Facial feminization surgery (FFS)
Facial feminization surgery (FFS) is a set of procedures that aim to harmonize facial features with each person’s identity. Dr. Alfredo Chama Naranjo, a board-certified plastic and reconstructive surgeon, designs an individual plan based on your anatomy and your goals, in Tijuana, minutes from the San Ysidro border crossing.
What an FFS plan includes
The exact scope is defined during your evaluation; these are the areas that most frequently form part of a facial feminization plan.
Each plan is individual and frequently combines several of these areas in a single surgical stage, so the recovery is approached as one process.
- Upper third — forehead and brow contouring, brow position.
- Nose — rhinoplasty with a harmonization focus.
- Middle and lower third — jaw and chin contouring.
- Neck — thyroid chondroplasty, reduction of the thyroid cartilage (tracheal shave).
Harmony with your face, not a template
The technical goal is proportion and harmony with your own face, not replicating someone else’s template. That translates into very patient-specific technique decisions, which are explained during your evaluation.
Surgery is performed in a hospital setting, with scheduled post-operative follow-up.
Care is dignified and confidential at every stage of the process.
What is reviewed before deciding
It is typically considered when facial features do not align with your identity and affect your well-being, your overall health is good, and you have realistic expectations about what surgery can achieve for your face.
As with any facial surgery, nicotine use that cannot be stopped — smoking or vaping compromises blood flow and healing — and uncontrolled medical conditions are reasons to postpone or expand the prior evaluation.
Dr. Chama explains every risk, complication rate, and realistic expectation during your evaluation — before you decide. A medical website that only shows results and omits risk is not giving you complete information.
Your complete medical history, including medications and prior surgeries, is what allows an accurate assessment of your real risk.
What to expect, in general terms
Recovery varies depending on the areas treated and on each patient.
Post-operative care is explained during your consultation and provided in person or remotely.
- First days. Swelling and bruising are more pronounced in the operated areas, with tightness and mild discomfort managed with prescribed medication.
- First weeks. Visible swelling subsides gradually and many people resume non-strenuous activities.
- Following months. Final contours settle as residual swelling resolves.
Logistics for U.S. patients
If you’re traveling from the United States, the early post-operative period is part of the surgery. We guide you on the border crossing, recovery lodging, and transportation before scheduling a date.
Follow-up appointments can be coordinated remotely once you are home. If your underlying concern is the safety of having surgery across the border, the guide on having surgery in Tijuana explains what to verify before deciding.
Questions to ask during your evaluation
Before scheduling a date, these questions give you concrete information about your case.
- What areas does my FFS plan include and why?
- What technique do you recommend for my anatomy?
- What are my biggest risk factors based on my medical history?
- Where would the surgery be performed and who administers the anesthesia?
- How does follow-up work if I live outside of Tijuana?
Frequently asked questions
How much does facial feminization cost?
It is defined during your evaluation, because it depends on which areas your plan includes. We prefer to give you a personalized quote. Message us on WhatsApp and we’ll guide you.
What exactly is thyroid chondroplasty?
It is the surgical reduction of the thyroid cartilage, commonly known as the Adam’s apple, in the neck. It is often combined with other areas of the FFS plan based on your anatomy.
Can I combine multiple areas in one surgery?
Frequently, yes. A combined plan is evaluated with you so that recovery is approached as a single process, depending on your anatomy and your overall health.
Will it change my facial expression?
The goal is proportion and harmony with your own face, not a template. This is discussed in detail during your evaluation, along with what is reasonable to expect in your case.
How long is the recovery?
It varies depending on the areas treated and on each patient. During your consultation, the general pattern is explained stage by stage.
Do you offer consultations in English?
Yes. Consultations, planning, and follow-up are all bilingual — in Spanish and English — for local patients and those from the U.S.
I’m coming from the United States — how does the logistics work?
We offer care in Spanish and English and can start with a virtual consultation before you cross the border. We guide you on the crossing, recovery lodging, and remote follow-up.
Frequently asked questions
Questions about facial feminization surgery (FFS)
What is facial feminization and what does it involve?
Facial feminization surgery (FFS) is a set of surgical procedures that adjust the proportions and features of the face toward a more feminine appearance. Depending on your anatomy, it may include forehead and brow surgery, nose contouring, chin and jaw angle reshaping. It is not a single standard operation, but a plan designed for your face during the evaluation.
Am I a candidate? At what age or in what cases is it recommended?
It is typically considered in adults whose facial development is complete and who are in good overall health. Candidacy is defined after a clinical evaluation that assesses bone structure, soft tissues, and your goals. During the consultation, we explain which procedures would make the most difference in your case and which are not necessary.
How is it performed and what type of anesthesia is used?
FFS is performed in an operating room, in a hospital setting, generally under general anesthesia with the support of an anesthesiology team. Depending on which areas are treated, it may be done in one or multiple surgical stages. The exact detail of your plan and its duration are defined during the evaluation.
What is the recovery like? How much rest and swelling should I expect?
Swelling and bruising are expected in the first weeks, more noticeable in the first days and gradually subsiding. Relative rest and specific care are indicated; returning to your activities depends on which procedures were performed. The specific days of rest are defined during your evaluation and in the post-operative follow-up.
How long do the results last?
Changes to the bone and facial structure are permanent in nature. The final result becomes visible when the swelling fully resolves, which takes several months. The face continues its natural aging process over time, as with anyone; during the consultation, we discuss realistic expectations for your case.
What are the risks?
Like any surgery, there are risks: bleeding, infection, prolonged swelling, temporary sensitivity changes, or asymmetries that may require adjustment. Working with a board-certified plastic surgeon in a hospital setting helps manage them responsibly. During your evaluation, the specific risks are explained based on the procedures planned.
Does it leave a scar? Where?
Yes, every surgery leaves a scar, and in FFS the incisions are placed in discreet areas: within the hairline for the forehead, inside the mouth for the chin or jaw, and in natural folds when applicable. Over time, they tend to mature and become less visible. During the consultation, we show you where they would be based on your plan.
Does it hurt?
During surgery, you will not feel pain due to the anesthesia. Post-operatively, discomfort, tightness, and swelling are normal, more pronounced in the first days; this is manageable with the prescribed pain medication. Most patients describe it as more tolerable than they expected, though each person experiences it differently.
I’m coming from the United States — how does the crossing and recovery work?
We frequently treat patients who cross the border. We coordinate appointments and studies to make the most of your visits, and we tell you how many days it is advisable to stay in Tijuana before traveling back, in addition to follow-up consultations. The logistics plan is adjusted during your evaluation based on the procedures performed.
Can I start with a virtual consultation?
Yes. You can start with a virtual consultation to discuss your goals, answer questions, and guide the process remotely. Defining the definitive surgical plan requires an in-person evaluation to examine your facial structure. Message us on WhatsApp and we’ll help you schedule the first contact.
Do gender-affirming procedures require letters or a mental health evaluation?
For gender-affirming procedures, it is customary to request a mental health evaluation or letters from a qualified professional, following recognized standards of care. This is part of a responsible, multidisciplinary process, not an obstacle. During your evaluation, we clearly explain what documentation applies to your case.
How much does it cost?
The cost is defined after the evaluation, because it depends on which procedures your plan includes and how many surgical stages it requires. We do not publish standard prices, as every face is different. Message us on WhatsApp to get oriented and schedule your evaluation.
Consultation
Schedule your consultation
Direct attention from Dr. Alfredo Chama's team, board-certified plastic surgeon in Tijuana. Message us or call to schedule your appointment.
or if you prefer, directly:
Your Care Continues After Surgery
- Follow-up appointments with Dr. Chama
- Conveniently located near the San Ysidro border crossing
- Direct line for any post-op questions: +52 664 585 1602
- Detailed recovery guide before you travel home
Your safety and recovery are Dr. Chama's priority — before, during, and after your procedure.
Last updated: September 13, 2026