Facial Feminization Procedures

I had facial feminization surgery in 1996, and it still remains the best investment I have ever made. Period. Since I had it, many other women have come forward to share their experiences and results. I'm very proud to have raised awareness of the life-changing potential of this option.

My surgeon Dr. Douglas Ousterhout wrote a first-rate consumer guide to FFS, Facial Feminization Surgery: A Guide for the Transgendered Woman. It's an excellent 185-page overview of available procedures, with many illustrations and images. I highly recommend it for anyone considering these procedures, as it is the definitive consumer guide. It includes an introduction by Donna Rose, who, like me, had life-changing results from these procedures. Both of us are among the many patients who consented to having our results included in the book.

facial feminization book

This is a follow-up to materials in his medical book Aesthetic Contouring of the Craniofacial Skeleton.

I never would have gone to San Francisco if I hadn't written to Dallas Denny in 1996, who mentioned two surgeons on the west coast. So those who write to thank me should also thank Dallas!


If being accepted as female is your goal, one of the most important things to consider is facial feminization surgery. I feel that it can have a major impact in the quality of your day-to-day life, far more so than other aspects of transition. It's not enough by itself to make you be accepted as female, but for some, it's a necessity. I feel the key to being accepted as female is from the neck up. That means hair removal, voice, and face are vital. If you're serious about having a smooth transition and the option of stealth, you should read my section on how to prioritize.

Due to problems from disrespectful web surfers outside our community, some transwomen have removed their FFS photos from the web, including me. I apologize for this inconvenience.

In this section:

Procedures available

  • Forehead
  • Trachea
  • Jaw and chin
  • Nose
  • Ears
  • Injections
  • Facial implants
  • Facelift
  • Skin resurfacing

Information and recommendations

  • Complications
  • Choosing a surgeon
  • Costs
  • Opinions on facial surgery (pros and cons)
  • Letter to HBIGDA on medical necessity of FFS
  • FFS and insurance submission

My experiences with Douglas Ousterhout

  • Dr. Ousterhout and Cocoon Guest House:
  • Frequently-asked questions
  • My surgical journal: forehead/trachea
  • My surgical journal: jaw/nose
  • My surgical journal: my chin revision
  • Other patient experiences with FFS and/or Douglas Ousterhout
  • Appendix: Metro hotel

Related web resources