Facial surgery

On this page
Standards of care
Recovery
Costs
Locations
Risks
Downloads

Facial surgery, sometimes commonly referred to as Facial Feminisation Surgery (or FFS), is the name for a whole range of different operations that can be done to the face and neck.

Facial surgery is primarily undertaken by trans women and AMAB gender diverse people to change the shape of their face to better fit how they want to be seen, and see themselves. Masculinising facial surgeries are an emerging field. There’s no right or wrong way to be or embody your gender, regardless of your surgical status. Not all trans people want, seek or can have surgery, and being trans doesn’t necessitate surgery either. Find out more about that on our ‘Am I trans enough?’ page.

People under the age of 18 should talk to mental health and medical professionals to help with the decision-making process before considering facial surgery.

Information and resources to assist clinicians learn more about facial surgery can be found on our clinician page.

WPATH Standards of Care

The Standards of Care – 8th Ed (SoC8) is published by the World Professional Association for Transgender Health (WPATH) and offers guidance to clinicians working with trans patients all over the world, including criteria and recommended referral pathways for those seeking particular medical and surgical interventions.

The SoC8 do not specify an order by which surgeries should occur, if sought at all, and are guidelines, not legislated requirements.

The SoC8 highlight the benefits of facial surgeries for trans & gender diverse patients requesting it. WPATH state that surgeries modifying the face and/or neck ‘significantly improves both mid- and long-term quality of life’ and that ‘while gender-affirming facial surgery for AFAB individuals is an emerging field, current limited data points toward equal benefits in select patients.’

WPATH also highlight the need for aftercare and post-operative follow-ups. While the Standards of Care 7 mentioned the benefits of mental health support, the Standards of Care 8 state that ‘we recommend health care professionals should not make it mandatory for transgender and gender diverse people to undergo psychotherapy prior to the initiation of gender-affirming treatment, while acknowledging psychotherapy may be helpful for some transgender and gender diverse people’.

There are several kinds of facial surgical options, and the procedures chosen will depend on the surgeon’s expertise as well as your wishes.

Brow Lift

Lifting or shaping the eyebrows.

Cheek Enhancement

Adds filler to the cheeks to create a rounder and smoother appearance.

Forehead reduction (and hairline lowering)

Reduces the size and shape of the forehead.

Lip lift and reshaping

Several possible procedures, depending on desired patient outcomes, including lip augmentation (or lip filling), lifting the corners of the mouth, or an upper lip lift.

Nasal surgery (rhinoplasty)

Reduces the size, and changes the shape of the nose, by altering the nasal cavity, or reshaping the cartilage.

Scalp advancement

Moves the hairline forward and creates a more rounded shape, sometimes alongside hair transplantation.

Tracheal Shave (chondrolaryngoplasty)

Reduces the size of the thyroid cartilage, or ‘Adam’s apple’. A tracheal shave, or ‘trach shave’, is a fairly simple procedure and able to be done as an outpatient surgery under local anaesthesia, but it is often recommended to be performed under a general anaesthesia.

Recovery

The type of hospital stay required and length of the recovery process will take depends on what procedures you undergo, and if you undertake more than one successively. Generally, the surgical site will be bandaged, with drains, or small tubes, placed to help fluid and blood drain from the site. It may take several weeks for swelling to go down, and scars from the surgeries can be expected to fade over the first year.

The specific instructions for your recovery will vary from surgeon to surgeon, and depending on where and what specific surgical techniques are used.

Costs

Facial surgery can cost between $5,000 – $40,000 out of pocket, and sometimes more, depending on the procedures, techniques and surgeon. Many people choose to travel overseas for facial surgery which can increase costs due to travel, accommodation, and other costs.

Locations

Facial surgery options in Australia are limited for trans people. The Australian Professional Association for Trans Health hosts a provider list of their members. It includes surgeons in Australia and is available here.

Risks

All surgeries carry some risk, including complications, infection, blood clots, and rarely death. It’s important to ask your surgeon about possible risks and how to avoid them.