FFS is not covered by OHIP, so a referral from your primary care provider (PCP) is not required if you live in Ontario. However, we recommend getting one to keep your doctor informed. Plus, if you have a referral, your consultation fee is covered by OHIP.

Your provider can email the referral to info @ catalystsurgical.ca.

At Catalyst Surgical, we follow Facialteam’s core principles for FFS:

• Natural results
• Hidden incisions
• Enhancing femininity while preserving your identity

We do not recommend hairline incisions, as scars—even if thin—can remain visible and may heal unpredictably. Additionally, lowering the hairline does not effectively reshape it from an “M” or square shape to a softer, rounded one.

Instead, we offer simultaneous hair transplant, which:

• Uses hair follicles that would otherwise be removed during forehead feminization, ensuring no waste of this valuable resource
• Avoids visible scarring
• Specifically reshapes the corners of the hairline

Wait times vary based on your schedule and the time of year. If you’re flexible, surgery could be scheduled within a few months. Popular months, like April and May (due to academic schedules), tend to have longer wait times. We’ll work with you to find a date that fits your life, minimizing stress and ensuring a smooth recovery.

Health considerations may also impact scheduling. If pre-surgery bloodwork shows abnormalities, or if a specialist needs to confirm that surgery is safe in our facility, additional steps may be required before booking.

No, hormone therapy is not required for FFS. However, if you plan to start or are already on estrogen, we generally recommend waiting 6–12 months before surgery. This allows time for skin softening, which can impact how the skin drapes over the new bone structure.

No, you don’t. A CT scan is not required before your first consultation. At this stage, we focus on understanding your goals, assessing your facial features, and discussing options for your surgery.

A CT scan is needed later to help plan certain aspects of your surgery. We’ll guide you through that process after your consultation. For now, all you need to do is book your appointment. 

We recommend the following steps to ensure a smooth recovery period:

• Quit smoking/nicotine as soon as possible (this affects healing and surgical outcomes)
• Plan your recovery: Arrange for someone to help you for at least 24–72 hours post-op
• Confirm accommodations if you cannot recover at home
• Ensure transportation to and from appointments (especially for the first two weeks)
• Check your health card to ensure it is not expired
• Plan time off: Expect 2–4 weeks of recovery, depending on your job or academic schedule
• Limit social interactions before surgery to reduce the risk of illness (if you are sick on the day of surgery, it will be rescheduled)

Yes and no. 

As Catalyst Surgical is not a full hospital, we need to follow specific safety guidelines.

If your BMI is over 38, we’re still happy to receive your referral and meet with you for a consultation. Afterward, our team will carefully review your case to assess whether surgery can be safely performed at our facility. In some cases, additional testing may be needed, and scheduling options might be more limited.

If we determine that surgery at Catalyst isn’t the safest option, we’ll clearly explain why and help guide you toward alternatives—like a hospital setting—that may be better suited for your needs.

This doesn’t mean you can’t have surgery, or that you must lose weight. Our commitment is to help you explore all safe and available options.

We handle before-and-after photos differently than many clinics:

• Public galleries only showcase the best results, which may create unrealistic expectations.
• Surgery outcomes are highly individualized based on anatomy, healing, and skin quality.
• Your gender journey is not for our marketing. We will never pressure patients to share their results.
• If you want to help others, we encourage sharing on your platforms. Use #catalystsurgical and tag us @catalystsurgical (note: we cannot control hashtag content).
• You own your photos. While we need consent for medical records, marketing use is entirely your choice.

If before-and-after photos are essential for your decision, we understand that we may not be the right fit for you.

There have been rare reports of serotonin syndrome when combining SSRIs with tramadol or ondansetron (medications used before, during, and after surgery). However, these cases typically involve high doses. We carefully tailor medication plans to ensure your safety. Please discuss any medication concerns during your consultation.

This depends greatly on what activities are involved in your daily life. Some people who do mostly desk work from home are ready to do some desk work in 1-2 weeks. People with heavy manual labor jobs should not expect to return to full workloads until 2 months after surgery.

Surgery is a stressful experience, and energy management is an important part of recovery. You might not have much pain after surgery, particularly 2 weeks after, but you might not have the energy or attention to perform at your pre-surgical level. Most people take 2-4 weeks off from work to allow themselves to recover.

Our suggestion is to usually arrange for more time off work than the bare minimum. If you feel great before that time, you can always renegotiate with your employer.

Surgery timing is something we discuss as part of your consultation so that you can decide when surgery is best for you, knowing that you’ve wanted surgery for a very, very long time, and that “yesterday” is the time you would prefer.

The main limiting factor to having sex after surgery is pain. If engaging in sexual activity does not cause discomfort at your surgical site, it is generally safe to do so.

For those who have had rhinoplasty, avoid bumping or putting pressure on your nose for the first 4-6 weeks.

For those who have had jaw or chin surgery, with incisions inside the mouth, avoid activities that require excessive mouth opening or repetitive oral movements for about 3 weeks.

Most forms of masturbation are usually feasible after the first week. Partnered sex can vary, and if you participate in any kinks or specific activities, it may be best to discuss them to ensure they do not interfere with healing.