Douglas Ousterhout

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Douglas K. Ousterhout is a retired[1][2] craniofacial surgeon who practiced in San Francisco, CA, United States.[3][4][5] His specialty was facial feminization surgery for trans women, and he was widely considered the foremost facial feminization surgeon in the United States.[6] Ousterhout also pioneered facial masculinization surgery for people undergoing female-to-male gender reassignment.[7][8] Ousterhout received MD and DDS degrees from the University of Michigan Ann Arbor. He is a voluntary clinical professor of surgery in the School of Medicine[9] and an adjunct professor of dentistry in the Dental School at University of California, San Francisco.[10]

Facial feminization surgery (FFS) began in 1982 when Darrell Pratt, a plastic surgeon who performed sex reassignment surgeries, approached Ousterhout with a request from a trans woman, a patient of Pratt's who wanted plastic surgery to make her face appear more feminine, since people still reacted to her as though she were a man.[11] Ousterhout's prior practice had involved reconstructing faces and skulls of people who had suffered birth defects, accidents or other trauma.[11] Ousterhout was interested in helping but knew that he didn't know what a "female face" was, so he investigated by first reading the physical anthropology from the early 20th century to identify what features were "female", then by deriving measurements defining those features from a series of cephalograms taken in the 1970s, and then by working with a set of several hundred skulls to see if he could reliably differentiate which were females and which were males using those measurements.[11][12] Ousterhout then began working out what surgical techniques and materials he already used that he could apply in order to transform a male face into a female face; he pioneered most of the procedures involved in FFS and was involved in their subsequent improvements as well.[12]

FFS generally involves advancing the hairline, making the forehead smaller and rounder, reducing the brow ridge, shortening and narrowing the nose, shortening the upper lip, shortening the chin, narrowing the jaw, and reducing the laryngeal prominence.[13] As of 2006 there were only about twelve surgeons in the world performing FFS.[6]

Notable Ousterhout patients who have written about their surgery include Lynn Conway,[14] Andrea James,[15] and Nicole Hamilton.[16]


Ousterhout and wife Nancy also own and manage Ousterhout Wine and Vineyards.[17][18] Wine & Spirits website featured their 2012 Zinfandel as part of National Zinfandel Day in 2015[19] and their 2011 Zinfandel as part of the 2014 California Wine Month celebration.[20]

Personal life[edit]

Ousterhout lived in the Mrs. Doubtfire home, which he bought in 1997. The title character in the movie, played by Robin Williams, is a divorced man who pretends to be an older female nanny so he can be around his children. Ousterhout briefly knew Williams and liked the connection, explaining, "I turn boys' faces into girls' faces. It seemed only natural."[21] In 2015, a disgruntled former patient tried to set the front door on fire.[22]

See also[edit]


  • Ousterhout, Douglas K., ed. (1991). Aesthetic Contouring of the Craniofacial Skeleton. Lippincott Williams and Wilkins. ISBN 0-316-67410-9.


  1. ^ Kron, Joan (June 12, 2015), "A Look at Caitlyn Jenner's Facial Feminization Surgery", Allure, Condé Nast, retrieved June 15, 2016
  2. ^ Eric Plemons (2017). The Look of a Woman: Facial Feminization Surgery and the Aims of Trans- Medicine. Durham : Duke University Press. ISBN 9780822372707. By the time he retired in 2014, he had performed nearly 1,700 FFS operations - far and away the most of any surgeon in the world.
  3. ^ Scurlock, James D. (2012). King Larry: The Life and Ruins of a Billionaire Genius. Scribner, a Division of Simon & Schuster, Inc. pp. 171–175. ISBN 9781416593942.
  4. ^ Van Marie, Karin (1006). Sex, Gender, Becoming: Post-apartheid Reflections. Pretoria University Law Press. p. 12. ISBN 9780958509756.
  5. ^ Douglas Ousterhout, Home, archived from the original on January 15, 2012, retrieved February 6, 2018
  6. ^ a b Guthmann, Edward (April 26, 2006). "Facing facts". SF Chronicle. Retrieved 29 June 2014. Ousterhout, who practices at the California Pacific Medical Center's Davies campus on Castro Street, is widely considered the country's foremost facial feminization surgeon.
  7. ^ Colebunders, Britt; D'Arpa, Salvatore; Weijers, Steven; Lumen, Nikolaas; Hoebeke, Piet; Monstrey, Stan (2016). "Chapter 15: Female-to-Male Gender Reassignment Surgery". In Ettner, Randi; Monstrey, Stan; Coleman, Eli (eds.). Principles of Transgender Medicine and Surgery (2nd ed.). Routledge. p. 282. ISBN 9781317514602.
  8. ^ Douglas Ousterhout, Masculinization, archived from the original on January 15, 2012, retrieved February 6, 2018
  9. ^ "Directory:Douglas Ousterhout". UCSF. Retrieved 19 July 2018.
  10. ^ "Dr. Douglas K. Ousterhout". Retrieved July 18, 2018.
  11. ^ a b c Plemons, ED (Oct 2014). "Description of sex difference as prescription for sex change: on the origins of facial feminization surgery". Soc Stud Sci. 44 (5): 657–79. doi:10.1177/0306312714531349. PMID 25362828. S2CID 24609120.
  12. ^ a b Altman, K (Aug 2012). "Facial feminization surgery: current state of the art". Int J Oral Maxillofac Surg. 41 (8): 885–94. doi:10.1016/j.ijom.2012.04.024. PMID 22682235.
  13. ^ Morrison, SD; et al. (Jun 2016). ""Facial Feminization " Systematic Review of the Literature". Plast Reconstr Surg. 137 (6): 1759–70. doi:10.1097/PRS.0000000000002171. PMID 27219232. S2CID 23174099.
  14. ^ Conway, Lynn (2011-11-16). "Lynn's Facial Feminization Surgery (FFS)". University of Michigan. Retrieved 13 July 2016.
  15. ^ James, Andrea (January 16, 1997). "My surgical journal: Scalp Advancement, Brow Shave, Brow Lift, and Trachea Shave". Retrieved 13 July 2016.
  16. ^ Hamilton, Nicole (April 8, 2013). "My Experience with Facial Surgery". Retrieved 13 July 2016.
  17. ^ Yarrow, Alden (January 24, 2015). "Vinography Unboxed: Week of January 18, 2015". Vinography. Retrieved 13 July 2016.
  18. ^ Mobley, Esther (September 2, 2015). "Tasting Notes: The spectrum of rosé wine recommendations". San Francisco Chronicle. Retrieved 13 July 2016.
  19. ^ "National Zinfandel Day: Ousterhout 2012 Alexander Valley Nance's Vineyard Zinfandel". Wine & Spirits Magazine. November 18, 2015. Archived from the original on 6 February 2018.
  20. ^ Sykora, Luke (September 3, 2014). "California Wine Month: Ousterhout 2011 Alexander Valley Nance's Vineyard Zinfandel". Wine & Spirits Magazine. Archived from the original on 6 February 2018.
  21. ^ Redell, Bob; Fernandez, Lisa (August 12, 2014). ""It Seemed Only Natural": Plastic Surgeon Owns "Mrs. Doubtfire" Home". NBCUniversal Media, LLC. Retrieved June 20, 2016.
  22. ^ Sernoffsky, Evan (January 6, 2015). "'Mrs. Doubtfire' home in San Francisco singed by arsonist". SFGATE.