What is Transgender Facial Surgery? A Comprehensive Guide  

An FFS patient smiling with a light pink dress and sun hat

 

Medically reviewed by Jennifer Richman on Oct 31, 2024.

What is Transgender Facial Surgery?

Transgender facial surgery is a medically necessary intervention for many trans, non-binary and gender non-conforming people to experience greater gender alignment with their faces–often the most visible part of their body. Facial Feminization Surgery (FFS), Facial Masculinization Surgery (FMS) and Non-Binary Facial Surgery reduce gender dysphoria and improve quality of life in qualified patients. The techniques vary and a consultation with your surgeon can help you determine which procedures are right for your unique anatomy and goals. You can request a free consultation with our surgeons to create a customized facial surgery plan here.

Facial Feminization Surgery (FFS)

FFS is designed to soften and refine facial features to reverse the effects of a first, testosterone-dominant puberty on the facial structure. Transgender women and non-binary patients can choose between the following procedures:

  • Hairline advancement: Bring down the hairline to reverse the effects of a receding hairline from testosterone
  • Brow bone reduction: Give the forehead a flatter contour, reducing the protrusion of the brow bone
  • Rhinoplasty: Reshaping the nose, most often reducing the size of the nose bridge and tilting the tip of the nose up
  • Cheek augmentation: Increase the volume of the cheeks with a fat transfer or silicone implants to create a fuller mid-face

These procedures work together to feminize the face, helping individuals feel more aligned with their gender identity. That said, patients can pick and choose how many they would like to undergo depending on their goals and unique anatomy.

In the following video, Dr. Alexander Facque (he/him) discusses forehead feminization and hairline advancement for FFS and why they are often performed simultaneously:

Facial Masculinization Surgery (FMS)

Transgender men, non-binary folks and gender non-confirming patients can choose between the following:

  • Rhinoplasty: Reshaping the nose bridge, the tip and/or other parts of the nose
  • Jawline enhancement: Augmenting, broadening and creating a more angular jaw
  • Chin augmentation: Creating a more pronounced and squared chin
  • Tracheal implant: Augmenting the size of the trachea to create a more pronounced Adam’s Apple.

These procedures help individuals align their outward appearance with their gender identity regardless of whether or not they have undergone testosterone hormone therapy.

Non-Binary Facial Surgery

Gender-affirming facial surgery for non-binary patients is tailored to the unique needs and goals of each individual. Several non-binary patients come into facial surgery not being interested in having surgical results that help them “pass” as a man or woman; they might be interested in what they would consider a more androgynous facial appearance.

Other non-binary patients come into a consultation asking to “feminize” or “masculinize” certain parts of their face. The point is, there is no prescription for non-binary facial surgery. In a free consultation, you and your surgeon will discuss your unique goals to help set realistic expectations for what surgery can accomplish for you.

Preparing for Transgender Facial Surgery

When preparing for gender-affirming facial surgery, it is important to think through your consultation, costs related to the procedures, physical risks and benefits, as well as logistical questions.

  • Consultation: Here at the GCC, we offer free consultations both virtually and in-person. Dr. Facque (he/him) and Dr. Ley (she/her/they) are board-certified surgeons with training, experience and continuing education specific to gender-affirming facial surgery.
  • Candidacy: Certain medical evaluations may be necessary for facial surgery to assess any risks. At the GCC, while we do not have BMI requirements or HRT requirements for facial surgery, some insurance providers require that patients undergo estrogen HRT at least one year prior to FFS to cover the procedure. After your consultation, your provider may require you to get an CT scan or other imaging of your cranium to prepare for surgery.
  • Costs: The costs of surgery vary greatly depending on the number of procedures you undergo. Cash pay patients who pay without insurance have been charged anywhere from $4,500-$100,000. At the GCC, our insurance concierge has a 90% success rate in securing coverage for interested patients, significantly reducing the costs of surgery. Patients can also look into these resources to finance their procedures if need be.
  • Logistics: Planning for surgery includes preparing for transportation to and from the hospital, post-operative care, and time off work. You will need a loved one to take you to the hospital for surgery, pick you up when you are discharged and take you to your surgeon’s office about a week after your operation for your first follow-up appointment. Likely, you will need 24/7 care for at least the first 72 hours after surgery. For more details on recovery logistics, click here.

Your Facial Surgery Consultation: Making a Unique Surgical Plan

During your free consultation with Dr. Alexander Facque (he/him), Dr. Zara Ley (she/they) or Dr. Karamanos (he/him), you will create a unique surgical plan to meet your goals. Some patients are not entirely sure what procedures they would like to undergo––to best treat their gender dysphoria or to stay within their budgets. In the video below, Dr. Facque provides some tips on how to make the most out of your facial surgery consultation:

The Recovery Process After Facial Surgery

The recovery process for FFS and FMS vary according to the scheduled procedures. While most patients recover within 4-8 weeks, it is important to discuss with your surgeon what the recovery period may look like for you.

  • Immediate post-op: Swelling, bruising, and tenderness are common. Pain is managed with medications, and rest is critical during the first week. Patients will need around-the-clock care for the first 72 hours after surgery. You may be placed on a soft diet for 2 weeks if incisions are present inside the mouth.
  • Weeks 2-4: Swelling decreases, and patients can resume light activities. Surgical sites require careful hygiene and monitoring.
  • Months 3-6: 80% of your swelling will resolve during this time. Still, you will not be able to see your final results until 12 months post-op. Continue to avoid lifting heavy objects and rigorous exercise during this time.

Although the most intense part of the recovery process takes about two weeks to overcome, patients should avoid vigorous exercise for at least six weeks. For more detailed instructions for the recovery process, click here.

Risks and Complications

As with any surgical procedure, the risks and complications associated with surgery vary. Pain, swelling and bruising are normal parts of the recovery process. However, if you experience excessive bleeding, pain, drainage of pus, fever and chills, increased swelling after day 3, or any other complication, please reach out to your care team immediately.

With FFS and FMS, patients can reduce risks significantly by quitting tobacco and nicotine consumption. If you have specific concerns about your health, you can speak to a surgeon during a free facial surgery consultation about them.

Costs and Financial Considerations

At the GCC your surgeon’s office will outline costs and financial considerations after your consultation. While transgender facial surgery can be a significant investment, our surgeons and insurance concierge team will work with you to ensure you receive the best coverage possible.

Transgender facial surgeries can be quite costly. For cash-pay patients, FFS can cost between $4,500 and $100,000 depending on the number of procedures you undergo.

That said, many of our patients are able to significantly reduce the cost of surgery with insurance coverage. For a list of providers we have successfully worked with, click here. Our free insurance concierge service has a 90% success rate in securing coverage for interested patients.

Financial assistance programs are available thanks to our partnerships with non-profit organizations to help patients manage costs.