The Ultimate Guide for 2024: Facial Surgery Costs and Insurance Coverage

Medically reviewed by Paul Gonzales on March 18, 2024.

There is clinical evidence that demonstrates that gender-affirming facial surgery like facial feminization surgery (FFS) and facial masculinization surgery (FMS) have overwhelmingly positive effects on trans and non-binary patients. These include reducing anxiety and depression, supporting a positive relationship to body image and improving many other elements of the quality of life. In this article we go over pricing scales, insurance coverage and how patients can afford surgery.

Facial surgery can cost between $4,500 and $100,000 for cash-pay patients depending on how many procedures are performed. That said, this price range can vary from patient-to-patient based on your unique surgical plan. Patients who can secure insurance coverage for their gender-affirming surgery can drastically reduce these costs. Below you can find more detailed cost breakdowns of facial procedures as well as information on insurance, payments, and financial assistance. We can give you a specific quote for your case after your free, virtual consultation with one of our board-certified surgeons.

At the Gender Confirmation Center (GCC), we offer a free insurance concierge service to patients and have successfully secured coverage for 90% of interested patients. Once you submit the required documentation to us after your consultation, we can begin the process of securing approval from your insurance.

Factors that influence the cost of facial surgery

The cost of any gender-affirming surgical procedure can vary from practice to practice based on the following factors:

Surgeon Expertise

The experience your surgeon has with the procedure(s) you are looking to get can impact how much they can charge. Board-certified plastic surgeons with proven surgical skills and many years of training and experience performing top surgery may have higher costs.

Undergoing surgery with a board-certified plastic surgeon with hospital privileges is one of the ways you can ensure the integrity of your results and your safety through the surgical process.

Geographic Location

The location of the hospital or surgical center where you get your operation can influence costs. Large cities and higher-quality facilities tend to have higher fees.

Additional Fees

• Consultation/Office Visit Fees: Our office provides free, virtual consultations to all patients. All follow-up office visits are also complementary after initial surgery at GCC. In-person consultations are $150 for cash patients. Patients with insurance will have their insurance billed for consultations and follow-up visits. Consultation and office visit fees will also be billed to insurance for those with insurance coverage.
• Procedure-Specific Costs: Facial surgery costs may vary based on the type of procedure and how many are performed. For example, a brow bone reduction will be more invasive and demand greater technical skill compared to a lip lift. Each of these procedures will have a separate fee that can add up to the total cost. The use of any facial implants (i.e. chin, jaw, etc) can also add to the costs of facial surgery.

What about patients traveling for surgery?

The price estimates for gender-affirming facial surgery in the following sections do not account for travel expenses such as flights or accommodations. If you are an out-of-state or international patient, we created a travel packet with recommendations for travel, lodging, and other services here. Patients traveling for surgery should plan to stay in the San Francisco Bay Area for at least one week after surgery for the first pre-op appointment before returning home.

The cost breakdown of facial surgery

FFS, FMS, and other forms of gender-affirming facial surgeries can vary greatly in price. This is because the length of surgery or the amount of procedures a patient undergoes is different for each patient. If you would like a more specific quote for different procedure types, you can create a unique, surgical plan with one of our board-certified surgeons by scheduling a free, virtual consultation.

The following cost breakdowns are for cash-pay patients (i.e., patients paying for the procedure without any insurance coverage or grants). We present these costs as ranges because the number of procedures conducted per zone and the techniques used differ from patient to patient. These prices also do not account for facility or anesthesiology fees, which are usually charged based on the duration of the procedure.

The upper third of the face

Operating on the upper third of the face can cost anywhere from $10,000-$50,000. Patients can choose from the following procedures to alter this region of the face:

• Hairline advancement a.k.a. hairline lowering
  • The hairline can be surgically lowered or advanced on the forehead to reverse the effects of a receding hairline. This can help eliminate the need for hair transplants.
• Brow lift
  • Lifting the eyebrows is a procedure that can make the face look more conventionally feminine by allowing the brows to sit higher on or above the brow bone.
• Frontal sinus removal/setback or augmentation
  • Setback: This procedure reduces the brow bone to give the forehead a flatter, more conventionally feminine appearance.
  • Augmentation: Patients with a flat forehead can elect to have the shape of their forehead augmented with implants, resulting in a more conventionally masculine look.

The middle third of the face

Operating on the middle third of the face can cost anywhere from $6,000-$18,000. Patients can choose from the following procedures to alter this region of the face:

• Cheek augmentation
  • The cheeks can be augmented with implants, fillers, or through an analogous fat transfer from elsewhere on the body.
• Rhinoplasty
  • A gender-affirming “nose job” tends to focus primarily on the nose bridge: making it wider or thinner. That said, rhinoplasties can also contour other parts of the nose (i.e. tip, nostrils, septum, etc) to make aesthetic or functional (respiratory) adjustments.

The lower third of the face and the neck 

Operating on the lower third of the face and the neck can cost anywhere from $4,500-$50,000. Patients can choose from the following procedures to alter this region of the face:

• Lip lift & lip augmentation
  • A lip lift involves creating an incision at the base of the nose, which allows the surgeon to pull up the skin above the upper lip. This makes the upper lip look more prominent, giving it a more feminine appearance.
  • A lip augmentation is often performed using a temporary filling of hyaluronic acid but can also be achieved through fat grafting if the patient is under anesthesia.
• Jaw contouring or augmentation
  • The jaw can be shaved down to create a softer, narrower, more conventionally feminine appearance. To augment the jaw, patients can opt for implants to be placed on the mandible, giving them a more prominent, angular jawline.
• Chin contouring
  • The chin can be reduced in size or augmented in size using implants.
• Tracheal shave (soft tissue/fatty compartment)
  • The Adam’s apple can be shaved down to reduce the bump in the neck by making a small incision on the chin or the neck. Conversely, an implant made from cartilage in the ribcage can be used to make the Adam’s apple appear more prominent.

Does insurance cover FFS?

Gender-affirming procedures like FFS and FMS are recognized as medically necessary for many trans and non-binary patients. In states like California, private insurance plans generally provide coverage for these procedures as long as documentation is submitted stating its medical necessity. Documentation usually includes a support letter from a mental health professional and a referral letter from your primary care provider if the surgeon is out of your insurance network or you have an HMO plan. Some insurance companies may require proof that a patient has been on gender-affirming hormone therapy for a certain amount of time.

The GCC has successfully partnered with several private insurances plans to secure coverage for procedures. Our free insurance concierge service has helped approximately 90% of interested patients secure full or partial coverage for their procedures. You can find a list of insurance plans we have worked with and had success securing coverage here.

The good news is, insurance has been covering FFS more than ever before. In the informational video below, Dr. Facque (he/him) describes how you can figure out if your plan will cover surgery:

How can I afford FFS? Is there financial assistance available for surgery?

Even with approval from insurance, some patients may still have fees if they haven’t met their deductible or their insurance only covers a certain percentage of the costs. All fees must be paid 6 weeks prior to surgery. Failing to do so will risk the cancellation of your procedure.

We recognize that the costs of a gender-affirming surgery can be overwhelming for some. To lower the barriers to access, we finance a variety of scholarship opportunities for gender-affirming procedures and accept payments made through trusted medical creditors like CareCredit.

Are consultations free with the Gender Confirmation Center?

Yes! At the GCC, we do not charge patients for consultations, virtual or in-person, with our surgeons. We recognize that many trans, non-binary and gender non-conforming patients experience immense financial barriers to accessing medically necessary gender-affirming care. In addition to offering our consultations free of charge, we provide a free insurance concierge service that has successfully secured insurance coverage for over 90% of interested patients. To schedule a free surgical consultation, click here.

Cancellation fees:

Our goal at the Gender Confirmation Center is to provide you with high-quality gender-affirming care in a timely manner. To help us do this, we have implemented the following rescheduling and cancellation policy for surgical procedures. By following these guidelines, you can help us better serve you and other patients by keeping appointment slots available for our community.

We understand that unforeseen circumstances may arise, and you may need to reschedule or cancel your surgery. However, to ensure efficient use of resources and minimize disruptions to our schedule a flat fee of $720 will be charged if you cancel or reschedule within 41 days of your scheduled surgery date. This fee may be waived in certain extenuating circumstances if evidence is provided.

We value the importance of early communication and understand that plans may need to change. Therefore, there are no fees or penalties for rescheduling or canceling your surgery if the requests are made 42 days or more before your scheduled surgery date. This allows us to make necessary adjustments to our schedule and offer the surgery date to another patient who needs it.