Facial feminization surgery (FFS) is a highly customized collection of procedures designed to soften traditionally masculine facial features and create a more feminine appearance. For many transgender women and non-binary individuals, FFS plays an essential role in aligning external appearance with gender identity, promoting emotional well-being and self-confidence.
Dr. Ali Totonchi is a board-certified facial plastic and reconstructive surgeon with years of experience performing facial gender-affirming procedures. He offers a full range of FFS options to patients in Cleveland, Westlake, and Lyndhurst, tailoring each surgical plan to the patient’s unique goals, facial structure, and transition journey. His approach is highly specialized, artistic, and deeply compassionate.
What Is Facial Feminization Surgery?
Facial feminization surgery is not one standard procedure — it is a suite of cosmetic and reconstructive techniques selected and performed based on each patient’s specific needs. The goal is to reduce or reshape features that are typically considered masculine (such as a prominent brow, square jawline, or wide chin) and enhance features considered more traditionally feminine, like fuller cheeks, a smaller nose, or a refined jawline.
While FFS is most often performed for transgender women as part of male-to-female (MtF) transition, any person seeking softer facial features may benefit from these procedures.
Who Is a Candidate for FFS?
You may be a good candidate for facial feminization surgery if:
- You are transgender, non-binary, or gender diverse and wish to align your appearance with your gender identity
- You are in good general health and able to undergo elective surgery
- You have realistic expectations about results and recovery
- You are currently undergoing or have completed hormone therapy (not mandatory, but recommended) and meet WPATH guidlines
Patients are encouraged to discuss their transition goals openly with Dr. Totonchi, who will help design a treatment plan that reflects both their anatomy and aesthetic vision.
Procedures Commonly Included in FFS
Dr. Totonchi offers a full range of surgical options to address the upper, middle, and lower thirds of the face. These may be performed as a single-stage surgery or in multiple sessions depending on patient goals and anatomy.
Forehead and Hairline Procedures
- Frontal bossing reduction – Shaves down the brow ridge for a smoother forehead
- Forehead reconstruction with plating or forehead III procedure – For more advanced reshaping and frontal sinus setback
- Hairline advancement (scalp advancement) – Reduces forehead height and feminizes the hairline
- Brow lift – Elevates the eyebrows for a softer, more open expression
- Hair transplant to improve the hair line
Midface and Nose Procedures
- Rhinoplasty – Refines and resizes the nose to align with feminine proportions
- Cheek augmentation (malar fat grafting or implants) – Adds fullness and roundness to the midface
- Eyelid surgery (blepharoplasty) – Enhances the eyes by removing excess skin or under-eye bags
Lower Face and Neck Procedures
- Chin contouring or reduction (genioplasty, osteoplasty, shaving) – Narrows and softens the chin
- Jaw contouring (mandibular angle shing/bone removal or V-line osteotomy) – Reduces jaw width for a more tapered appearance
- Lip lift and lip augmentation – Shortens the distance between the nose and upper lip and adds fullness
- Facelift and neck lift – Tightens facial skin and improves contour
- Tracheal shave (tracheoplasty) – Reduces the prominence of the Adam’s apple
Facial Feminization Gallery
What About Hormone Therapy?
Hormone Replacement Therapy (HRT), particularly estrogen therapy, plays an important role in feminizing body and facial features. It encourages fat redistribution, softens skin texture, and enhances breast development. While HRT has a powerful effect, it may not sufficiently alter bone structure, which is why many patients choose FFS.
Dr. Totonchi typically recommends that patients undergo HRT and live in their preferred gender role for at least one year prior to surgery, in line with WPATH (World Professional Association for Transgender Health) guidelines.
What Is Recovery Like?
Recovery from FFS depends on the number and type of procedures performed. Most patients require 2 to 3 weeks of initial downtime, especially when combining procedures like:
- Forehead contouring
- Rhinoplasty
- Brow lift
- Chin surgery
Swelling and bruising are expected to peak within the first week and then gradually resolve. Rhinoplasty may involve the use of a splint and nasal stents for up to two weeks. If performed alone, procedures like tracheal shave have minimal downtime.
Dr. Totonchi provides detailed aftercare instructions and ongoing follow-up appointments to ensure safe and comfortable healing.
How Long Do Results Last?
Many facial feminization procedures, especially bone reshaping, are permanent. Others, like fat grafting, may evolve over time due to natural aging. Patients can expect long-term improvements in facial balance, gender congruence, and self-perception. Practicing good skincare and sun protection helps maintain your results for the long term.
Facial Feminization Surgery Pricing Snapshot
Facial feminization surgery is highly individualized, and pricing depends on the combination of procedures selected, surgical time, and anatomical complexity. Below are typical starting prices for popular procedures performed by Dr. Totonchi:
- Hairline Shortening: from $8000
- Frontal Bossing Reduction & Brow Lift: from $9,500
- Forehead Reconstruction with Plating: from $6000
- Facelift (often recommended over age 40): from $8000-12000
- Malar Fat Injections (Cheeks): from 1600
- Upper Lip Shortening: from $2,500
- Chin Contouring (Osteoplasty or Genioplasty): from $3500-5000
- Reduction Genioplasty: $ 6000
- Mandibular Angle Shaving: from $3000
- Mandibular Angle Osiectomy: From $6300
- Mandibular body Osteotomy: $4000
- V-shaped Mandibular Osteotomy ( including chin, angle and mandiblar body) : $15000
- Tracheal Shave (Adam’s Apple Reduction): from $3000
- Rhinoplasty: from $7000-10000
- Secondary Rhinoplasty: from $9000-13000
- Upper Blepharoplasty: from $3000
- Four-Lid Blepharoplasty: from $6000
- V-Shaped Mandibular Osteotomy: from $10000.00
These estimates include surgical time but do not reflect anesthesia, facility, or post-op care fees, which will be outlined during your consultation. Patients often combine multiple procedures into a single surgical session to reduce overall cost and recovery time.
Why Choose Dr. Totonchi for Facial Feminization Surgery?
Dr. Totonchi combines surgical expertise, artistry, and empathy to deliver gender-affirming results that are both safe and beautiful. As a board-certified facial plastic and reconstructive surgeon, he has performed a wide range of FFS procedures and understands the emotional importance of facial harmony during and after the transition.
His offices in Cleveland and Westlake welcome patients from all over Ohio and beyond. Whether you’re early in your journey or ready to schedule surgery, Dr. Totonchi and his staff offer a supportive and affirming environment every step of the way.
Schedule Your Consultation
If you’re considering facial feminization surgery, Dr. Totonchi is here to help you move forward with confidence. Contact our office today at (440) 461-7999 to schedule your private consultation.
