FACIAL FEMINISATION SURGERY in London | Mr. Ivo Gwanmesia Skip to main content

What is Facial Feminisation Surgery?

Facial Feminisation Surgery, also known as FFS, is a series of plastic surgery procedures that provide congruence between one’s facial features and sex identity. These procedures soften and feminise the facial features of patients seeking transgender change from male to female, MtF.

Facial Feminisation Surgery procedures include hairline advancement, hair transplantation, forehead reshaping (also known as foreheadplasty) browlift, brow bone reduction, facelift, feminising rhinoplasty, cheek augmentation, lip lift, lip augmentation, chin and jawline contouring, and shaving of the Adam’s Apple.



Facial Feminisation Surgery – types of procedure:

Hairline Advancement

The female anterior hairline sits at a more anterior position compared to that in the male. To achieve this, we use a series of plastic surgery techniques advance and lower the anterior hairline. As a result the forehead will appear shorter. In some patients, Hair Transplantation may be an alternative to Hairline Advancement.

Hair Transplantation

Hair restoration can play an important role for transgender patients seeking gender-affirmation procedures. Because of this we provide a series of hair restoration procedures in our practice. Examples of these procedures include hairline lowering, facial hair restoration (including eyebrow and beard transplantation), and body hair transplantation.

Find out more about Hair Transplantation

Forehead Contouring Surgery (Foreheadplasty)

The forehead position in the male slopes posteriorly, and is longer and more prominent, so we contour the forehead using recognised plastic surgery techniques. As a result, we can make the forehead smoother and make it lie slightly anteriorly. We can also alter the prominent brow ridge, allowing for a more feminine appearance. This also makes the eyes appear bigger and more attractive.


The female brow lies in a more elevated position than the male, with its highest point at the junction between the middle and lateral thirds of the brow. As a result, we can achieve a more feminine appearance by elevating the brow.

Find out more about Browlift


A facelift attempts to elevate the soft tissues of the face and placing them in a natural position, allowing for a youthful appearance. Several facelift techniques are available, and we tailor the method used to the needs of the patient.

Find out more about Facelift


Rhinoplasty surgery refines the appearance of the nose, making it more attractive. In the female, the nose is smaller and narrower and, for those seeking softening of their facial features, a reduction rhinoplasty is essential.

Find out more about Rhinoplasty

Cheek Augmentation

High cheek bones make the face more attractive, and we can contour the cheek bones to make them more pleasing in appearance. We achieve this via a series of techniques including the use of cheek implants or fat grafting.

Find out more about Cheek Augmentation

Lip Lift and Augmentation

A long upper lip makes the face appear older. As such, we would consider a a lip lifting procedure for those seeking to make their faces more feminine and youthful. The procedure makes the lip more plump by injecting either fat or a filler.

Chin and Jawline Reshaping

By using a variety of plastic surgery techniques, we can make the chin narrower and less masculine. The chin in the male generally has a square appearance. However, by using various chin surgery techniques, we can alter this appearance into a more feminine shape. The jawline can also be altered, making it narrower and better defined.

Shaving of the Adam’s Apple (Chondrolaryngoplasty)

In the male, the Adam’s Apple is usually prominent. Through an incision in the neck, we can shave down the excess cartilage around the thyroid, making it less prominent. It’s also important to take care not to reduce the tension on the vocal cords, as this could alter the tone of the voice.

Mr Ivo Gwanmesia’s approach to transgender surgery:

Mr Ivo Gwanmesia is one of the UK’s leading craniofacial surgeons and specializes in facial reconstruction and facial cosmetic surgeries. He is widely acknowledged as an expert in genioplasty (chin reshaping) and deep plane facelift. Ivo has perfected the full suite of FFS procedures and has an extensive catalogue of patient before and after photographs as well as testimonials.

Mr Gwanmesia adheres to the global ‘Standards of Care’ (SOC 8) established by the World Professional Association for Transgender Health (WPATH) of which he is a member. He also performs FtM TOP surgery for transgender patients diagnosed with gender dysphoria. Mr Ivo Gwanmesia treats his patients with empathy and understanding. He combines a diverse range of cutting-edge technologies with innovative surgery in order to obtain the best outcomes for his patients.

WPATH Membership Badge

World Professional Association for Transgender Health

More about Mr Ivo Gwanmesia

View Prices

Schedule A Consultation


Whilst some of the above-mentioned procedures involve reshaping the soft tissues of the face, most of them involve reshaping of the bony structures of the face. As such, it is best to find a plastic surgeon who is also trained in craniomaxillofacial surgery. More importantly, the surgeon needs to have a good eye for facial balance and harmony.

If Ivo is appointed as your plastic surgeon, you can be reassured that he has the necessary training and experience in craniomaxillofacial surgery which is essential to undertake any of the FFS procedures covered on this page. In addition, he has an expert eye for facial balance and harmony as you’ll see from his extensive patient before and after gallery.

There is no single rule for every patient seeking facial feminisation surgery. Having a facelift will depend on any excess skin around the face and neck area. As such, it is usually best to give it a few months after procedures like jawline contouring surgery before embarking on a facelift.

The concept of facial femininity and facial beauty are two very different concepts. Features of facial femininity include a lower anterior hairline, a smaller and less prominent forehead, a higher brow and larger eyes.

It entirely depends on how many procedures are being undertaken in a single setting. Mr Gwanmesia divides the procedures into upper and lower face. As such, both sets of procedures are performed at about 3 months apart, with each set taking anywhere from 4 to 6 hours. The procedures are performed under general anaesthesia.

Mr Gwanmesia’s patients will stay for one night in the hospital after surgery. They will be provided with painkillers should they need to. Antibiotics are also provided. At one week, they will return to the clinic for their first postoperative visit where all the stitches are removed. They will also experience some facial swelling, but this will improve over the course of a few weeks to a few months. Patients can usually return to their normal activities after 10 days, and can begin to wear makeup at 2 weeks postop. Further follow up visits to the clinic will be at 6 weeks, 3 months, 6 months and 12 months.

The FFS procedures offered by Mr Gwanmesia’s Harley Street Clinic are for those patients who seek to feminise their facial features such as the hairline, forehead, brow, nose, chin and jawline. The types of patients who predominantly seek these procedures are transgender patients transitioning from male to female. We also offer these procedures to non-binary, gender fluid and cis-gender patients who seek to feminise their facial features.

We prefer to split the face into upper and lower halves when it comes to performing FFS. All the procedures in the upper half of the face can be performed in one setting. The lower half of the face can be treated separately, with a time interval of 3 months. On certain occasions, we may provide procedures in both halves of the face. We prefer however to limit surgery time to no more than six hours.

The cost for these procedures will vary from surgeon to surgeon. It usually depends on surgeon’s experience, reputation and location. These procedures are expensive, and Mr Gwanmesia’s clinic does provide credit facilities.

View Mr Gwanmesia’s price list

Following surgery, there is swelling. We advise that patients give it up to 3 months before they can begin to see final outcomes. The amount of swelling will vary from patient to patient. We provide a range of facial garments to all our patients after surgery to help reduce the swelling, as well as for facial support.

Because of the increased risks of developing blood clots with hormone therapy, we advise all patients to cease taking these hormone therapies at least 7 days before surgery. They may resume the hormone therapies as soon as they are fully mobile.

As with any surgery, there are always associated risks. These include, but are not limited to, infection, bleeding, hematoma formation, scarring, asymmetries, nerve injuries, dissatisfaction with the outcome and revision surgery.

Dr Ivo Gwanmesia

Dr Ivo Gwanmesia is one of Harley Street’s most experienced and renowned craniofacial plastic surgeons. With over a decade of professional experience, he has transformed the lives of countless patients from all over the UK & abroad.

Due to his vast and hands-on training in the UK and the US, Dr Ivo now specialises in more than a dozen different aesthetic, craniofacial and transgender procedures. Some of them include face, neck, and brow lifts, upper and lower blepharoplasty, breast reduction & breast uplift as well as facial feminisation surgery, to name a few.

Dr Gwanmesia has also conducted pioneering research, which led to the development of a new technique for the reconstruction of the middle vault of the nose, known as the ‘Fulcrum Spreader Graft’. He was also part of a study comparing the efficacy of the Sheen Spreader Graft and the Fulcrum Spreader Graft. The study has since been published on PubMed and the Journal of the American Society of Plastic Surgeons.