Is FMS one operation?
No. It is a personalized group of facial procedures.
Your plan may involve one feature or several, treated together or in stages.
Gender-Affirming Surgery • Face
Facial Masculinization Surgery (FMS)
Facial masculinization surgery combines selected procedures to create facial features that feel more masculine and better aligned with your gender.
Do I need to take testosterone first?
Not necessarily.
Hormone use is not a universal requirement. Discuss current or planned testosterone use because it can affect facial hair and soft tissue, which may influence planning.
How much time away should I plan?
It depends on the procedures and your work.
Some plans involve a few weeks away from work or public-facing activities; more extensive bone surgery may need longer. Returning to work does not mean healing is complete.
01 · Overview
A facial plan shaped around you
Facial masculinization surgery, often called FMS, is gender-affirming care focused on facial appearance. You do not need to want every available procedure, and choosing not to have surgery is equally valid. [1]
A plan may include chin or jaw augmentation, changes to the nose, or selected forehead and cheek procedures. Implants add structure, while some operations reposition bone or reshape existing tissue. These approaches have different limits and risks. [2]
FMS is different from facial feminization surgery, which usually pursues different facial changes. It also does not replace corrective jaw surgery for a bite problem, voice treatment or facial hair restoration. Your surgeon should explain which goals fall within the proposed operation.
- Treatment area
- Selected facial features
- Approach
- Bone, implants or soft-tissue changes
- Anesthesia
- Often general anesthesia for combined surgery
- Planning
- One operation or staged procedures
How are facial proportions assessed?
Your surgeon considers your face as a whole, including bone structure, skin thickness, facial movement, bite and breathing. Photographs and sometimes imaging help with planning. Simulations can support discussion but cannot predict an exact result.
Can I choose a subtle change?
Yes. Bring descriptions of what feels right to you, including features you want to keep. A surgeon can explain whether a subtle or more noticeable change is realistic for your anatomy.
02 · Concerns & Goals
What would you like to change?
You may want a stronger jaw, a broader chin or changes to your nose. Masculinity does not have one facial shape; your priorities guide the conversation.
A softer jawline
You may want more width or definition at the jaw angles. Bone shape, muscle, skin and soft tissue all affect what surgery can change.
Chin size or projection
A chin that feels narrow, short or recessed may be a priority. Assessment should include how your teeth meet, not just your profile.
Nose shape and balance
You may want a different bridge, tip or overall proportion. Appearance goals need to be considered alongside nasal breathing.
Overall facial alignment
You may feel that several features together do not reflect your gender. A coordinated plan can explore those concerns without assuming that every feature needs surgery.
03 · Options
How the approaches differ
These are possible parts of an FMS plan, not a required package. Suitability depends on a surgeon’s assessment of your anatomy, health and goals.
Jaw augmentation
Adds width or definition to the lower face.
How it worksSelected implants may build out the jaw angles or contour. More complex skeletal concerns may require a different specialist approach.
May suitPeople seeking greater jaw definition without assuming a change to their bite.
Main tradeoffImplants can become infected, shift or need removal. Added width may not create the contour you expect if soft tissue is the main concern.
Chin augmentation or genioplasty
Changes chin projection, width or height.
How it worksAn implant adds contour; a sliding genioplasty cuts and repositions the chin bone.
May suitPeople whose chin proportions are a central concern and whose bite has been assessed.
Main tradeoffThese are distinct operations with different limits. Risks include numbness, asymmetry, implant problems or bone-healing problems.
Masculinizing rhinoplasty
Reshapes the nose in relation to the rest of the face.
How it worksBone and cartilage may be reshaped or supported with grafts to pursue an agreed profile and contour.
May suitPeople seeking nasal changes that can be balanced with airway function.
Main tradeoffBreathing can change, swelling can last months, and revision may be needed. Not every desired shape is structurally safe.
Selected forehead or cheek contouring
Addresses upper- or midface proportions when appropriate.
How it worksDepending on the goal, a specialist may discuss augmentation, bone contouring or carefully selected soft-tissue changes.
May suitPeople with specific concerns that are not addressed by chin, jaw or nasal surgery alone.
Main tradeoffThese procedures are not routine for everyone. Scars, sensation changes, asymmetry and irreversible contour changes need careful discussion.
FMS combines techniques rather than following one standard recipe. Implant surgery, bone repositioning and rhinoplasty each have their own recovery needs and risks. [1] [2] [3].
Should procedures be combined or staged?
Combining procedures may reduce the number of separate recovery periods, but it can increase operating time and make early recovery more demanding. Staging may be safer or allow you to reassess your goals after an initial change.
Will a chin implant fix a bite problem?
No. A chin implant changes contour, not how the upper and lower teeth fit together. Bite problems may require evaluation by an orthodontist and an oral and maxillofacial surgeon.
04 · Results
What may improve and what may remain
Changes tailored to your goals
The aim is a face that feels more aligned with you.
- Your surgeon should describe the changes each procedure can realistically make.
- Surgery cannot guarantee how others will perceive your gender or how you will feel afterward.
A result that develops gradually
Early swelling can hide definition and exaggerate unevenness.
- Facial contours settle over months rather than days.
- After rhinoplasty, refinement can continue for a year or longer.
Lasting changes, with limits
Bone changes are generally lasting; implants may need future treatment.
- Aging, weight changes and hormonal changes can continue to affect facial appearance.
- Revision may be considered for complications or unmet goals, but it adds risk and cannot guarantee satisfaction.
Nasal swelling can fluctuate during healing. Your surgeon will help distinguish normal settling from a concern that needs assessment. [3]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery depends on the exact combination of procedures, incision locations and your health. Ask for a written plan specific to your operation and follow your surgical team’s instructions.
Step 1 · Day of surgery
Treatment day
You are monitored as anesthesia wears off. Depending on the operation, you may leave with a responsible adult or stay overnight. Dressings, splints and mouth incisions vary by procedure.
Step 2 · First several days
Early recovery
Swelling, bruising, tightness and temporary numbness are common. Your team will explain pain control, eating, wound care and any mouth care. Ask your surgical team whether compresses are appropriate and exactly how to use them.
Step 3 · Following weeks
Gradual return
Energy and comfort usually improve gradually. Follow-up visits help guide return to work, exercise and normal eating; visible swelling may still be present.
Step 4 · Following months
Continued healing
Contour, scar appearance and sensation may continue to change. Bone healing and nasal refinement take longer than the initial recovery period.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Work and social plansPlanning context: Plan flexibility for fatigue, swelling and follow-up visits.What affects it: The number of procedures, physical job demands and comfort with visible swelling affect timing.
Eating and mouth carePlanning context: Jaw or chin procedures may require temporary changes. [2]What affects it: Incisions inside the mouth and bone work determine food texture and oral-care restrictions.
Exercise and liftingPlanning context: Resume in stages only as your team allows.What affects it: Bleeding risk, bone healing and implant stability can delay strenuous activity or contact sports.
DrivingPlanning context: Wait until your team clears you and you can respond safely.What affects it: Sedating medicines, vision changes and restricted movement can make driving unsafe.
A return-to-work estimate is not a measure of complete healing. Ask for separate guidance for your job, exercise and activities that could put pressure on your face.
Before your procedure
- Describe the features you want to change and those you want to preserve.
- Share your medical history, prior facial procedures, dental concerns and anesthesia experiences.
- Review all medicines, supplements and hormones; do not stop prescribed treatment on your own.
- Discuss nicotine use and the team’s requirements for stopping before and after surgery.
- Arrange transportation, early support at home and time for follow-up appointments.
- Obtain individualized instructions for fasting, eating after surgery and incision or mouth care.
Will I have numbness?
Temporary altered sensation can follow facial surgery, especially around the chin and lower lip. Recovery varies, and some changes can persist. Ask which nerves are near the planned surgical area.
What if I live far from the surgeon?
Agree on how long to stay nearby, when you need in-person checks and who will assess urgent concerns after you return home. Remote visits cannot replace every examination.
06 · Safety
Risks and what your clinician assesses
Swelling, bruising, soreness, tightness and temporary altered sensation can occur. Their extent depends on the procedure, and symptoms should follow the recovery pattern your team describes.
Bleeding or a blood collection
Bleeding beneath the skin may cause increasing swelling or pressure and can require urgent treatment or another operation.
Infection or wound problems
Incisions can heal slowly or become infected. Infection around an implant may require antibiotics, drainage or implant removal.
Nerve or nearby structure injury
Sensation changes can persist. Depending on the operation, facial movement, teeth or tooth roots may also be affected.
Implant or bone-healing problems
Implants can shift or become exposed. Bone procedures can involve delayed healing or hardware problems and may need further surgery.
Unwanted appearance or functional changes
Asymmetry, noticeable scars or contour irregularities may occur. Nasal surgery can affect breathing; lower-face procedures may affect comfort with chewing.
Anesthesia and general surgical complications
Anesthesia reactions, blood clots and heart or lung complications are possible. Your health and the length and extent of surgery influence risk.
Discuss these risks and your individual health history with your surgeon. [1]
What your clinician assesses
- Medical conditions, anesthesia history and factors that affect healing
- Facial anatomy, skin and soft tissue, dental health and bite
- Medicines, hormones, supplements and nicotine use
- Personal goals, emotional readiness, practical support and expectations
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope: the specific facial procedures, implant or graft choices, facility setting and follow-up arrangements. A combined operation and a staged plan may have different total costs.
Surgeon
Surgical care
Surgeon fees for the agreed procedures and any planned implant or graft work.
Ask your surgeonAsk which procedures are included and how additional surgery or revision would be billed.
Facility
Anesthesia and facility
Anesthesia services, operating-room use and any planned overnight care.
Ask your surgeonAsk whether these are separate bills and what happens if surgery or observation takes longer.
Supplies
Supplies and follow-up
Possible charges for implants, imaging, medicines, dressings and postoperative visits.
Ask your surgeonConfirm what is included, how long follow-up is covered and how complications are handled.
TRC
Patient Services
Any separately offered care-coordination or administrative services.
Ask TRCAsk whether these services are optional, what they include and whether they carry a separate charge.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Is FMS only for transgender men?
No. Transgender men, nonbinary people and others seeking facial masculinization may explore it. Suitability depends on individual goals, health and a surgeon’s assessment, not a single identity label.
Will testosterone create the same changes?
Testosterone can affect facial hair and soft-tissue appearance, but it generally does not recreate surgical changes to adult facial bones. Discuss your hormone plans with the clinicians involved in your care.
Will insurance cover FMS?
Coverage varies by plan and procedure. Ask about medical-necessity criteria, documentation, prior authorization and network requirements. Authorization does not necessarily mean every charge is covered.
Will I have visible scars?
Some incisions can be placed inside the mouth or in less noticeable locations, but every incision leaves a scar. Location and visibility depend on the procedure and your healing.
0 consultation questions in your plan
View in My TRC workspaceMy Aesthetic Plan
Prepare for your consultation
Bring these to help your consultation:
- Agree on the features to change, the features to preserve and realistic limits.
- Confirm the procedures, staging, personal risks and individualized recovery plan.
- Clarify written costs, coverage requirements, follow-up and urgent contact arrangements.
View My Aesthetic Plan
Choices stay in this visit until saving to your account completes. Nothing is sent to a clinician.
Sources
- [1]American Society of Plastic Surgeons: Gender Affirmation SurgeryGender-affirming facial surgery, individualized procedure selection, consultation and general surgical risks.
- [2]American Society of Plastic Surgeons: Facial ImplantsChin and jaw augmentation, implant risks, postoperative care, eating restrictions and warning symptoms after surgery.
- [3]American Society of Plastic Surgeons: RhinoplastyNasal reshaping, breathing considerations, surgical risks and prolonged swelling and refinement.
- [4]American Society of Plastic Surgeons: Dermal FillersNonsurgical contour changes, temporary filler effects and risks including vascular injury, skin injury and vision loss.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.