The First Week After Facial Feminization Surgery
As I binge-watch another episode of "Yuri!!! On Ice" (a BL anime about figure skating) from the living room leather recliner, I temporarily forget that my face looks like I got my ass whooped in a bad fight. No, I'm just fresh out of an 11-hour surgical procedure in pursuit of heightened femininity.
Dr. Seth ran me through our procedure four times over the course of eight months. I thought I understood everything perfectly. Hairline advancement, forehead reduction, eyebrow lift, orbital contouring, etc., etc. He also mentioned that breathing would be difficult the first week, and I'd need to sleep on a 30-degree incline for 14 days.
When it comes to big life decisions, my brain is the hare and my body is the turtle. My brain assimilates information like a first-generation immigrant in America– quickly, completely, and defensively. But just because we understand something does not make it true in our blood. I can imagine and conceptualize the process of shaving bone and moving skin, but until I've gone through it myself, that feeling is empathy without experience.
For better and for worse, I've used the copious time this first week to reflect physically and mentally on the lived experience of surgically feminizing my face. Many of the things that other dolls told me I would experience were true, and many more things were completely new. So I've written them down as a reminder to myself and a note to dolls who will walk the same path down the line.
5 Things I've Learned in the 1st Week Post-FFS
1. Listen to Your Body.
The black face compression garment snatches my cheeks and jawline upwards, but then I can't breathe. My bottom lip is so swollen that it presses against my top lip and closes my only breathing hole. My nose is held in place with plasters on the inside and a cast on the bridge.
This first week will be an insane rollercoaster ride for your body. Depending on how long your surgery took, the anesthesia marinade will linger in your body for two to three days post-procedure. This will give you the false impression that the surgery wasn't so bad after all; my famous last words before the anesthesia wore off. On day two, I ventured outside to the backyard and inhaled a huge gulp of freshly-rained air. The cold breeze was like a mint for my lungs. I shuffled through the garden slowly, visualizing the negative ions from the trees entering my body. I imagined my cells rejuvenating their strength to continue the healing process. I even texted a friend, "I'm actually doing great!" Joke's on me.
Without it, I started to feel the pain from my scalp to my chin at their respective full capacities. My head felt like I was wearing a bike helmet that was two sizes too small. The backs of my eyes hurt. My nose hurt. My chin, jaw, and the inside of my mouth were sore and inflamed.
Throughout this physical journey, I've come to realize that the best time to listen to your body is when it's in recovery. Does your body want to nap? I started to religiously drink a mango-turmeric lassi. The antibiotics I was taking were killing all the bacteria in my body. Naughty or nice, it didn't matter. My physician assistant had suggested yogurt as a way to replenish the bacteria in my gut. I probably eat yogurt once a year, if that, but with the mango puree packets my mom bought from Costco, I could combine forces and make a better, tastier creation–the lassi. I added a few spoonfuls of yogurt to the blender, a full packet of mango puree, sometimes even a little mango sorbet (!), soy milk (for the estrogen, obvi), and a half teaspoon of this turmeric latte blend I found hiding in the back of the cupboard. Blend that for a minute. The moment I took a sip of my golden smoothie, a wave of energy entered my bloodstream, travelling from my mouth to the top of my head. This was it. I heard my body's message loud and clear.
And the secret part of listening to your body is to lower the volume of your brain. Ego and Pride are two of the loudest voices inside our heads that talk over the body. During this first week of recovery, it's important to let your hair down and your brain chill.
2. Fall Back Onto Your Support System.
Speaking of ego, recovering from major surgery is definitely not the time to be Miss Independent. In fact, most (good) doctors won't proceed with your facial feminization surgery unless a support system is confirmed for post-procedure. It's that serious. Fortunately, life brought me back home to my parents' house a year before my surgery, as if the universe knew I would need my best team with me for this life-changing moment. And I've found that the more I let go, the easier it is for them to help me.
If you're living alone, I recommend having one or two consistent friends, family members, or people you trust check in on you and support your recovery. Keeping you on schedule for your five different prescriptions throughout the day. Cooking or heating up food. Blending smoothies for you. Picking up Arnica tablets or a Costco-size package of soymilk during this first week. Laundry and cleaning. If there are friends who can't give you their time, maybe they can donate $20 or order food for you.
3. Your Prescriptions are not The Only Healing Tools.
Your surgeon or maybe a physician assistant will send you care instructions for your recovery along with prescriptions for painkillers, antibiotics, and steroids. It's important you listen to them. These are not optional medicines for you to take when you feel like it, except for the oxycodone if you're given that. Don't get too reliant on it. Your doctor should only prescribe you the minimum dose necessary for that first week or so of recovery. Opioids are no joke.
At the same time, these pharmacological drugs aren't the only ways for your body to heal. Take a step back from Western medicine, and there is Eastern medicine, Traditional Chinese Medicine, and sound healing. Growing up with a mother who prescribes plant and herbal remedies for all types of ailments means that I always had a foot in the door of Eastern Asian medicine, whether it be the Rhodiola capsules I discovered worked for my anxiety or the detox teas I would drink, thinking I had something to purify. This recovery was no exception. I drank pine extract and dried powder made from 12 different herbs and plants. I also started to look into sound therapy, drawing on my knowledge from yoga teacher training, and found out about Solfeggio frequencies. These are specific musical tones that promote healing, a balanced mind, and even less stress. 174hz is the best for pain relief. So I put on my headphones and listened to a nine-hour YouTube video of that frequency during my naps/closed-eye sessions. It may have just been a placebo, but I did feel some distancing from the pain. In Japanese, there is a saying that basically translates to, "Those who believe are saved," and that's exactly it.
While you're lying down for your 2 pm nap, try playing some Solfeggio frequencies, which are a category of sonic wavelengths that promote mental and physical wellness. 174hz is best for pain relief. If you take a walk in your neighborhood, hug a tree, or sit among the trees for a minute or two. Ask for hugs from those you trust and feel the power of human touch. [CUTTING - redundant with what you just wrote] During this first week, one of your biggest jobs will be to remind your body it's safe.
4. Hello Hunger, Goodbye Sleep.
I hate being hungry, and I love sleeping well. The dolls had told me about the two-week liquids diet, "It's rough. But you'll look so snatched afterwards! Waist? Gone." Well, yes. I can confirm that what they said is true. If you're getting anything on the bottom half of your face revised for your facial fem, chances are that just opening your mouth will be a struggle. For this first week, my only utensil was a spoon from which I could slurp up my food like a primordial bacterium. My lips were too swollen to sip from a straw, and there was no chance I would be able to chew anything I could stab with a fork. Luckily, my mother cooked different kinds of porridges and soups, so I'd at least have some flavor and minor textural variety. Even though my blocked nose prevented me from enjoying the taste of most foods, I'd still pick up on the general taste of foods, whether it be broccoli soup or pumpkin soup. Texture was important for me. Pureed soups get pretty boring after a while, so my mom tried adding cut-up noodles or boiled-down veggies to add some more excitement to my otherwise baby food. And honestly, this first week, the appetite isn't really strong since the body will be busy processing and healing from the trauma.
This trauma that your body didn't sign up for will make sleep feel like an impossible task. There's also the 30-degree incline you're instructed to sleep at for the first two weeks. On top of all that, while you sleep, your brain processes everything that's been happening, which includes the cutting, shaving, and stitching. For me, personally, I couldn't sleep more than 2-3 hours at a time. Oftentimes, especially at night, I'd wake up drenched in my own sweat, droplets rolling down my neck and inner thigh. After three cycles of this from 10 pm to 6 am, I'd give up on sleeping and get out of bed. Usually when I woke up from sleep, I'd drink some water and take some painkillers depending on how bad my head hurt. Other times, I'd wake up hungry. I heated up soymilk or premade hot chocolate that I could drink in the night to carry me over until morning. All I could think about in these moments was satisfying my needs and how crazy of a procedure I signed up for. Every night I woke up was a reminder that I was just getting started in recovery. The psychological struggle of knowing you should be sleeping to heal, while not being able to sleep, is a cruel part of this journey I wasn't ready for.
5. Days Three to Six are The Worst.
After the anesthesia wears off after the first couple of days, you'll enter hell. The constant pain will exhaust you physically, the sleepless nights will tire you out mentally, and knowing that this road to your new face has only just started might bring you down to rock bottom. On day five, I woke up at 3:00 am and couldn't fall back asleep. I was staring at the ceiling, and this thought came into my head: "What if I did all this and I end up looking worse?" I felt empty in my brain and body, like I'd pulled an all-nighter. For the first time since the surgery, I wondered if I'd made the right choice.
Fear not, as many other dolls have echoed the sentiment that days three to six are the worst days of your recovery. This is where taking care of yourself becomes even more critical. Make sure you're nasal rinsing three times a day. Keep applying that Aquafor to your scars. Stay hydrated and well-fed. If you can get through this part, it will get better. Well, it might get worse in other ways, but this is a marathon, not a sprint, remember. Most doctors and dolls will say that their face didn't settle in until six months to a year out from surgery. Good things don't come easy, and a new face is definitely going to take some time.
Most importantly, during this first week, I internalize the necessity of self-affirmation. Without beating around the bush, I look awful this week. When I catch my reflection in the bathroom mirror every time I squirt saline up my nose or put Aquaphor on my lips, I don't recognize myself. A stranger is staring back at me. Swollen, bruised, and expressionless.
My trans sisters who'd gone through this process weren't lying. My hairstylist from when I lived in Los Angeles was the first one who told me that days three to six would be the worst. The girls in the comments of TikTok videos about the procedure jokingly framed the slimmed-down figure from the liquid diet as a positive side effect of not being able to chew for two weeks. They told me napping would be better than trying to get six to eight hours of continuous sleep. They were right about all of it.
And now, on day seven, I write this down for the dolls who come next. We can read all the Reddit threads and watch every YouTube video, but until we're the ones bandaged and barely able to speak, we won't truly know.
What I know now is: Recovery is brutal. Your face will feel like a stranger's. Sleep will be impossible. You'll question everything. But you'll get through the first week. And when you do, you'll write your own version of this, adding details I missed, correcting things I got wrong, passing the torch to the next doll in line.
That's how we make it through as a community. One week at a time, one doll at a time, telling the truth about what this actually costs.