Appropriate Timing For FFS?

[MelissaPaige]

I realize everyone is different, but a question I have is how long should you be on HRT before considering FFS?  I've been on hormones for almost five months and just got my first remote feedback from a regarded surgeon mentioned in this forum.  He said that FFS could be done at any point, and the right time is when I want to make the switch to RLE.  Does it matter if you do FFS before "the operation"?  Can it be done earlier in HRT, and is that even advisable?

I'm just trying to plan ahead on FFS with research.  I thought hormones should change quite me a bit based though so that might be something to hold off?  Thank you for any thoughts you have.

[Jessica Merriman]

Personally I would at least wait one full year. Hormones are very finicky and if there is nothing major in the first 5 or 6 months it can rocket the next six months. I and most I know personally have done RLE before any surgeries or in some cases hormones. FFS can be done at any time pre or post SRS. Give the hormones time to work first. HRT will not change bone structure of course, but could redefine your face to require not so much FFS to please you.

[Carrie Liz]

I agree, it's good to wait. I was completely obsessing over FFS back in early transition because I was so sure that I had facial features that would never look feminine. But then all of a sudden around the 15-month mark, everything rapidly fell into place, and now I don't even think I need it anymore.

People who do it early in transition are usually just as happy as people who wait, because it almost never hurts your appearance or sense of self to have it done, but if you're on the fence about whether you need it or not, or if money is an issue for you, I'd wait. Your appearance really doesn't start settling down into being near its permanent state until around the 18 month - 2 year mark. I'm at 19 months on HRT now, and I've been growing a LOT of cheek fat over the last few months that has significantly balanced out my chin and forehead and tipped the scales definitively into the female range.

It's not that FFS will hurt you if you do it early in transition, (unlike BA, which is a VERY bad idea until you've reached your full natural development,) it's just that you might end up not needing it if you wait a bit longer.

[Dash]

I agree with those who say wait. I've only just passed the two year mark on HRT and have started seriously thinking of FFS.

[calicarly]

I realize everyone is different, but a question I have is how long should you be on HRT before considering FFS?  I've been on hormones for almost five months and just got my first remote feedback from a regarded surgeon mentioned in this forum.  He said that FFS could be done at any point, and the right time is when I want to make the switch to RLE.  Does it matter if you do FFS before "the operation"?  Can it be done earlier in HRT, and is that even advisable?

I'm just trying to plan ahead on FFS with research.  I thought hormones should change quite me a bit based though so that might be something to hold off?  Thank you for any thoughts you have.

I don't there is a right or a wrong answer to this ...

Here's my opinion on it:

Like most responses so far, I think time is on your side, some people like to use FFS as a way to bypass the fears they have of RLE, or sometimes to bypass the awkward first few months of transition, but truly I think those of us who went for it with only HRT realised it wasn't as tough as we thought, nobody is saying its easy but, if you can wait, and then re-assess what you truly need doing to bring you into female range it will be best, regardless of how early FFS is done, there are certain changes caused by HRT that will make things fall into place that can't be sped up. I saw the biggest changes on HRT from 6 months to 2 year mark. Yes you will be pleased either way like someone said above. It is an improvement regardless, but hey, a few months while you research your best surgeon and options wouldn't hurt and it also gives you time to make a really informed decision too those who had FFS on day one before RLE or at the same time as starting HRT will still have to wait a good year or two to reach their facial feminization plateau. It's just the way it works. You already have 5 months on your side anyway. Whatever you decide, good luck!
X

[Jennygirl]

I've heard "about a year" tossed around a lot, but everyone is going to be different.

I know of some who have gone for FFS much much earlier (3 months). For bony work it makes no difference at all, but still seems to make sense to see how everything balances out after some time on HRT. It might save a procedure or two with estrogen's feminizing effects on skin, fat, and muscle.

[MelissaPaige]

Thank you, everyone.  I think I will wait a while.  I was going to wait, I think, anyway; but the doctor's response got me questioning that.  Taking a chance at minimizing surgery by waiting seems like probably a good thing given risks involved in it.  But it at least never hurts to do some initial research.  Thank you!!

[MeghanAndrews]

I waited like 10 months I think. I agree that it's an incredibly personal decision with lots of things involved. Good luck

[LizMarie]

My observations (not having yet done FFS) are as follows:

Give HRT time to make whatever changes it will make to your face. HRT plus facial hair removal (this is important!) will change the surface structure of your face over time. Male facial skin is intentionally thicker, to support the denser and larger male facial hairs. Removal of those hairs plus HRT will thin the skin to a more feminine thickness which will change your appearance.

Have reasonable expectations going into surgery if you plan to do it. Too many people expect to become Miss Universe with FFS. You're still going to be you, with changes, either large or small, but still essentially you. So don't create false expectations for yourself.

Most trans women don't really need FFS, but most transwomen would at least benefit from FFS. By this I mean that many transwomen, after a year or two on HRT can visually pass as women, but there are still facial features that don't completely "fit" the feminine expectations of a viewers eye. FFS can correct those to make those first impressions positively feminine instead of usually feminine.

As for when? I've heard of people doing it before even starting HRT but I, like many others, would urge you to give HRT time to work.

[matriarch]

Hi everyone
It all depends every one is so different. I am 15 years post op.Give the hormones time they are very powerful, things change 1 year  2years or 5 years.Its very different in retrospect .When I went through transition there was no internet it was just being born so not the support and info available now ,Its where you are at and how you see yourself.I am doing mine at this point in life to fine tune things.I have decided to go with Dr Bart met with him and his wife and was very impressed.He was the most honest about what I needed done and a fair price just under $20,000 Can
Forehead ,rhino, chin , acid peel. Having this resource is incredible hearing all your experiences. Thank you everyone. Kristine

[Lauren1]

I wouldn't touch the cheeks or lips for a few years, or anything muscular or tissue/fat based for that matter. Even your nose can change in perception (with more plump cheeks and a less hollow face your nose might be in balance).

But like chin, forehead, trachea, you probably couldn't go wrong having it done at any point. None of these will change. BUT, your self-image might change.

[Erica_Y]

I went for FFS at about 8 months HRT and my thoughts on this are you go when you are emotionally and mentally ready to go including the recovery from the surgery. There are many personal reason to consider FFS and the timeline is unique to every person out there, I do not see a rule of thumb per se. I had about 90% of the people say you do not need it you are doing really well already and stuff like that but I knew I wanted it for many reasons they could not understand. Now that I am 3 months into recovery I can say that I am so happy that I did it when I did as it has allowed a level of integration now based on post recovery experience that I was not experiencing before.

This surgery changes allot about what you identify with as yourself and it can impact you and your family, friends and coworkers more than you may think. The recovery sucks big time as well so for me being emotionally and mentally ready, wanting and prepared for it is more important than specific timelines with what I experienced. It is easy to focus on just the physical changes and stuff however that is less than half of what FFS really impacts.

Good luck and what every you chose will be right for you!

[Apples Mk.II]

I will be doing FFS at 18 months. I wanted to do it early, but it's not been possible to travel. From the beggining I knew I was going to need, since the biggest part of my issues originate from bone facial estructure, something that is not changed by HRT.

I did not have improved skin or an under the skin layer of fat to soften my features, so I can conclude I look nearly the same as before HRT. THe only changes I have come from weight loss, shaping my eyebrows and makeup.


My original plan was to do it at the year mark and then go full time after it. Sadly,  nothing has gone according to plan. The only difference I see is that I have been able to wait and see if If my face filled. I know that I will probably need fat grafts to the cheeks too, since HRT failed me.

[Dash]

^ Apart from the fat grafts, I could have wrote that.

It's been two years, one month since I started taking hormones and come november, two years since I went full time.

[Apples Mk.II]

Yep, that's the point. Some non bone features could or could not improve in HRT. If I had done FFS early, I might have to consider going back and doing the fat grafts. Now I can think of adding them.


PS: This is just an hypothetical example. Chettawutt doesn't do fat grafts, and I have no money for additional procedures.