Question 1

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 undertake an examination of 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.

Question 2

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 3D shape of the face can only really be seen in person.  The cost of the consultation is £240

Question 3

Can I see some before and after photographs?

Accepted Answer

Yes, you can see some photographs during consultation.  Mr Maini does not tend to ask patients' permission to publish photographs online or send them out in emails.  He does have permission to show photographs during a consultation.

Question 4

Why do you practice 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.

Question 5

What scans do I need?

Accepted Answer

For forehead surgery, 3D imaging is absolutely essential.  We often use cone beam CT scanning as this gives excellent quality images with reduced radiation compared to a conventional CT scan.   For surgery to the lower jaw, either a scanning x-ray or a cone beam CT scan is needed.   If you decide to proceed with surgery, we can organise these scans for you with our partners at Medical Imaging Partnership in East Grinstead.  If you are having a scan, please ask them for the fee when you are booking in for the scan.  After consultation, if you would like us to request a scan at your local Nuffield Hospital, this is possible, however this tends to cost a bit more than our usual scanning partner, and the dose of radiation of a normal CT scan will be greater than a cone beam CT scan.

Question 6

How long is the wait for surgery?

Accepted Answer

The waiting time for an initial consultation is around 3-4 months.  The waiting time for surgery tends to be around 6-9 months after the decision to proceed.  Smaller operations lasting less time can often be fitted in sooner.

Question 7

What is the cost of surgery?

Accepted Answer

Please see here for an approximate guide

Question 8

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

Accepted Answer

Yes, if you have a long journey, we can arrange admission the evening before surgery so you are relaxed and ready on the day.  After your one or two nights' stay in hospital for nursing care  after FFS, it is a good idea to stay in the local area until your initial follow up appointment which is around a week after surgery.

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

Mr Maini offers both type 1 and type 3 forehead reconstruction, depending on your forehead, seen on a CT scan.  During forehead surgery, orbital contouring is performed, as well as a brow lift.  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.

Question 11

Where is the incision for forehead surgery made?

Accepted Answer

The incision can be made in one of two locations:  An irregular tricophytic hairline incision if the hairline needs to be lowered. 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 cartilage of the Adam's apple is then reduced in prominence.  An incision is never made directly over the prominence because this can be obvious afterwards.

Question 13

Do you do facelifts?

Accepted Answer

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

Question 14

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 15

Do I need a Coronavirus test?

Accepted Answer

You do not need to have a coronavirus test to have a consultation. If proceeding with surgery, the current Nuffield Health safety protocols need to be followed.  This means a PCR test and a period of self isolation is needed before surgery.

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