Facial masculinization surgery: What to expect

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FMS is a type of gender-affirming facial surgery.

It includes a set of surgical procedures that modify facial characteristics. The goal of FMS is to achieve a more typically masculine appearance while taking the person’s overall facial proportions and anatomy into consideration.

These modifications can involve various aspects of the face, including the following:

• chin
• nose
• jawline
• forehead
• cheekbones
• Adam’s apple

FMS may help alleviate gender dysphoria, a form of psychological distress that individuals whose gender identity does not align with their assigned sex at birth can experience. The procedure can help people affirm their gender identity and feel more comfortable in their own skin.

Learn more about gender identity.

FMS is most common in transgender males and other individuals who wish to achieve a more typically masculine facial appearance.

While hormone therapy with testosterone can help achieve traditionally masculine facial characteristics such as skin texture, facial hair, and an anterior hairline, FMS can create a greater degree of masculinization. FMS can also appeal to cisgender men.

Gender dysphoria can cause significant emotional distress, and for many, undergoing FMS is a vital step toward reducing this distress and enhancing their overall well-being.

However, not all transgender people desire or undergo surgery. The decision to pursue FMS is a profoundly personal one.

Learn more about gender dysphoria.

Depending on the procedures involved, individuals will generally need to take some steps to prepare for FMS.

Common steps before undergoing FMS include:

1. Consultation: The first step in preparing for FMS is to schedule a consultation with a qualified plastic surgeon who specializes in gender-affirming procedures. During this consultation, the surgeon will:
   • assess the person’s facial features
   • discuss surgery goals and expectations
   • provide information about the various surgical options available
2. Medical evaluation: The person will undergo a thorough medical evaluation to ensure they are in good health and are suitable for surgery. This evaluation may include blood tests, imaging, and other diagnostic assessments.
3. Psychological evaluation: Some surgeons may require people seeking FMS to undergo a psychological evaluation to assess their mental health and readiness for the procedure. This evaluation helps ensure individuals make informed decisions and are emotionally prepared for surgery and recovery.
4. Lifestyle changes: In the weeks leading up to surgery, individuals may need to make certain lifestyle changes, such as quitting smoking and avoiding medications or supplements that can increase the risk of complications.

FMS is a highly personalized procedure. The specific surgeries a person has will depend on their individual goals and facial characteristics.

Some common surgical techniques surgeons use in FMS include:

• Jaw contouring: This involves creating a more prominent and angular jawline by reshaping the jawbone, removing excess soft tissue, or both. Jaw contouring can also include implants to the angles or corners of the mandible to make them more prominent and defined.
• Chin augmentation: This procedure creates a stronger chin using implants or by reshaping the existing bone and tissues.
• Cheek augmentation: This can enhance the appearance of high and defined cheekbones, typically with implants or fat grafting.
• Forehead contouring: This can involve reducing the prominence of the brow ridge or augmenting the forehead.
• Adam’s apple enhancement: Surgeons can perform thyroid cartilage enhancement to enhance the size and shape of the Adam’s apple, also known as laryngeal prominence.

The specifics of each surgery will vary, and some people may undergo multiple procedures during a single surgical session.

Surgeons can use advanced techniques to minimize scarring and ensure natural-looking results.

The recovery process following FMS can vary depending on the extent of the procedures. However, there are some general expectations:

• Swelling and bruising: These are common after FMS but typically subside within a few weeks. People will need to keep their heads elevated and apply cold compresses to reduce swelling.
• Pain management: Pain and discomfort are also common during the initial recovery period. Surgeons can prescribe pain medications to help manage these symptoms.
• Diet and nutrition: People will typically follow a soft or liquid diet for the first few days after surgery to minimize strain on the jaw and facial muscles.
• Activity restrictions: Individuals will need to avoid strenuous physical activities for several weeks to allow for proper healing.
• Follow-up appointments: Regular follow-ups with surgeons are crucial to monitor the healing process and address any concerns or complications a person experiences.

Following the surgeon’s postoperative instructions is essential to ensure a smooth recovery and optimal results.

FMS may offer a range of benefits, including:

• Alignment with gender identity: FMS can help individuals align their outward appearance with their gender identity, reducing the distress associated with gender dysphoria.
• Improved mental health: Gender affirmation and relief from gender dysphoria following FMS can lead to significantly improved mental health and overall well-being.
• Enhanced self-confidence: FMS can boost self-confidence and help individuals feel more comfortable in their own skin.
• Personal empowerment: FMS can empower individuals to take control of their gender journey and express themselves authentically.

While FMS can be life changing for many, it is important to be aware of the potential risks and complications associated with the procedure, such as:

• infection
• hematoma
• nerve damage
• prolonged swelling
• unsatisfactory results
• anesthesia risks

Individuals considering FMS will need to thoroughly discuss these risks with their surgeon and decide whether the benefits outweigh the potential risks.

Support can play a vital role in the experience of individuals who undergo FMS.

Support groups and services, both online and in-person, can provide a sense of community, shared experiences, and emotional support.

These groups offer a safe space for individuals to discuss their hopes, fears, and postoperative experiences. They also provide an opportunity to connect with others who may understand the unique challenges of gender-affirming surgeries.

Facial masculinization surgery (FMS) is a transformative medical procedure that allows transgender and gender-diverse individuals to align their outward appearance with their gender identity.

It involves various surgical techniques to modify facial features that can provide numerous benefits, including improved mental health, enhanced self-confidence, and alignment with one’s gender identity. However, FMS is not without risks, and individuals having the procedure will need to consider their options carefully and consult with qualified surgeons.

The decision to undergo FMS is highly personal, and the journey is unique for each individual. For some, it can be a significant step in affirming their gender identity. With the support of medical professionals, support groups, and loved ones, these individuals can navigate the challenges of FMS and celebrate the transformation the procedure can bring to their lives.