FMS is a type of gender affirming medical care. It’s not one specific procedure but a group of different surgeries often performed by different specialists. FMS procedures may include jaw contouring, cheek augmentation, and rhinoplasty.

Some transgender men and transmasculine people assigned female at birth (AFAB) pursue FMS and other gender affirming procedures. That said, not every trans person wants or receives facial surgery.

Cisgender men — that is, people who identify with the male sex and boy gender they were assigned at birth — might also want facial surgery to make certain features look more traditionally masculine.

Your surgical strategy ultimately depends on your specific aesthetic goals. FMS may involve adjusting the following facial features:

Not every person who undergoes FMS gets the same procedures. For example, one person might have forehead augmentation as part of FMS, and someone else might decide not to.

FMS is done to make the face look more masculine, which can have several benefits.

For example, it can help people feel more comfortable with how they look and possibly reduce a type of psychological distress called gender dysphoria.

When left untreated, people with gender dysphoria may experience mental health complications. Feeling comfortable in your skin can enhance your self-confidence and mental health.

FMS may also help trans people “pass” around others. Given that transphobia is still prevalent, “passing” can help someone feel safer.

Transgender men and transmasculine people might want FMS. Cisgender men might also want cosmetic surgery to make their faces look more masculine.

The requirements for surgery might differ from one surgical practice to the next, but generally, you might be a good candidate for FMS if:

  • you’re old enough to consent to the surgery
  • you’re mentally well enough to consent
  • the bones of your head and face are finished developing
  • you don’t have a health condition that makes surgery particularly risky

You may need clearance from a psychiatrist, general practitioner, or both to undergo this surgery.

FMS can cost anywhere between $1,000 and $20,000, sometimes more.

The cost of FMS depends on several factors, including:

  • the exact procedures
  • the number of procedures
  • your surgeon’s experience

The costs include:

  • prescription medications
  • blood tests
  • imaging tests
  • surgeon’s fee
  • hospital fee
  • anesthesia

You’ll need time to rest and recover after the surgery, so you also need to consider whether you can afford to take time off work or school.

Your insurance might cover part of the costs of FMS. Although Medicare covers some gender affirming treatments, it doesn’t usually cover facial surgery.

The following patient assistance programs may cover FMS:

If you’re in touch with a local nonprofit or community-based organization that supports trans people, you could ask them if they know of any patient assistance programs in your area.

Before the procedure, your treatment team will likely perform a thorough assessment. They might assess your:

  • mental health
  • physical health
  • medical history
  • allergies
  • current medications

Your treatment team will also discuss the surgery with you, including:

  • your goals for the surgery
  • what happens during the procedure
  • what to expect
  • how to take care of yourself during recovery

You’ll likely have to take imaging scans, specifically X-rays or CT scans, before the surgery.

The exact procedures and techniques depend on which facial features you’d like to adjust.

Generally, this is what happens during the following procedures:

  • Adam’s apple surgery: Using cartilage from other parts of the body, a surgeon can create an Adam’s apple on your throat.
  • Cheek surgery: A surgeon can make your cheeks look more angular by adding implants or fat grafting.
  • Forehead surgery: This can involve making the forehead larger or flattening the brow ridge.
  • Jawline surgery: Using implants, your surgeon could make your jawline look more angular. They could also make your chin look more pronounced.
  • Nose surgery: Surgeons can make your nose larger or broader using bone grafting or cartilage from other body parts.

Before you undergo surgery, your surgeon and care team will explain exactly what happens during the surgery and what outcome to expect.

The risks depend on the exact procedure. General risks may include:

  • anesthesia side effects
  • bleeding
  • facial swelling (edema)
  • infection
  • implant migration (where an implant shifts out of place)
  • nerve damage
  • numbness
  • unsatisfactory results

Your care team will tell you how to look after yourself after surgery to reduce your risk of complications.

You may need to stay overnight at the hospital, although this isn’t always necessary.

After your surgery, you might experience pain and swelling. You will probably also have noticeable bruising and incision marks.

The recovery period depends on your overall health and the nature of the surgeries you had. However, you’ll likely have bandages and wound dressings for at least a few days. You might also have surgical drains, which help fluids drain from your face.

You’ll need to rest after surgery and will likely need to take time off work or school. Your care team will tell you how many days you need to rest.

Your care team will prescribe pain medications to help manage discomfort after your surgery. They will explain how to use the pain medication and how often you can use it.

If you feel that facial surgery will enhance your quality of life, it’s worth taking the next step and consulting a professional.

Together with a trans-friendly healthcare professional, you can discuss your goals and figure out whether FMS can form a part of your plan.

There are several ways to find an affirming healthcare professional in your area. For example, you can:

  • check out the World Professional Association for Transgender Health’s online directory
  • view OutCare’s online directory
  • contact your insurance provider to ask whether they have a list of in-network gender affirming healthcare professionals
  • book an appointment through an LGBTQIA+ telehealth service, like Folx, Plume, or QueerMed

Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.