ABOUT DR. PAUL MITTERMILLER

Dr Mittermiller is a craniofacial plastic surgeon dedicated to providing personalized gender-affirming care for the transgender, nonbinary and gender-diverse community in and around Los Angeles. He specializes in gender-affirming facial surgery (facial feminization surgery and facial masculinization surgery). He is one of the few plastic surgeons in the U.S. with specialty training in craniofacial and facial feminization surgery.

A Southern California native, Dr. Mittermiller works closely with his patients to find the exact combination of surgical options that will meet their personal goals. He has been actively involved in research to advance facial feminization surgery, and his published peer-reviewed research has gained recognition from the Plastic and Reconstructive Surgery journal.

FACIAL FEMINIZATION

Facial feminization surgery increases feminine appearance and is performed for transgender women, non-binary individuals, and gender diverse individuals to relieve symptoms of gender dysphoria.

It can also decrease anxiety, anger, depression, and social isolation and increase positive affect, meaning, purpose, and overall mental health for transfeminine individuals.

FACIAL FEMINIZATION PROCEDURES

Facial feminization surgery (FFS) describes a set of procedures used to feminize the face. Dr. Mittermiller is one of only a few surgeons in the states with specialty training in craniofacial and facial feminization surgery.

  • Hairline Modification
  • Brow Lift
  • Brow Bone Reduction(forehead reduction/setback)
  • Orbital Rim Contouring
  • Cheek Augmentation (Implants or fat grafting)
  • Rhinoplasty
  • Lip Lift and Lip Augmentation
  • Genioplasty & Jaw Contouring
  • Tracheal shave (chondrolaryngoplasty, Adam’s apple reduction)

FACIAL MASCULINIZATION

Facial masculinization surgery (FMS) describes a set of procedures used to masculinize the face. These procedures are for transgender men, non-binary and gender diverse individuals. The procedures below can be performed in isolation or can be combined during one or more operations:
 
  • Forehead augmentation (Increase Forward Protrusion of the Brow)
  • Rhinoplasty (Augment or Lengthen the Nose)
  • Jaw Augmentation
  • Genioplasty (Chin Surgery)

HOW TO PREPARE FOR FACIAL MASCULINIZATION SURGERY

The first step is to have a consultation with a surgeon who specializes in gender-affirming facial surgery. You will discuss the facial features of concern and the surgeon may point out additional areas that can be addressed.

ACT scan may be performed to evaluate your facial structure. This allows the patient and surgeon to better visualize the underlying bone structure of the face to best tailor a surgical treatment.

If the surgery is for gender dysphoria, letters from one or more health providers may be necessary to state the need for facial surgery to help relieve symptoms of gender dysphoria.

During the consultation, we will ask you about your medical history, including any medical problems that may exist, whether you have previously had surgery, what medications you take, which allergies you have, and whether you have any habits such as smoking or drinking.

INSURANCE INFORMATION

Unless your insurance plan specifically has transgender exclusions, our office is quite adept at working with most insurance plans. After your initial visit with Dr. Satterwhite or Dr. Safir and the surgical team at Align, you will have a consultation with our financial advisor, who will provide in-depth information on the insurance process. Our goal is to make the process as easy as possible for you.

INSURANCE COMPANIES WE CANNOT WORK WITH:

  • Medicare
  • Medicaid
  • Straight Medi-Cal
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Align Surgical Associates is absolutely wonderful! They are kind and compassionate. You can see that they really care about their patients. They always took the time to listen to me and was there when I needed them. I would not hesitate to recommend them.

WHAT ARE THE ADVANTAGES OF FACIAL MASCULINIZATION SURGERY?

Improved congruence between your inner and outer self Enhanced self-confidence and quality of life. More masculine facial structures improved definition in the forehead, nose, cheeks, chin, jaw and neck Natural-looking results.

WHO IS A GOOD CANDIDATE?

People who wish to optimize their image and affirm their gender identity will be excellent candidates for facial surgery, provided they are physically and mentally healthy.

Surgery should only be performed for your own personal reasons, and not to please others or conform with societal standards. A realistic and individualized approach based on your private consultation with our team will serve you best in moving forward.

WHAT DOES RECOVERY ENTAIL?

Following surgery, you will be bandaged and have gauze dressings on your incisions. You may be asked to wear a compression support garment that helps to minimize postoperative swelling and keep your new facial contours intact. Small tubes may be in place to help drain off any excess fluids or blood as you heal.

The doctor will provide you with a complete aftercare plan that includes instructions for taking pain medications and antibiotics, bathing and washing the wounds, sleeping, exercising, returning to work, and scheduling follow up appointments. Healing is different for everyone and may take between 2 and 6 weeks, depending on the precise nature of the treatments you had performed, and on your personal recuperation abilities.

THE BEST CANDIDATES FOR SURGERY…

Are seeking more masculine facial features
Are old enough to provide informed consent
Have thoroughly researched the procedure and have attended a consultation
Have suffered with persistent gender dysphoria
Have a positive outlook and realistic goals
Have any medical, mental or social issues under control

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