The average cost of facial feminization surgery (FFS) in the U.S. is $37,566, according to 248 patient reviews on RealSelf.
However, the cost can range from $17,000 to as much as $66,000, depending on a few key factors. Read on to find out why you might pay more or less, and whether the cost is really worth it.
The average cost of FFS for cisgender women is very similar to the cost of FFS for transgender women seeking gender-affirming surgeries. All of these procedures are intended to soften masculine or androgynous facial features, so that they look more traditionally feminine.
Related: Everything You Need to Know About Facial Feminization Surgery
At an initial consultation, your prospective surgeon will recommend a treatment plan to achieve your desired results. This is the perfect time to ask for a detailed, personalized cost estimate that includes all of these line items:
Ask about the cost of any prescription medications, compression bandages, or other recovery supplies you’ll need to purchase yourself, so you can budget for them.
Also, inquire in advance about how your doctor handles the cost of revision surgery, in case you’re unhappy with your results.
These factors will have the biggest impact on the price you pay to feminize your facial features.
A FFS operation includes a combination of surgical procedures, customized for each person based on their aesthetic goals. Each procedure you have will increase your bill.
FFS procedure options include:
When necessary, facelifts and neck lifts can also be incorporated, though these procedures aren’t fundamental to how people perceive the gender of a face.
While having multiple FFS procedures done in a single operation is usually more cost-effective, there is an exception to this rule: if you have so many procedures in one operation that your surgeon advises you to stay overnight for medical observation, this could add hundreds or even thousands of dollars to your bill. During your consultation, discuss what type of combination could be safely done as an outpatient procedure.
Also, don’t be upsold on procedures you don’t need, advises Dr. Toby Mayer, a board-certified facial plastic surgeon in Beverly Hills, California, who specializes in FFS.
Dr. Mayer says that sometimes a single change can make a patient look much more feminine. “Surgery comes with risks, and you should be very careful about being ‘sold’ something you will regret,” he cautions.
If your budget is limited, talk with your provider about which procedures will help soften your features the most, to deliver the greatest return on your investment.
Even if cost is a major concern, look for providers—ideally board-certified craniofacial, maxillofacial, or facial plastic surgeons—who specialize in FFS and perform several feminization procedures each week. Pay special attention to their patient reviews and before and after photo galleries.
While a surgeon may know technically what’s required for a facial feminization procedure, not all of them understand the subtle aesthetic qualities of what truly makes a face look feminine.
An experienced provider with the skill and artistry to successfully capture authentic feminine gender expressions will charge higher fees than one who’s less experienced, or not as artistically or technically skilled. However, you’ll be more likely to get your desired result and avoid the additional cost (and pain) of revision surgery.
You’ll pay more if your surgeon practices in a major metro area, where the cost of living and demand for their services is high.
For example:
If you don’t live in a major city, you may have to travel to have surgery with a top facial feminization surgeon. This will involve extra costs, like transportation and accommodations.
Another factor is the surgical facility itself. Your procedure will be more expensive if performed in a hospital setting versus an ambulatory surgical center, which usually has a lower facility fee.
As we mentioned above, your cost could increase dramatically if you need to stay overnight after your surgery. The likelihood of this increases with the number of procedures you have.
FFS is usually performed under general anesthesia, which is significantly more expensive than local anesthesia.
Why the higher price? General anesthesia has to be administered by either an anesthesiologist (an MD) or nurse anesthetist (a CRNA), who then monitors your vitals throughout your procedure.
You’ll pay a higher fee for an anesthesiologist, but some surgeons insist on using them because they have more advanced training, which can increase patient safety.
A few procedures, such as hairline advancement and cheek or lip augmentation, can be done with local anesthesia and sedation. In these cases, your surgeon may be able to administer your anesthesia, which could save you thousands of dollars.
Facial feminization surgery has a 88% Worth It Rating from reviewers on RealSelf, so most patients who have reviewed their facial plastic surgery results think they were worth the investment.
This customized combination of procedures is especially popular with transgender women who want their facial features to align more closely with their gender identity, but FFS is sought out by many cisgender women as well.
“Masculine facial features can make it difficult for many women to integrate into society, and FFS helps women of all backgrounds to look and feel more beautiful,” says Dr. Carson Hyunh, a board-certified oral and maxillofacial surgeon in Atlanta who specializes in aesthetic facial surgery.
Unfortunately, not all FFS is successful—questions about revision surgery aren’t uncommon on RealSelf. Secondary procedures usually come with a higher price tag, too, because scar tissue can make revision surgery more complex.
Those reviewers who say FFS wasn’t worth it cite poor final results and, in some cases, facial damage.
If you’re on the fence about surgery, there are more affordable, nonsurgical treatment options to feminize the face. For example, Botox can narrow the jawline and injectable fillers can create fullness in the cheeks and lips. For budgeting purposes, keep in mind that most of these contouring methods are not permanent and will require repeat treatments (at additional cost) to maintain the result. Also, your outcome won’t be as dramatic as surgery.
Everyone has a different idea of what’s aesthetically pleasing, so be sure you and your surgeon understand your goals for a more feminine appearance and agree on the best treatment plan to achieve your desired look.
FFS is usually considered an elective cosmetic procedure, so it’s not covered by health insurance.
However, some insurance plans do include FFS coverage for transgender patients. If that’s your situation, contact your insurance provider to find out what kind of documentation they require to submit a claim.
Some surgeons also support their patients in working with their insurance companies. In a recent study, plastic surgeons at the University of California, Los Angeles, were able to obtain insurance coverage for 90% of 40 transfeminine patients with gender dysphoria who consulted for FFS. Doing so was not easy, though. “Navigation of the process is both laborious and confusing,” they reported.
Yes, most surgeons accept financing options to help make FFS costs more affordable. Many also offer monthly payment plans.
“Our ultimate goal after any surgery is not just a better-looking nose or a more feminine jaw—it’s a happy, healthy patient,” says Dr. Bryan Rolfes, a board-certified facial plastic surgeon in Wayzata, Minnesota. “With that in mind, part of the presurgical planning process should include creating a realistic plan for payment, to limit the financial burden as much as possible.”