Question 1

When will you start seeing patients again

Accepted Answer

We are starting to see new patients again in 2026.  Patients who completed the form asking to be notified when consultations are opening are being contacted in date order to obtain details and arrange a consultation.

Many more people completed this form that Mr Maini can see for consultation, so unfortunately everyone that registered will not be offered a consultation.

Question 2

How long is the wait for surgery? Why are you rarely seeing any new patients?

Accepted Answer

Waiting times for surgery after consultation vary depending on the procedures being carried out.  In general this is 6-12 months.

The waiting list for new FFS consultations is often closed due to high levels of demand and limited capacity for surgery.  Mr Maini is still seeing patients from the waiting list and committed to continuing to provide facial feminisation surgery in Brighton, UK.

It would not be fair to see you for a consultation without being able to offer a date for surgery in a reasonable time.

Question 3

What happens during the initial consultation?

Accepted Answer

Mr Maini will discuss your facial features with you, gaining an understanding of what areas cause the greatest dysphoria.  You will be asked about your medical history, and about the history of your transition.  Mr Maini will assess your face, and discuss procedures, including the benefits and risks of surgery.  You will have a chance to ask questions, and you will receive a letter afterwards to summarise the meeting.

You will get most out of a face to face consultation but if this is not possible, online video consultations are offered.

You can have a CT scan on the same day as your consultation.  Please do ask for this in advance, as the scan needs to be booked.

Question 4

Do I have to come for a face to face consultation in Brighton?

Accepted Answer

No, if you prefer, you can have a video consultation.

It is preferable to have a face to face consultation to get the greatest benefit though.  Photographs and webcams can be misleading.  They can distort the face, and the true three dimensional shape of the face can only really be seen in person.

The cost of the consultation is £250

Question 5

Can I see some before and after photographs?

Accepted Answer

Yes, you can see some photographs during consultation.

Mr Maini does not ask patients' permission to publish photographs online or send them out in emails.  He does have permission to show photographs during a consultation.

Question 6

Why do you practise in Nuffield Brighton Hospital?

Accepted Answer

Mr Maini only performs private facial feminisation surgery at Nuffield Health Brighton Hospital because of the team and the facilities available.

The hospital has a long history of supporting patients with treatment for gender dysphoria.  The nursing staff have looked after patients following facial feminisation surgery many times before.  The operating theatre staff are familiar with the surgery, and all necessary specialist maxillofacial equipment is available.

Nuffield Brighton has three fully equipped operating theatres,  35 patient rooms with en-suite facilities, and 24 hour on site medical and nursing cover.  For major facial feminisation surgery, this level of support is essential.

https://youtu.be/PVjZJzMe78I

Question 7

Do I need a scan?

Accepted Answer

For forehead surgery, 3D imaging is absolutely essential.  This means a CT scan or a Cone Beam CT Scan.
 
For surgery to the lower jaw, a CT scan is needed.
 
If you like, Mr Maini can request a CT scan for you to have in Brighton on the same day as your consultation.  Nuffield Brighton will charge you a fee of around £350 for the CT scan.

Please do let us know in advance if you require a CT scan on the same day as a consultation.

Question 8

I am travelling from a distance, can I come the day before surgery?

Accepted Answer

If you have a long journey, you should arrange to come to Brighton the day before your operation and stay locally overnight.

After your stay in hospital for nursing care after FFS, it is a good idea to stay in the local area until your first follow up appointment which is around a week after surgery.  Having support from a partner, friend or relative during the healing period is essential

Question 9

Do I need to stop my HRT?

Accepted Answer

No, stopping hormone replacement therapy is not usually required around the time of facial feminisation surgery.

Question 10

What forehead reconstruction technique do you offer?

Accepted Answer

Changes to the forehead are usually among the most important parts of gender confirmation surgery.  The aim is to reduce the prominence in the brow bone, above the eyes, and re-contour the edge of the eye socket (orbital shaving).

Mr Maini offers both type 1 and type 3 forehead reconstruction, depending on how your forehead is made up, seen on a CT scan.

Type 3 reconstruction involves not only shaving bone but also repositioning the plate of bone that lies over the air sinus in most people's foreheads.

Type 3 forehead reconstruction was pioneered by Dr Douglas Ousterhout in San Francisco, who like Mr Maini, is a facial surgeon qualified in both medicine and dentistry.   In the UK, very few surgeons offer this technique.

Question 11

Where is the incision for forehead surgery made?

Accepted Answer

The incision can be made in one of two locations:

1. An irregular tricophytic hairline incision if the hairline needs to be lowered.
2. A coronal incision, behind the hairline if hairline lowering is not needed.

Question 12

What sort of tracheal shave technique do you use?

Accepted Answer

The incision is placed higher up in the neck where the lower jaw meets the neck, in a skin crease if possible.  The structures overlying the Adam's apple are separated.  The cartilage is then carefully shaved or reduced in size, within safe limits, to create a flatter and smoother appearance. The procedure is performed under general anesthesia, and stitches are used to close the incision.

An incision is not made directly over the prominence because although this makes the surgery easier,  this can leave an obvious scar in a prominent place.

The risks of surgery include scarring and voice change.  The risk of permanent voice problems is very low.

Question 13

How do you reshape the lower jaw?

Accepted Answer

Mr Maini uses sliding genioplasty to reshape the chin.  With this technique, it is possible to reduce the horizontal width and the vertical height of the chin, by removing sections of bone, then using small miniplates to join the pieces together in their new shape.

Reducing the angle of the jaw involves refining excessive squareness or angularity by removing prominent areas of bone.

For some patients, virtual surgical planning is useful and Mr Maini has access to this technology as well as 3D printing of custom surgical guides.

Risks:
There is some discomfort, bruising and swelling which temporary.
With chin surgery, the nerves supplying the lower lip and chin with feeling are carefully protected, but these areas are commonly temporarily numb after surgery.  Permanent altered sensation is very rare indeed.  Infection is uncommon, as is the need to remove the miniplates in the future.

Question 14

Do you do skin tightening procedures?

Accepted Answer

Mr Maini does not perform face or neck lifts, he focuses on facial feminisation procedures.

Question 15

Do you do rhinoplasty surgery?

Accepted Answer

Mr Maini is more and more selective with the scope of rhinoplasty that he offers and while he is trained to perform dorsal hump reductions with an open tip approach with an incision between the nostrils, he will very often recommend that you see a specialist rhinoplasty surgeon.

If other issues need to be addressed, such as difficulty with breathing, or work to make significant changes to the tip of the nose, or revision rhinoplasty, this is something that Mr Maini does not offer.

Question 16

Do I need to stop smoking? What about vaping?

Accepted Answer

Yes, it is absolutely necessary to stop smoking and the use of all nicotine containing products including vapes for 2 months before surgery and for 4 months afterwards.  This is to reduce the risk of healing problems and complications.

Question 17

What if I am overweight?

Accepted Answer

Your BMI must be below 40 for you to be able to have feminising facial surgery at Nuffield Brighton Hospital.  This is a limit set by Nuffield Health Brighton

Calculate Body Mass Index (https://www.google.co.uk/search?q=Calculate+body+mass+index+UK)

Question 18

Why do you ask for a diagnosis of gender dysphoria?

Accepted Answer

• Facial feminisation surgery is medically necessary (not cosmetic) surgery to treat gender dysphoria.
 • Cosmetic surgery is subject to VAT, whereas medically necessary surgery is VAT exempt.
 • Nuffield Health require this.

Question 19

Can you make me look like someone else? Can I bring a picture?

Accepted Answer

The aim of facial feminisation surgery is to soften and modify masculine features from your face.  The aim is not to make you look like someone else, rather a more feminine version of yourself.

Question 20

I have read that FFS surgeons in the UK are not as good as those abroad.  Is this true?

Accepted Answer

Please do not believe all you read on forums.

Mr Maini has made considerable effort to ensure his training in craniomaxillofacial and facial plastic surgery has prepared him for the surgery that he undertakes.  He spent years working with his mentor and predecessor and has subsequently adapted as the evidence and techniques for FFS have evolved.  He performs FFS using the same techniques as surgeons in Europe and the USA for example type 3 forehead reconstruction.  He uses virtual surgical planning and 3D printing technology where this is needed.

Question 21

Will I get a good result from my facial feminisation surgery?  Will everything be perfect?

Accepted Answer

Mr Maini strives to achieve the best possible outcome for each patient undergoing facial feminisation surgery. As a specialist maxillofacial surgeon, Mr Maini employs advanced techniques tailored to individual facial structures to aim for natural, harmonious results. While he is committed to high standards of precision and care, it is important to understand that, as with any surgical procedure, perfection cannot be guaranteed.  Imperfections and asymmetries are common.  Preoperative consultations, planning, and post-operative care are designed to manage expectations and and deliver results that feminise your facial features while prioritising your safety.

Question 22

Do I have to pay in advance?

Accepted Answer

The consultation fee of £340 must be paid in full to secure the consultation date.

The deposit required to book a date for surgery is 10% of the fee. This deposit is not refundable in the event of cancellation or rescheduling.

The remaining balance of the fee is to be paid to Nuffield Health before admission to hospital.

Initial Consultations

Contact Mr Maini's office:
No new FFS enquiries please

Initial Consultations

Contact Mr Maini's office: No new FFS enquiries please

Contact Mr Maini's office:
No new FFS enquiries please