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FFS Consultation Guide: Everything You Need to Know

Medically reviewed by Jennifer Richman on October 09, 2024.

What is an FFS Consultation?

The first step in a patients’ surgical journey is requesting a consultation with a board-certified surgeon who specializes in gender-affirming facial surgery. At the GCC, our facial feminization surgery (FFS) consultations, like all others, are free of charge. Whether you book a virtual or in-person consultation, their purpose is to help you get to know your surgeons, talk through your unique goals for surgery, discuss your medical history and accommodations you may need. In this article, we go over:

• What to expect at FFS consultation
• How to prepare for or what questions to ask in a surgical consultation
• Choosing an FFS surgeon

The FFS consultation is your opportunity to meet your surgeon and determine if they are a good fit for you. This is your space to have all of your questions answered and to create a unique, surgical plan tailored to your needs. We hope that this FFS consultation guide helps you figure out how to make the most out of your facial surgery consultation.

Tips for Your Consultation

We encourage patients not to stress out about preparing for their consultation. Our surgeons have expertise in facilitating conversations that help identify patient goals and needs. Likewise, if need be, patients can schedule a follow-up consultation with their surgeon or meet with multiple surgeons until they feel confident in their plan.

The following tips can help you make the most out of your consultation:

• Consider the areas of your face that cause dysphoria and how you might want to adjust them to cause euphoria. Bringing in a photograph or facial map can be one way to let your surgeon know the parts of your face that cause you discomfort.

• What our surgeons find even more helpful is when patients bring in photos that resemble the results they would like to achieve. For example, many patients bring in photos of family members they would most like to resemble. This allows your surgeon to have a clear sense of your goals so that they can determine how realistic they are.
• Please be honest about your medical history. For our surgeons, it is essential to know your previous medical history so we can best understand and strategize your surgical plan accordingly. While we do not have body mass index (BMI) requirements for facial surgery, patients with higher BMIs may need special accommodations to reduce the chances of any potential complication. We want you to be safe and confident your surgery will proceed with the best possible results.

One of our FFS surgeons, Dr. Facque (he/him), answers questions related to medical history, surgical safety and eligibility here.

Choosing the Right Surgeon for FFS Consultation

It is important to choose a surgeon who carries the following credentials and characteristics before requesting a consultation. You should feel comfortable asking your surgeon about these elements of their professional experience and training before beginning surgery with them. Each is recommended by the World Professional Association for Transgender Health.

1. Board Certification: Board Certification is required for practicing Medical Doctors to legally provide surgical care
2. Continued Learning and Practical Experience: It is helpful to know if your providers value the importance of ongoing education as the landscape of services and concerns changes for transgender patients.
3. Patient Reviews or Before and After Photos: Reviews and photos can give you a real perspective into the experience of prior patients. Take a look at Camille, one of our patients who underwent FFS with Dr. Facque here (link).

Our surgeons Dr. Ley (she/they) and Dr. Facque (he/him) are board-certified specialists in FFS. They are passionate about continued learning, and carry years of experience serving trans, non-binary and gender non-conforming patients. Their positive reviews and testimonials reflect their expertise in crafting successful FFS plans with their patients. You can meet with Dr. Ley (she/they) or Dr. Facque (he/him), our board-certified surgeons, free of cost by requesting a consultation here.

Preparing for FFS consultation

Ideally, you should leave your consultation feeling safe and comfortable with your surgeon, having a better understanding of the options available to you and clarity on what FFS can realistically accomplish for you.

At the GCC, our patients are in the driver’s seat. We know how to work with patients to develop a clear understanding of their goals and make sure that they are realistic for surgery. The following steps are necessary to take prior to meeting your surgeon:

• Essential Documents: At the GCC, we want to develop an honest and open environment for our patients. We know that this environment will allow our painters to share information about their medical history, the most essential component to the FFS consultation. Our patient care and insurance teams will guide you through any necessary documentation you need to undergo and receive insurance coverage for your surgery. You can leave those worries to us.

• Pre-Consultation Photos: If your consultation is virtual, you will be asked to take quality photos of your face for your surgeon to review. Take a look at our guide for taking quality photos here. Example photos can be found below:

Next Steps Post-Consultation

At the GCC all consultations are free of charge to cash pay patients. Patients who pay with insurance will have their insurance plans billed for the consultation. We can schedule you for multiple phone conversations with the surgeon if necessary until you feel confident in your surgical plan. These conversations can help you feel informed and confident about your decision before you begin surgery.

The most important elements of the consultation for your surgeons at the GCC is, 1) developing a surgical plan you feel confident about and, 2) learning about your medical history to ensure your surgery goes as smoothly as possible. Once this information is finalized, you will receive a quote for your surgery and/or we will initiate the process of soliciting insurance approval for your medically necessary, gender-affirming procedure.

Before surgery, our clinical team will cover Information on the risks and complications around FFS that you might expect during or after surgery. Our insurance advocates and surgeon will also work with you to discuss costs, financing, and a quote for a concrete estimate on the costs of your surgery.

FAQ

How much does FFS cost?

For cash-pay patients, FFS can cost between $4,500 and $100,000 depending on the number of procedures you undergo. That said, many of our patients are able to significantly reduce the cost of surgery with insurance coverage. You can read more about insurance coverage for medically necessary, gender-affirming surgeries here.

Do I have to fly into San Francisco for my FFS consultation?

Some gender-affirming procedures, like bottom surgery, require that patients come in-person for their pre-surgical consultations. Facial surgery patients, however, can have their consultation virtually or through a phone call. Therefore, out-of-town patients can wait until their surgery date to come in-person to our San Francisco office. If you are traveling for surgery, you can check our free travel guide here for tips on reducing costs and finding trans-friendly resources.

Do I need to undergo estrogen hormone replacement therapy (HRT) to undergo FFS?

While some surgical practices require patients undergo HRT for at least 1 year prior to undergoing gender-affirming facial surgery, the GCC has no such requirements. That said, patients on full dosage HRT are encouraged to wait 1-1.5 years to see the how soft tissues of their face. This can help them make more precise decisions about which procedures would be right for them.

How painful is FFS?

For some individuals, the amount of pain they may experience after surgery is a big deciding factor in getting FFS or not. Although pain levels vary depending on the procedures you undergo, many patients consider FFS to be one of the most painful gender-affirming surgeries. That said, our clinical team will work with you to make sure you have access to the proper prescription and over-the-counter pain medications for your recovery.

Conclusion

We know that the initial consultation can be the most challenging for our patients seeking FFS. At the GCC, our free consultations will provide you with the space to work through these anxieties, develop a personalized surgical plan, and help you feel confident about your decision to pursue gender affirming care through FFS. We are here for you.

You can request a free consultation today to begin the process of achieving your personal gender-affirmation goals for facial surgery.