What is Transgender Facial Surgery? A Comprehensive Guide 

Medically reviewed by Jennifer Richman on December 02, 2024.

For many of our patients, regardless of whether or not they are undergoing hormone replacement therapy, facial surgery is a necessary step to treat gender dysphoria. 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. This comprehensive guide explores the procedures the Gender Confirmation Center (GCC) offers, as well as benefits, financial considerations, and the recovery processes to help our patients make more informed decisions.

What is Transgender Facial Surgery?

For many transgender individuals, facial features play a vital role in gender expression, as they signal masculinity and femininity to ourselves and others. Facial feminization surgery (FFS) and facial masculinization surgery (FMS) can help improve confidence, reduce gender dysphoria, and improve quality of life. The techniques vary and a consultation with your surgeon can help you determine which procedures are right for you. You can request a free consultation with our surgeons to create a customized facial surgery plan here.

The Different Types of Transgender Facial Surgery

Of course, with such complex surgeries it can be helpful to categorize the types of Transgwnder Facial Surgeries available to our patients. There are two main types tailored to creating a unique facial contour: Facial Feminization Surgery (FFS) and Facial Masculinization Surgery (FMS). Non-binary patients and patients of any gender identity are welcome to choose any of the following procedures, regardless of what category (FFS or FMS) they are sorted under. 

Facial Feminization Surgery (FFS)

FFS is designed to soften and refine facial features to create a more conventional feminine appearance. Transgender women, non-binary folks and gender non-conforming patients can choose between procedures that alter the upper (hairline, brow bone & eyebrows), middle (nose & cheeks) and/or lower (lips, chin, jaw & trachea or Adam’s Apple) thirds of the face. Common procedures include:

  • 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 protruding brow bone that grew out from a first, testosterone-dominant puberty
  • Rhinoplasty: Reshaping the nose, most often the nose bridge and the tip of the nose, to achieve a more delicate contour.
  • Cheek augmentation: Enhancing the appearance of the cheekbones through fat grafting or silicone implants to create fuller, rounder cheeks.
  • Lip lift or augmentation: Increasing the volume of the lips to create more conventionally feminine facial proportions.

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.

Facial Masculinization Surgery (FMS)

FMS enhances facial features to create a more conventionally masculine appearance. Transgender men, non-binary folks and gender non-confirming patients can similarly choose between procedures that alter the upper (hairline, brow bone, eyebrows), middle (nose & cheeks) and/or lower (lips, chin, jaw) thirds of the face.  Common procedures include:

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

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

Benefits of Transgender Facial Surgery

Both patient testimonials and peer-reviewed studies have demonstrated the enormously positive impact of gender-affirming facial surgery on qualified patients. These benefits include:

  1. Increased self-esteem and confidence in their appearance due to increased gender alignment.
  2. Reduced gender dysphoria and anxiety related to facial features.
  3. Improved mental health and overall quality of life.

Some of our patients describe how FFS and FMS allows them to feel a greater sense of wholeness and peace with themselves. Even minor adjustments to facial features that are designed to target sources of dysphoria can cause major relief. When patients are given the chance to look in the mirror and see a face that aligns with their gender, they are often able to experience more ease and comfort in every area of their life.

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.

The Recovery Process After Facial Surgery

Recovery from transgender facial surgery varies depending on the procedures performed. Here’s what to expect:

  • 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. 
  • 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. 

Patients must follow post-operative instructions carefully to ensure a safe and successful healing process. For more detailed instructions, click here.

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. 

Insurance coverage for transgender facial surgery varies. Some policies cover gender-affirming procedures, while others do not. Financial assistance programs and payment plans may also be available to help patients manage costs.

Real Patient Experiences and Testimonials

Hearing from others who have undergone transgender facial surgery can provide valuable insights and inspiration. Take a look at these testimonials from two of our patients: 

“I felt confident in my choice to proceed with GCC for my medical care. In total I have had three surgeries with Dr. Facque and I could not be happier with my results! He performed a double incision with nipple grafts, body contouring (flank, abdomen, thighs), and facial masculinization surgery (chin lipo). In every case, the process was smooth and straightforward (despite some of my surgeries taking place during the height of COVID). I scheduled consults, communicated with the insurance team, and got on the surgery schedule – each time with ease. The process really helped calm my nerves around this pivotal moment in my life, the team was respectful and answered all my questions, and Dr. Facque made me feel seen and heard. I think it speaks volumes that each time I’ve decided to proceed with a gender affirming surgery, I’ve always returned to GCC. I am now a more confident, joyous, and excited version of myself, and running around with my shirt off never gets old!”

–Dr. Facque facial masculinization patient

“Thanks to the entire staff of the Gender Confirmation Center and notably Dr. Alexander Facque, every time I see myself in the mirror and pictures, I am overwhelmed with joy that I get to look like this everyday now.

I have also improved immensely, emotionally and mentally. I go out of my way to check myself out in the mirror, where before I actively avoided. I rely less on camera tricks while taking selfies, and I take plenty of them. I have a newfound sense of self-confidence in addition to the help of hormones, makeup and developing my aesthetic. Facial surgery and the recovery were some of the most physically and mentally intense things I have gone through, but I know it was the right decision to make. I am so thankful for the opportunity to unlock my fullest potential.”

—Camille, Dr. Facque facial feminization patient

While any transgender facial surgery can be a physically and emotionally intensive process, patients consistently express that the long-term relief of gender dysphoria makes the process well worth-it.

Frequently Asked Questions About Transgender Facial Surgery

How long is the recovery process?

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. 

During the first 72 hours post-op, you will likely need a support person with you 24/7 to help you change ice packs, assist you with meals and more. Most patients can return to work two to four weeks after surgery, so long as their job does not involve heavy lifting. 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. You can find more information about recovery here. 

What are the risks and complications associated with the surgery?

As with any surgical procedure, the risks and complications associated with surgery vary. 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.

How much does transgender facial surgery cost? Will insurance cover the procedure?

Transgender facial surgeries can be quite costly. For cash-pay patients, facial surgeries 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.

How can I ensure the best results?

Working closely with your surgeon, following preoperative and post-operative instructions, and adhering to an appropriate recovery plan will ensure the best results of your surgery.  We recommend that you familiarize yourself with recovery instructions before surgery.