How to prepare for Facial Feminisation Surgery?

Gender dysphoria involves multimodal approach. It includes Psychotherapy, hormone therapy and Surgery. It is important to involve endocrinologist, psychiatrist and other relevant specialties besides plastic surgery.

Gender affirming surgery encompasses gamut of surgeries.

  1. Feminisation Surgery:

  • Face: Facial feminisation, Thyroid cartilage reduction, Hairline modification, Voice modification
  • Chest: Breast augmentation using fat or implants
  • Genitalia: Replacement of penis, testis and creation of vagina, clitoris
  1. Masculinisation Surgery:

  • Face: Facial Masculinasation, Lipofilling/Liposuction, Voice modification
  • Chest: Removal of breast, Pectoral implants
  • Genitalia: Penis formation, Testicular implants

WPATH or World Professional Association of Gender Health has laid down specific guidelines for patient assessment and management.


  1. Mental Health Assessment: Confirmation of diagnosis of Gender Dysphoria
  2. Counselling: Assessment by consultants in the field of endocrinology, gynaecology,counsellors.
  3. Tests: Hormonal levels, Complete blood count, Chest X-ray, ECG


  1. Top/Chest/Breast Surgery:

  • A minimum of 12month of hormonal therapy
  • Age more than 18 years
  • Confirmed diagnosis of Gender dysphoria
  • Clinically no comorbidities
  • One referral letter from psychiatrist
  1. Bottom/ Genitalia Surgery:

  • A minimum of 12month of hormonal therapy
  • Age more than 18 years
  • Confirmed diagnosis of Gender dysphoria
  • Clinically no comorbidities
  • Two referral letters from psychiatrists
  • 12 months transition period
  1. Facial Feminisation surgery/Non-Breast/Non- Genital Surgery:

  • Referral letter advised but not mandatory
  • 12 months of hormonal therapy and living in gender congruent role (Advised)

Who should not opt for Facial Feminisation surgery?

  1. Unconfirmed diagnosis of gender dysphoria
  2. Uncontrolled medical conditions
  3. Unable to give informed consent
  4. Unrealistic expectations

Risks of facial feminization surgery

  • Swelling
  • Bruising
  • Hematoma
  • Infection
  • Scarring
  • Infection related to implants

Benefits of facial feminization surgery

  • Improved self-confidence
  • Increased social acceptability




  1. TESTS: Required for fitness for surgery.
  2. REASSESSMENT: CT scans and facial contours planning in consultation with patient
  3. DON’Ts: Smoking, Alcohol, Vitamin E, Herbal Supplements, Green tea, Ginger supplements
  4. DO’s: Healthy active routine, continue medicines as prescribed



  • CAREGIVER: Ensure that there is someone in family/friends who is there or informed.
  • CLOTHES: Bring your own clothes before surgery that are comfortable.
  • JEWELLERY: Better to keep at home/locker
  • POST SURGERY GARMENTS: Facial surgery might require customized garment which should be bought before surgery.
  • DOCUMENTS: Don’t forget to bring all important documents
  • TALK: Talk to your doctor about days in hospital and post op visits well in advance.
  • MEDICINES: Bring all your medicines being consumed




  1. GENERAL ANAESTHESIA: A small tube that is endotracheal tube is inserted through mouth that allows you to sleep. It is safe and painless ensuring quick recovery.
  2. INCISION: It will be discussed before surgery where the cuts will be given to ensure they are well hidden
  3. SUTURES: Stitches will be placed over the incision which are removed after 5-7 days of surgery.
  4. DRESSING: Stitch line will be covered with dressing that is changed regularly.
  5. DRAINS: In some cases drains are placed to prevent any fluid collection post- surgery. Usually removed in 2-3days.
  6. MEDICINES: During hospital stay IV Medicines are given which includes antibiotics and painkillers and it is given as oral once you are discharged.
  7. FOLLOWUP: Follow up visits are planned. Usually schedule is 1 week, 1month, 3months, 6months and one year.




Dr. Chugh, Cosmetic & Plastic Surgeon based in Delhi and Gurgaon, India is amongst the few surgeons in world performing these complicated set of Facial Feminisation surgery to ensure restoration of self- confidence by helping them achieve their desired looks.

To know more about Facial Feminisation Surgery In India, Call or Whatsapp at +91-9588754188