Facial Feminization Surgery: Hairline Advancement


Facial Feminization Surgery (FFS) is not a single procedure, but a bundle of many different procedures. As we discussed about in the first post of this series, Facial Feminization Surgery: An Introduction, there is no one way to decide on what (if any) surgical options are right for you. Each patient must decide which individual procedures they want to undergo, based on their personal preferences and priorities, and what their facial structure is prior to surgery.

In an earlier post, Dr. Thomas Satterwhite told us that the individual FFS procedures are often grouped into three categories: the upper face, the middle face, and the lower face. This week, we’re talking with Dr. Satterwhite about hairline advancement, one of the procedures that helps to feminize the upper part of the face.

“A more masculine hairline is going to be square, and you’re going to have what’s called temporal recession,” explains Dr. Satterwhite. He goes on to discuss various techniques that are typically used to surgically create a rounded hairline, which is often read as feminine. Which technique is used depends on the amount of hairline recession and hair loss a patient has, as well as whether the patient has had any previous surgeries in the forehead area.

In the coming weeks, we’ll bring you information on two other procedures that help to feminize the upper face: forehead contouring and the brow lift. Stay tuned!

Note: this video is captioned in English. To access the captions, click the CC in the bottom left of the video frame.

Informing Consent: Empowering Trans Folks through Information


Five years ago, I was lying in a hospital bed, excited and nervous for my life to change for the better. I was two years into my transition from female to male, and I was about to get top surgery. My mind bubbled with fantasies of shirtless adventures in my near future. I’d lie on the beach with my friends, carefree as the sun beat down on my bare chest. I’d strip off my tank top in a gay bar, tuck it casually into the waist of my pants, and a hot man would buy me a drink, seeing me as my true gender. Life was going to be so much better.

It didn’t turn out so well.

I’d chosen to have the periareolar (more correctly called the “circumareolar”) procedure, a tricky surgery in which a donut of skin is removed, leaving a scar only around the nipple itself. I was drawn in by the surgeon’s promise that I’d maintain nipple sensation and have no noticeable scarring. What I didn’t know was that few trans men are good candidates for this procedure, and my surgeon didn’t know how to correctly judge my candidacy. My chest was too large, and I had too much extra skin. As a result, my incisions split open, became infected, and my chest had a lumpy, strange contour that looked wholly unnatural. It wasn’t at all what I’d imagined.

My original surgeon attempted to revise my result with two follow-up surgeries, neither of which improved things much. Finally, I lost faith in him, and sought the opinion of Dr. Michael Brownstein, a well-known and highly respected top surgeon. From him, I learned that I never should have undergone the peri procedure; double incision was a far better choice for me. He performed this procedure on me, resulting, finally, after more than two years, thousands of dollars, and four surgeries, in the chest I’d dreamed of.

Certainly, part of my bad experience with top surgery was because I didn’t see enough doctors beforehand. I was a student at the time, and although my university insurance covered a large percent of the cost of surgery, I didn’t have the luxury to travel around the country consulting with lots of surgeons. But in this day and age of digital information, there is no reason that I, or any trans person, should have to rely on in-person consultations to glean the necessary information about medical transition.

Transitioning should be easier, in all regards. Our medical options should not be mysterious. We should no longer need to rely on the limited information available from local doctors and our local trans communities. And with more and more doctors implementing the forward-thinking “informed consent” model of care, the onus is on us to educate ourselves. To do that, we need resources. We need reliable sources of information.

And this is the impetus for Informing Consent. We partner with surgeons who are regarded as experts in their fields and asked them to discuss, on video, the medical procedures that are essential (for some of us) to making our lives worth living. Over the next few months, we will release videos weekly, presenting information on Facial Feminization Surgery with Dr. Thomas Satterwhite, Phalloplasty with Dr. Curtis Crane, and FTM Top Surgery with Dr. Scott Mosser. Eventually, we will have information on other procedures as well, including vaginoplasty, metoidioplasty, breast augmentation, hysterectomy, and others.

We also know that surgery is not the only topic trans folks need information on. In addition to surgical videos, we’re working hard on tutorials on changing your name and gender on essential documents such as your driver’s license, passport, birth certificate, and social security card.

This Monday, August 3, 2015, we’ll officially launch with an overview of Facial Feminization Surgery presented by Dr. Thomas Satterwhite. Stay tuned, follow our blog, and keep up with us on Facebook or Twitter.