• Home
• Facial Surgery
• Techniques and Incisions
• Non-Binary Facial Surgery

Gender Affirming Facial Surgery for Non-Binary Patients

Medically reviewed by Jennifer Richman on February 27, 2025.

This article is an overview of how the techniques often associated with Facial Masculinization (FMS) and Facial Feminization Surgery (FSS) can be incorporated into Gender-Affirming Facial Surgery (GAFS) for non-binary patients. GAFS is an umbrella term for the vast array of reconstructive facial surgery options that allow patients to alleviate gender dysphoria and experience gender euphoria around the appearance of their face. 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 neck surgery.

What is Non-Binary Facial Surgery?

At the Gender Confirmation Center, Dr. Alexander Facque (he/him) and Dr. Zara Ley (she/her/they) are our two expert facial surgeons. Both Dr. Ley and Dr. Facque have experience working with non-binary and gender expansive patients whose needs go beyond the typical surgical plan for FFS or FMS. For many non-binary patients interested in facial surgery, they may be interested in one or more of the following options:

• Techniques that reduce or soften certain facial features
• Techniques that augment certain facial features or make them more angular and pronounced
• Techniques that reduce fat (e.g., buccal fat removal) or augment the volume of certain facial features (e.g., lip augmentation or cheek augmentation)

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, virtual consultation, you and your surgeon will discuss your unique goals to help set realistic expectations for what surgery can accomplish for you.

Puberty and Face Development: Bone and Soft Tissue Changes

Depending on your surgeon, in your surgical consultation, you may hear about the changes that testosterone can make to the face during and after a first puberty. Some patients find it helpful to review these changes to get a sense of which ones they wish they would have undergone or not: 

• Receding hairline (typically occurs in adulthood, after puberty is complete)
• Brow bone and orbital bones develop out, becoming more prominent
• Cheeks may contain less fat
• Nose bridge becomes broader
• More space between the bottom of the nose and the top of the lips (smaller upper lip)
• More prominence in the jaw and chin
• Adam’s Apple or tracheal cartilage develops

How do I Choose Which Facial Procedures to Undergo?

At the Gender Confirmation Center (GCC), our patients are in the driver’s seat: you set your own goals for surgery. That said, depending on your medical history, there may be limitations on what procedures can be performed for you.

If you are unsure of which areas of the face to target in facial surgery, we encourage you to contemplate the following questions:

• What parts of your face bring up feelings of gender dysphoria when you look at them? 
  • Are there parts of your face that you do not like because you associate them with a gender expression you do not identify with (masculine or feminine)?
• In your own words, are you interested in “looking like a man,” “looking like a woman,” or having a more androgynous facial appearance? If so, what would you need to change about your face to achieve that goal?
• If you are taking hormone replacement therapy (HRT), what do you like about the changes you have experienced to the appearance of your face? After about a year on HRT, what changes do you feel are still missing?
• Do you have pictures of a family member or someone else that you would like to more closely resemble?
• Do you have other concerns related to surgery? For example, are you worried about how much help you will need or how much pain you will experience in recovery? If these factors might impact your decision about what procedures you are willing to undergo, discuss them with your surgeon in a free consultation.

Your Options for Facial Surgery Explained

The following is a list of possible procedures you can choose from. Depending on the number of procedures you are interested in undergoing, you may need to have multiple stages of surgery to achieve your final goals. Please remember that it can take up to 12 months to see your final results from facial surgery.

• Hairline: The hairline advancement technique can help reverse the effects of a receding hairline, giving the forehead a smaller and rounder appearance. 
• Forehead contour: Procedures such as forehead contouring or brow bone reduction can create a flatter, more gently sloping forehead and soften the brow ridge. A brow bone reduction is usually performed with an orbital bone reduction, opening up the eyes to look more visually apparent. Conversely, patients can have an implant placed on their brow bone ridge for an augmentation procedure.
• Eyebrows and eyelids: An eyebrow lift will raise the position of the eyebrows on the face. A blepharoplasty can also be performed to remove excess skin in the eyelids, giving them a larger appearance.
• Cheeks and Cheekbones: Cheek augmentation through fat grafting or silicone malar (cheekbone) implants can enhance and define the cheekbones. 
• Buccal fat removal: By removing the fat pads in the lower cheeks using small incisions in the mouth, patients can achieve a more sculpted and angular contour to the cheeks. This may be a good option for patients wishing to reduce the fullness in their midface region.
• Nose: Rhinoplasty (nose reshaping) can change the appearance of the nose. Patients can request for the nose bridge or the nostrils to be reduced or augmented. Likewise, the tip of the nose can be inverted, giving the nose a slight upward turn. 
• Chin and Jawline: The chin and jaw can be reduced or contoured through mandible contouring and genioplasty procedures. These techniques can slim down and soften the jawline, creating a more oval, heart, diamond or rectangular shaped face. Conversely, implants can be placed to augment the jawline, giving it a more prominent, angular appearance.
• Lips: A Lip augmentation or a lip lift can create fuller, more defined lips. A lip lift reduces the skin between the bottom of the nose and the top of the upper lip, pulling up and therefore augmenting the size of the top lip. Patients can also augment their lips through a fat transfer.
• Adam’s Apple: A tracheal shave is a technique that involves reducing the size of the Adam’s Apple so it has a less prominent appearance. Patients can also have their Adam’s Apple augmented. This procedure is performed in a way to not alter the vocal cords.
• Neck Contour: Patients can also have unwanted fat removed in their neck through liposuction. A neck lift can also be performed to tighten loose skin and muscles in the neck.

Costs and Insurance

The cost of facial surgery varies greatly from patient to patient. The number and type of procedures performed can increase the costs of hospital and facility fees. For example, depending on the number and type of procedures you undergo, you may need to stay your first night after surgery in the hospital. For rough estimates, you can consult our guide on FFS costs.

The GCC has great success helping patients securing insurance coverage for gender-affirming facial surgery, which can tremendously reduce your share of costs. If you would like for our insurance concierge team to offer you free help to get your gender-affirming surgery covered, you can request a free consultation with us today.