So I am restarting HRT and have come to terms with the fact that it might not do as much as I'd like.

If after a year on HRT and I have not shown too much feminization, is that when I should start setting up appointments?

My health insurance will cover everything I need, so even if I do show considerable feminization, I am still going to get FFS. And I know I'm only 21 and I have a good possibility of having a great reaction to HRT,  but it's still won't hurt to turn down something that right?

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No surgery should be taken lightly and FFS most of all. Depending on the work being done, it's up to a 12 hour brutal surgery with a long, painful recovery. I have not had it and while I think about it, I don't think I will ever have it. The decision to have it and when is very personal but I suggest you wait as long as possible and see what HRT and time gives you. We are often our own harshest critics and we still see the male in our face long after everybody else sees only female.

We are all different in what we aspire to be as a female and the physical attributes. During puberty the male and female hormones change our unisex appearance, some more than others. We all aspire to pass comfortably.

Since my various surgeried I have come to know some beautiful TGs in Bangkok. For many the surgeries needed are done as they earn enough to afford them. The first surgery is their teeth and adams apple, if needed then face. FFS wise they all have new noses, brow shave and lips. Many others also have fillers, chin work and cheek done as they like a pointed face.  Then its the hip and butt implants and breasts. SRS tends to be the final surgery. Many beautiful tgs have a penis and are referred to as ->-bleeped-<-s. Post op are referred to as ladyboys post op.

We all want to look the best we can but only you can decide on what you consider is necessary. I had FFS with brow, nose, and lips. I was a good looking male with unisex features. Even then I opted to be more feminine. If its free go for it YES

I had facial surgery not even a year after starting HRT.  I knew the underlying bone structure would not change with hormones, and though they might be hidden for a while by nice skin and fat deposits, those fade with age, and bone does not.

I had forehead reconstruction with a hair advance; rhinoplasty, correcting a deviated septum; lip lift; trachea shave; mandible reduction, and chin tapering along with a sliding genioplasty.  Best money I ever spent, that and electrolysis. 

A good time to get it isn't according to your hormone schedule, but to your dysphoria level and timeline for going full time.  I actually didn't come out or transition at work before my surgeries, so as to maintain my income.  After it was all done, I left and went into a new line of work, which I did for my narrative protection.  I did, though, make sure I was getting cleared (electrolysis) in less than 2 hours a week. 

If your insurance covers it anyways and you feel you want to do it anyways, go for it as soon as you want to. If the issues with the face ar ein the bones, no hormones will change that. If your issues are however others, you may want to wait, but since you are informed about FFS and have done insurance work already, I am sure you know enough about FFS to know which things will benefit you in any case.

It is a major surgery though, if you are willing to take the risks and consequences - that is more the thing you have to decide. Honestly, if I would get it paid for and not fear the risks and negative outcomes, I would go for it. Even at younger age. I was in my early 20ies when I transitioned. I did not need it back then, but I still did not like my face and if I had the option , I might have considered it. Hormones do a good job at that age and I looked good for years, with age it kind of starts to diminish a bit and previous features resurface slowly. So it makes little sense to wait. I think what you really should think about however are the risks and consequences. There are surgery risks, there is the risk of an unfavourable outcome that looks like something was done and there is the risk of some damage, like nerver damage, scars, damage to frontal bones or sinuses, etc. These risks are what keeps me from doing it presently even though I would have the money for it. If those are not worrying you, I would go and find a good surgeon and start up 😉

In 2 weeks, I will have FFS. I need it. I have not posted a picture of my face because after 50 years of Testosterone, and only 2 years of Estrogen, I am not satisfied with my face.

At age 21, you may or may not need FFS. Only you can make that decision. Keep in mind that after every surgery, there will be scars. A good surgeon can hide the scars well.

Best wishes and do your research well. Your face will be on display daily for the rest of your life!