A Comprehensive Guide to Facial Masculinization Surgery: Procedures, Costs, and What to Expect

Chiseled jawline, pronounced brow, and a stronger nose — these features define society's perception of masculinity. Facial masculinization surgery (FMS) offers a path to greater confidence and self-expression. And more people are looking into this procedure than ever before. 

Curious about what FMS actually involves and how it might change your life? This article explores every facet of facial masculinization — procedures, preparation, costs, results, and the final impact.

Table of Contents

1. What is Facial Masculinization Surgery?
2. Who is a Good Candidate for Facial Masculinization Surgery?
3. Facial Masculinization Surgery Cost
4. Facial Masculinization Surgery Preparation
5. Types of Facial Feminization Surgery
6. Non-Surgical Facial Masculinization
7. Facial Masculinization Surgery Procedure
8. Recovery Process
9. Surgery Risks
10. Surgery Results
11. What Other Gender-Affirming Surgeries Are Available for Trans Men?
12. Takeaways

What is Facial Masculinization Surgery?

Facial masculinization surgery (FMS) is a type of facial gender confirmation surgery that transforms feminine facial features into traditionally masculine ones. It reshapes bones and soft tissues to create more angular facial features. This procedure can involve alterations to several areas of the face, such as:

• jaw;
• forehead;
• nose;
• chin;
• cheeks;
• Adam’s apple.

Why is it done?

Facial masculinization surgery can help trans men and non-binary individuals align their physical appearance with their gender identity. This alignment significantly reduces gender dysphoria and boosts self-confidence. 

"Passing" — being perceived as male by others — is another popular motivation. In a world that frequently judges gender by appearance, FMS can help trans men navigate social situations more comfortably and safely. It can alleviate the stress of constantly being misgendered or facing scrutiny in public spaces.

However, FMS isn't exclusive to the trans community. Some cisgender men also undergo surgery to create a more masculine appearance and feel more confident.

What doctor performs FMS procedures?

FMS should be performed by experienced surgeons with specialized training in facial procedures. Here’s who typically performs these surgeries:

• Plastic surgeons — experts in cosmetic and reconstructive surgery.
• Craniomaxillofacial surgeons — specialists in head, neck, mouth, and face surgery.
• Otolaryngologists — surgeons focused on the ear, nose, and throat.

Choosing a Bookimed-recommended surgeon with experience in gender-affirming surgeries increases the likelihood of a successful and satisfying outcome.

Who is a Good Candidate for Facial Masculinization Surgery?

You might be a suitable candidate for facial masculinization procedures if:

• You are of legal age to consent to transgender surgery.
• Your mental health allows you to make informed decisions.
• Your head and facial bones have finished developing.
• You don’t have a severe health condition that would make surgery particularly risky.

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Facial Masculinization Surgery Cost

The cost of FMS can be anywhere from $1,000 to $20,000 or even higher. Several factors contribute to such a wide range, including:

• the exact types of surgeries;
• the number of procedures;
• surgeon’s experience.

Aside from the surgery itself, the cost includes:

• medications;
• blood and imaging tests;
• surgeon’s fee;
• hospital fee;
• anesthesia.

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Facial Masculinization Surgery Preparation

Preparing for facial masculinization surgery involves several essential steps to ensure the best possible outcomes:

1. Initial consultation. Patients meet with a plastic surgeon specializing in gender-affirming procedures to discuss goals, assess facial features, and explore surgical options. Surgeons expect patients to prepare questions and clearly articulate their desired outcomes.
2. Medical evaluation. The medical team conducts a comprehensive health assessment before approving transgender surgery. This may involve blood tests, imaging scans, and other diagnostic procedures to ensure fitness for surgery and identify potential risks.
3. Psychological assessment. Some surgeons require transgender patients to undergo a psychological evaluation. This thorough assessment confirms the patient's readiness for physical changes and establishes realistic expectations.
4. Hormone therapy. Many surgeons recommend patients on testosterone HRT wait 1-2 years before pursuing facial masculinization surgery. This allows time for hormone-induced facial changes, such as fat redistribution and jaw shape alterations, to develop fully. Waiting helps patients and surgeons make more informed decisions about necessary FMS procedures, potentially reducing the extent of surgical intervention required.
5. Lifestyle changes. Patients often need to adjust certain habits in the weeks before gender reassignment surgery. They may need to quit smoking, adjust medications, or avoid specific supplements to optimize surgical outcomes and recovery.
6. Procedure scheduling. Surgeons may recommend a staged surgical approach, dividing procedures across multiple surgeries. This method can enhance safety and patient comfort, though it extends the overall timeline.

Types of Facial Feminization Surgery

Your surgeon will develop a personalized treatment plan for you, which may include several plastic surgery procedures to enhance your masculine facial features. The most effective approach to facial masculinization considers the face as a whole so that all features balance and complement each other.

1️⃣ Forehead augmentation

Surgeons flatten and lengthen the forehead while enhancing the brow ridge to create a more prominent brow. They can adjust the hairline to increase forehead height, as a higher hairline typically appears more masculine.

2️⃣ Adam's apple surgery

To create a visible Adam's apple (thyroid cartilage), surgeons insert either cartilage implants or the patient's own tissue. This procedure adds a distinctly masculine feature to the neck area. Surgeons carefully position the implant so that it moves naturally when speaking and swallowing.

3️⃣ Rhinoplasty (nose surgery)

Rhinoplasty for facial masculinization aims to create a larger, broader nose. Surgeons widen the bridge, reduce upward tilt at the tip, and may increase overall nasal prominence. They can use implants, cartilage, or bone grafting to build up specific areas of the nose. To minimize visible scarring, they make incisions either inside the nose or discretely at its base.

4️⃣ Chin and jaw contouring

Surgeons can use implants or reposition the bone to create a broad, angular jaw and a strong chin. Implants are inserted through incisions inside the mouth, leaving no visible scars. These procedures significantly alter the lower face profile, creating a more square, defined look typical of masculine features.

5️⃣ Cheek augmentation

Implants or fat grafting can enhance the cheekbones to appear high and defined, adding to the chiseled look characteristic of a masculine face.

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A Different Path: Non-Surgical Facial Masculinization

If you’re looking for facial masculinization without plastic surgery, dermal fillers might be an option. Fillers are injectable materials that can reshape or enhance certain facial features, such as the nose or jawline.

Pros and cons of facial masculinization fillers

Pros:

👍Quicker and easier to use than surgery.

👍Avoid the risks and recovery time associated with surgery.

👍If you're unsatisfied with the initial results, doctors can easily make adjustments.

Cons:

👎The results are temporary, so you’ll need repeat injections to maintain the look.

👎The amount of the masculinization filler that can be safely injected is limited, which might not be enough to achieve your desired results.

👎The cost of repeat treatments can add up over time.

When deciding between fillers and surgery, consider how comfortable you are with undergoing surgery, your budget for initial and ongoing costs, and how often you're willing to go for maintenance treatments.

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Facial Masculinization Surgery Procedure

⏳Duration: The length of the surgery depends on the number and type of procedures you're having. A single procedure might take several hours, while multiple procedures can take 6 to 12 hours in total.

🏥Hospital stay: Some procedures may require a hospital stay of 1 day or so to ensure proper healing before you can go home.

👨‍⚕First follow-up: Your first follow-up appointment typically happens within 1 week of the surgery and will be scheduled before you leave the hospital.

FMS Recovery Process

🗓️Day 0-1: Leaving the hospital

• Arrange for someone to pick you up and provide care at home.

🗓️First 72 hours: Intensive care

• The period of peak pain and swelling. Use prescribed pain medications and keep your head elevated.
• Have someone with you around the clock to help with medications and icing your face every hour to reduce inflammation.

🗓️Weeks 1-2: Initial healing

• Wear compression garments or bandages on your face as much as possible to help reduce swelling.

• To minimize swelling, follow a low-to-no-sodium diet. Stick to soft foods if you have mouth incisions from jaw or chin augmentation.
• Walk around your house daily to prevent blood clots. Avoid stairs, clutter, and loose rugs.

🗓️Weeks 3-4: Continued healing

• Significant swelling will start to subside.
• Swallowing and opening your eyes wide will become easier.
• You may see more noticeable improvements in your facial features.
• Continue to follow your surgeon's advice on increasing physical activity, but avoid strenuous exercise.

🗓️Month 12: Final results

• Most swelling will resolve, scars will mature, and facial ligaments will settle.
• Your facial features will settle into their final positions, allowing you to see the complete results of your surgery.

Facial Gender Confirmation Surgery Risks

Like any surgery, facial masculinization surgery (FMS) carries some general risks, such as:

• anesthesia side effects;
• bleeding;
• facial swelling (edema);
• infection;
• implant migration;
• nerve damage;
• poor healing of bones and incisions.

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Facial Masculinization Surgery Results

☝️High success rates. Multiple studies show high satisfaction rates among FMS patients, with no significant complications reported.

✌️Alignment with a person’s gender identity. FMS helps align a patient’s outward appearance with their gender identity. It allows them to see their true selves reflected in the mirror.

👌Improved mental health. Untreated gender dysphoria can lead to serious mental health complications, including depression and anxiety. Research confirms that gender-affirming surgeries generally lead to a 42% reduction in psychological distress and a 44% reduction in suicidal thoughts.

🖖Social comfort and safety. In a world where transphobia is still prevalent, passing can significantly enhance a person's sense of safety and social comfort. Feeling more secure in social interactions can contribute to a better quality of life.

What Other Gender-Affirming Surgeries Are Available for Trans Men?

Other surgical procedures that you can pursue as part of your gender affirmation include:

👉Top surgery — a gender-affirming surgery that removes breast tissue to create a masculine chest contour.

👉Bottom surgery — gender-affirming procedures that create or enhance male genitalia. This includes:

• metoidioplasty, which creates a small neophallus using existing genital tissue;
• phalloplasty, which constructs a regular-sized penis using grafted tissue from other parts of the body.

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Takeaways

✦ Facial masculinization surgery (FMS) is a type of gender-affirmation surgery that reshapes feminine facial features into traditionally masculine ones by altering bones and soft tissue.

✦ It can reshape the jaw, forehead, nose, chin, cheeks, as well as create the appearance of an Adam’s apple.

✦ FMS helps trans men reduce gender dysphoria, boost self-confidence, and aids in "passing" to enhance social comfort and safety.

✦ Preparing for FMS involves consultations, medical and psychological evaluations, hormone therapy, lifestyle changes, and a staged approach to scheduling procedures.

✦ Multiple studies show universal patient satisfaction with facial masculinization surgery results, with no major complications.

✦ Full recovery can take up to 12 months, with significant improvements in the first few weeks.

✦ Dermal fillers are an alternative to facial surgery, but the results are temporary.

✦ In addition to FMS, other gender-affirming procedures that can complement your transition include top surgery and bottom surgery.