Greetings,
Here is what it says in the SOC about this surgery:
Other surgeries that may be performed to assist feminization include: reduction thyroid chondroplasty, suction-assisted lipoplasty of the waist, rhinoplasty, facial bone reduction, face-lift, and blephoroplasty. These do not require letters of recommendation from mental health professionals as does genital reconstruction therapy.
I have seen a wide variance in the amounts of time between different people who are on HRT and their FSS (if they choose to get it at all). I know some who won't go full-time until they've had FFS, other's only after being on HRT for a while. It's more a matter of how masculine one's face looks before hand, so each person really needs to decide what is right for themselves.
The thing about HRT is that it will not affect your bone structure if your bones are already fused...something that happens in the teen years; HRT does change the fat distribution of one's face and does make one's face look more feminine. The affects of HRT can and often do vary widely from one person to the next; genetics seem to play a large part in just how sensitive a persons body is to HRT.
Just be aware of the sticker shock with FFS, plan on a minimum of $20,000 and a lot of people spend more...$25,000 isn't uncommon...
Peace and love,
Isabelle St-Pierre