What to Know About Facial Feminization Surgery

  • Facial feminization surgery (FFS) alters the face to give it more traditionally feminine physical characteristics.
  • The surgery often involves multiple procedures.
  • The results can be supported by nonsurgical tweaks using dermal filler and neuromodulators like Botox.

Earlier this year, TikTok influencer Dylan Mulvaney documented her experience with facial feminization surgery (FFS), outlining each step of the day-of and recovery process. While not a new procedure by any means, this up-close-and-personal peek increased the awareness of FFS as another gender-affirming surgery outside of top surgery that allows transgender people to truly feel confident in their skin. By altering different components of the face through both surgical and nonsurgical procedures — such as the face shape, nose size, and eyebrows — you can help the face appear softer or, at least societally, “feminine.”

“Ideals of feminine physical characteristics have long been studied by artists and psychologists,” SkinSpirit aesthetic nurse specialist Vinny Sathe, BSN, RN, tells POPSUGAR. “Aesthetic providers look to accepted universal and cultural ideals when developing a plan of care for patients.” This tends to look like a heart-shaped face, fuller cheeks, and arched brows, to name just a few examples.

Facial feminization surgery can be a life-changing procedure for transgender women in particular. In general, with the topic of plastic surgery becoming less taboo, and many celebrities speaking openly about the work they’ve had done, there’s been more interest in the topic. Many people want to know more, like what the procedure entails, what the risks are, and how long the recovery process is.

Ahead, three experts, including two plastic surgeons and an aesthetic nurse specialist, share everything you’d want to know about facial feminization surgery.

What Are Facial Feminization Surgery Procedures?

Though “facial feminization surgery” sounds like one treatment, that’s not the case. “Facial feminization is not a single surgery, but rather a number of procedures that modify the shape and contours of the face and also change the balance of different facial features,” says Konstantin Vasyukevich, MD, double board-certified facial plastic surgeon and face-lift expert. It addresses a number of different components of the face, including the forehead size, brows, eyes, nose, and jawline.

“Another popular procedure is a tracheal shave to reduce the Adam’s apple,” says Jennifer Levine, MD, a double board-certified facial plastic surgeon.

Benefits to Facial Feminization Surgery

Seeing as facial feminization surgery is multiple procedures, rather than just one, it has a number of benefits. Characteristically, men’s foreheads are often higher and more prominent. “It is typically flatter with prominent bony ridges and a hairline that appears more square,” says Dr. Vasyukevich. The eyebrows are also typically lower and less arched, and cheeks tend to be flatter and more angular looking. The “nose is typically wider with the nasal tip pointing more downward,” and while not always the case, many men have thinner lips. “The shape of the lower face is heavier and more square with [a] stronger chin and prominent jaw angles.”

How Much Does Facial Feminization Surgery Cost?

Many people wonder about facial feminization surgery insurance policies, and it’s important to note that this is often considered an elective cosmetic procedure and therefore not covered. However, some health insurance plans do cover at least some of the costs associated with the procedure, including AllWays Health Partners and Amerigroup (Anthem). If you’re unsure, check with your insurance provider.

If the surgery is not covered by your health insurance, the exact price will vary depending on your location, which surgeon you see, and how many procedures you are opting to get. According to RealSelf, facial feminization surgery costs on average $35,000, while Healthline reports it ranges from $20,000 to $50,000.

Facial Feminization Surgery Risks

The risks associated with facial feminization surgery are similar to that of a face-lift. This includes visible scarring, nerve damage, and imbalanced features. “Each procedure has its own risks, but bruising, swelling, numbness, and displeasure with the results are the most common,” says Dr. Levine. With any type of major surgery, there’s a risk of poor healing, according to Dr. Vasyukevich, but it can be mitigated by following the post-op instructions your doctor provides you. This type of procedure also requires anesthesia, which has its own list of risks, including allergic reaction.

How Long Does Facial Feminization Surgery Take?

Facial feminization surgery is highly customizable, so “the surgery length will depend on the number of procedures being performed,” says Dr. Levine. The procedures are typically done in stages. “Changing the contour of the bone, such as chin reduction or shaving off prominent forehead ridges, is usually done first,” says Dr. Vasyukevich. “Lifting of the soft tissue such as a brow-lift, mid-face-lift, and a face-lift (when necessary) would be the next stage.”

The final step usually involves adding volume and contour with injectables like neuromodulators (e.g. Botox) and filler. “Dermal fillers are the most effective way to achieve nonsurgical facial feminization and come in a broad variety of formulations,” says Sathe. There are different kinds, so consulting with your provider is important to find the right fit for you. “Results are immediate and improve in the weeks following treatment.”

Neuromodulation via Botox or Dysport can also help. “They can be used for facial feminization by reducing the muscle size of the mid-brow and jaw,” says Sathe. “The results produce a flatter brow bone and a slimmer jawline.”

It’s important to keep in mind that results from dermal filler and neuromodulation are not permanent and will require touch-ups. “Longevity of results varies based on a variety of factors including the type of filler, injection technique, and the patient’s unique health characteristics,” says Sathe. “Longevity also varies by area.”

Facial Feminization Surgery Before and After


Facial Feminization Surgery Recovery

Facial feminization recovery time varies depending on what procedures are done, but typically, you can expect the immediate postoperative process to take one to three weeks, “with the complete healing often requiring six months to a year,” says Dr. Vasyukevich.

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