Facial Feminisation Surgery

Facial Feminisation surgery (FFS) is a set of surgical procedures aiming at removing the masculine traits of a face, making it look more feminine

Facial Feminisation Surgery (Dr Bart van de Ven)

Words from a patient

A patient sent me this by e-mail. I couldn’t explain better what FFS is about:


My whole life i have known that inside i am a woman, and not a man. The last two years my shrink and I have been working on my transition from man to woman. My mental health is fine, just my outside appearance is not (in my opinion). For me it is not enough to know that I’m a woman, I want total strangers to think I’m a woman too since strangers make up an important part of your life (shops, services, etc).

My goal has always been, that when I walk into a store (where nobody knows me) they all think that I’m a women and greet me with Miss and not Mister without a shadow of a doubt. Passability to me is a big thing, probably to most transgenders. My family, friends and co-workers all know I feel inside like a women, and will probably accept me as a woman regardless whether I do FFS or not.

To me FFS is the most important surgery, and not SRS which results will be invisible for most people. FFS however will be visible to all.

It will mark a restart of my life, a new one…”

Genetic women

In the last 2 years some genetic women have come to me with the question if I would also operate them, which I did. Many genetic women have some masculine features in their faces as well. It can be some frontal bossing with low eyebrows, a receding hairline with widow peaks, a hanging tip of the nose, sometimes with a hump, a flat midface, a wide and/or high chin, low jaw angles, long upper lip, small vermillion of the lips, large ears or just earlobes etc. Over the years normally the face looses some subcutaneous fat. With that fat disappearing these masculine facial features, that are caused mostly by the shape of the bones, become more visible. That is why many women, as they grow older, start to look more and more like their father. Facial feminisation surgery, done either at a young or an older age, can take away these masculine features. It makes these faces not only more feminine, but also younger and more attractive. Therefore facial feminisation surgery is to be considered a new type of facial plastic surgery.

Facial Feminisation surgery is performed by the  maxillofacial surgeon, Dr Bart van de Ven.

  • Exceptional Experience: Dr Bart is the most active, experienced and innovative FFS surgeon in the world (4-5 FFS operations a week).
  • Talent: Dr Bart is a talented surgeon with courage, triggered by challenge and with an open mind for solutions. His talent together with his experience have created the exceptional craftsman he is in the field of facial feminization.
  • Consistency: Consistently good and predictable results.
  • Natural Result: As conservative as possible, as aggressive as needed but always aiming at a natural result.
  • 100% Dr Bart: Dr Bart van de Ven has no residents. He does the operation 100% himself, with the same two fantastic nurses Els and Karen.
  • Passion: Dr Bart really cares for his patients and is enthusiastic about his work. The result of your surgery matters as much to him as to you. He seeks for perfection, with commitment for every single detail.

How would the clinic deal with an emergency if serious complications were to arise during the procedure?

If a patient needs hospitalisation we would transfer her to the Middelheim hospital which is 8 minutes or 3,5km from our clinic.

We have had this situation 2 times in more than 700 surgeries. In case this would be because of a mistake from our side we have an insurance that covers the cost. More likely is that it happens without anyone having made a mistake. In that case most health insurances cover these costs.  If you don’t have a health insurance it’s your (financial) risk.

When can I judge the final result?

After three weeks you would look presentable but it takes at least 4 months to get a good impression of the final result. Sometimes after chin and jaw work it can take up to a year for the swelling to completely disappear. Scars take about a year to fully mature.

What type of care is needed after the treatment? Will I require check-ups in my own country?

All care in Antwerp is provided. In general no extra care is needed in your home country. Check-up with Dr Bart is after 4 months and can be in any city where Dr Bart van de Ven provides consultations.

What happens if there are complications after the procedure and is this covered?

We will correct the complication if surgically possible, without charging any surgical fees. Hospital, material and traveling costs are for the expense of the patient.

How long is the waiting time to book an operation?

The average waiting time for an operation at the moment is two months. For big surgeries it can be a bit more, for small surgeries often less. You can check availability through our online operation planner.

Is FFS painful?

There is no complete answer to this. It depends entirely on the pain threshold of the patient, and the operation procedures performed.Most procedures will involve the need for some incisions, and closure with sutures. Inevitably these will lead to some level of discomfort for some period post-operation. Mostly patients describe it as ‘uncomfortable’ rather then ‘pain’.

Can I loose feeling permanently in some areas following FFS surgery?

Some temporary numbness in any of the areas where bone work is done is an absolute certainty. That could include the scalp, forehead, chin, jaw or even cheek areas depending on where the surgery has been done. This is simply because the flesh is detached from the bony area. Several thousand minor nerves are severed, and it will obviously take some while for those areas to heal. Up to 18 months is not unusual, but less than that is more common.

I’m a bit overweight. What is the maximum BMI for elective surgery?

In principle the maximum BMI is 30. If your BMI is higher but you are in good health, your case is considered on an individual basis by our anaesthesiologist.

Will I have numbness?

The treatment areas will feel numb in the beginning. It will take 3-6 months to recover feeling, and you may not regain the same level of feeling as before.

Should I wait with FFS until I have taken hormones long enough?

The hormones will have their effect on the soft tissues of your face: the fat will redistribute and the muscles will atrophy a bit. Also the facial hair will diminish and hair to the scalp will become denser and thicker. All this will make your face look softer and more feminine.
Dr van de Ven will try to make your face as feminine as possible and there is no negative effect to your face becoming even more feminine after your FFS due to the hormones. Those last changes will be very subtle. Therefore Dr van de Ven does not see a reason to postpone FFS if you have only started taking hormones recently.