Risks and Complications Associated With Gender-Affirming Facial Surgery

Facial surgery can yield incredible results and increase patients’ experiences with gender euphoria. An individual’s choice to undergo a surgical procedure is often based in part on the comparison of the risks to potential benefits. While gender affirming surgery is performed in ways to prevent any risks or complications from occurring, every surgical procedure involves a certain amount of risk.

Although the majority of patients do not experience  complications, you should discuss each of them with Dr. Facque to make sure you understand the risks, potential complications, and consequences of facial surgery. Some of the below risks are an expected part of facial surgery and may be short-lived (for example, changes in sensation), and some of the risks and complications listed on this page are very rare. 

We understand that this list might be daunting, and we hope not to discourage anyone from pursuing this important step towards gender affirmation. The content on this page should be used for informational purposes only. To learn more about facial surgery and its risks, schedule a consultation with Dr. Facque.

Risks associated with all surgical procedures include:

  • Infection
  • Scarring
  • Bruising and swelling
  • Changes in skin texture
  • Fluid build-up (seroma)
  • Adverse reaction to anesthesia
  • Bleeding (hematoma)

Facial Surgery Risks

The following is a list of risks that are associated with specific facial surgery procedures. Because not all patients are candidates for all available procedure types, contact Dr. Facque to learn more about the likelihood of risks associated with the specific procedures you are considering. The risk of experiencing a serious complication listed below is less than half of one percent, while mortality risks are less than 0.001%.

  • Changes in skin sensation 
  • Nerve injury
  • Frontal sinus problems
  • Nasal septal perforation 
  • Nasal airways alterations
  • Damage to deeper structures
  • Asymmetry 
  • Delayed healing, especially common for smokers 
  • Allergic reactions
  • Hair loss
  • Eye irritation and eyelid disorders
  • Chronic pain
  • Hardware and deeper structures issues

Reducing Facial Surgery Risks

There are a number of things you can do to reduce your risk of complications before and after facial surgery. First, 

  1. Dr. Facque recommends following our pre-surgical care guidelines as closely as possible. 
  2. Second, it’s very important that you are honest and upfront about your medical history and surgical goals. From this information, Dr. Facque will be able to determine if you are healthy enough to undergo major surgical procedures. This information will also help us determine if extra precautions are necessary during or after surgery. 
  3. Lastly, patients are asked to quit smoking for 6 weeks before and after surgery, including all cigarettes, nicotine products, and marijuana smoke. We ask that people who use marijuana switch to edibles and/or tinctures (oil) during this time. 

Long term effects of sun exposure, aging, and weight loss or gain may impact your surgical results over time. Gender affirming facial surgery will not prevent patients from experiencing the normal signs of aging.

Age and Surgical Risk

Generally speaking, your overall health (rather than age) is a much better indicator of your risk level. However, because older patients are at a higher risk of serious medical conditions, they may have higher risks. You may not be a good candidate for surgery if you have any of the following conditions:

  • Heavy smoker, drinker, or drug user
  • Diabetes
  • High blood pressure
  • A bleeding disorder
  • Lung or heart disease

Gender-affirming facial surgery may not be for everyone. Dr. Facque will be able to determine if surgery is right for you following a personal examination and consultation.