micallef Plastic Surgery, Dr. Micallef offers a personalized, holistic approach that focuses on each patient’s unique needs, providing natural, long-lasting results.

We are honored to be a part of your transformation and look forward to helping you achieve an appearance that reflects your true self. Schedule a consultation with Dr. Micallef today to begin your journey toward facial feminization in San Antonio.

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