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Gender Affirming Facial Surgery for Non-Binary Patients

This article is an overview of how the techniques of Facial Masculinization and Facial Feminization Surgery (FMS and FFS) can be incorporated into Gender Affirming Facial Surgery for non-binary patients. Gender Confirming Facial Surgery and Gender Affirming Facial Surgery are both umbrella terms commonly used in the field of gender confirmation surgery to refer to the vast array of reconstructive facial surgery options that can be used to help achieve gender euphoria. We go over how the unique needs of gender expansive, gender fluid and androgynous-identifying patients can be made through hairline, forehead,  cheek, nose, jaw, chin and adam’s apple surgery.

What is Non-Binary Gender Confirming Facial Surgery?

At the Gender Confirmation Center, Dr. Alexander Facque and Dr. Ellie Zara Ley are our two expert surgeons who offer gender confirming facial surgeries. All three surgeons have experience working with non-binary and gender expansive patients whose needs go beyond what is typically offered in the menu of options for either facial feminization surgery (FFS) or facial masculinization surgery (FMS). We use the term gender affirming facial surgery (GAFS) interchangeably with gender confirming facial surgery as an umbrella term for all gender confirming facial surgeries that can help people of any gender who experience gender dysphoria associated with the appearance or certain features of their face.

During surgery, the areas of the face that can be targeted are those that are most influenced by hormones during puberty. GAFS can reduce or remove the impacts of testosterone on one’s face, or augment areas of the face that would have been impacted by testosterone when there has been low quantities of it during one’s initial puberty. GAFS can change the bones, skin, and soft tissues of the face.

It is important to note that not all transgender and nonbinary people experience gender dysphoria or incongruence associated with their face. This content is not meant to prescribe a one-size-fits-all method of facial surgery or suggest that trans people need to undergo GAFS in order to feel aligned with their gender. This content is meant to guide and inform people who want to learn more about facial surgery, the procedures available, and to help prospective patients make informed decisions about their potential surgical goals and outcomes.

Procedures Options for GAFS

Each patient that pursues GAFS will work with their surgeon to develop an individualized plan. This is a list of possible procedures; however, you should know that you may not undergo all or even most of these, depending on your priorities and goals:

• Hairline surgery: The hairline can be advances, reversing the common hairline recession effect of testosterone
• Forehead surgery: The shape of the forehead can be augmented or decreased
• Cheek contouring/augmentation: The cheeks can be made more prominent and angular, or rounder and softer
• Rhinoplasty: The nose can be made wider and longer, or smaller and thinner
• Jaw surgery: The jaw can be made squarer and thicker, or narrower
• Chin reshaping: The chin can be made more square and wider, or thinner and narrower
  
• Adam’s apple surgery: The Adam’s apple can be reduced in size, or made larger

Other parts of the face and neck that can be changed include the lips, eyelids, and neck. Our practice also offers hair restoration procedures. If you would like to talk to one of our expert surgeons about creating a specialized facial surgery plan for your own needs, you can schedule a consultation here.

GAFS can involve major procedures which can help reduce feelings of gender dysphoria or gender incongruence. That said, making surgical alterations to bone, skin and soft tissue also has the potential for risks and complications. As a patient, it is important to seek the services of experienced, board certified plastic surgeons and to be aware of the potential risks so you are fully prepared for surgery and have proper expectations. Recovery time from GAFS will vary depending on which procedure(s) you undergo. For more information on the recovery process you can reference our materials on recovery from FFS.

Insurance Coverage for Gender Confirming Facial Surgery