Before Facial Feminization Surgery

The following suggested items may be helpful to you, depending on your unique surgery plan. Go over them now and make a list of those items which apply to your needs. Remember that after facial surgery there is a strong likelihood of swelling around the eyes and other post-op mobility restrictions due to the intense nature of FFS, so we recommend setting yourself up for success (as much as possible) before your surgery date.

If you are uncertain of any of the items below, please contact one of our staff members.

From the pharmacy/drug store:

  • Prescription medications that Dr. Facque will prescribe for you including pain medications, prescription mouthwash for mouth incisions, stool softener
  • Throat lozenges and cough drops 
  • Lip balm
  • Mild shampoo for use after scalp or facial surgery
  • Breath mints or mouth spray
  • “Sensitive” labeled mouthwash for rinsing out oral incisions (use prescription mouthwash for first two weeks, then switch to over-the-counter mouthwash)
  • Moisturizer
  • Petroleum jelly (Vaseline, Aquaphor, Bacitracin)
  • Antacid if you have a sensitive stomach
  • Ultrasonic humidifier (especially helpful following nasal surgery)
  • Acetaminophen (Tylenol if an over the counter pain medication is needed prior to surgery, any NSAIDs like Ibuprofen/Advil aren’t allowed in the week leading up to and following surgery)
  • Saline eye drops to moisturize eyes after surgery, i.e., Natural Tears, ReFresh

For Your Recovery Area (we recommend keeping these items next to your bed on a nightstand or bedside table):

  • Warm socks or booties with traction on the bottom (to help avoid any slips)
  • Night light
  • Bib (to protect your clothing when eating in bed)
  • Child’s covered cup or flexible straws with cup or glass
  • Paper towels and tissues
  • Trash bags (at bedside)
  • Baby wipes (for quick clean ups)
  • Pencils / pen / paper
  • Towels
  • Older sheets (softer, less likely to cause creases or irritation of the skin)
  • Cetaphil soap substitute (after facial surgery)
  • Rolled bath towels (use behind your neck after facial surgery)
  • Prop yourself up with a couple of pillows to be in a reclined position. It is recommended to place a pillow under your knees for better circulation.

Suggestions for setting up your room:

  • Remove anything you might trip over
  • Keep your phone near your bed, but be sure to take time to rest and not answer calls if needed. Keep emergency phone numbers handy (doctor, pharmacy, etc.).

Six Weeks Prior to Surgery

  • If you have recently been or were previously a smoker, then it is very important that you don’t smoke even a little bit during this time. We ask all our facial feminization surgery patients not to smoke cigarettes or consume any other nicotine products (vaping, gum, patch, etc.) for 6 weeks before and after surgery. If you are a marijuana user, switch to edibles or tinctures during this time.
  • Do not have any laser hair removal or electrolysis performed within 6 weeks of surgery as this will irritate the skin and affect the surgery. You may resume 4 weeks after surgery. 

Two to Three Weeks Prior to Surgery

  • You will usually have your preoperative visit and lab work done about two weeks before surgery. Note that there may be additional costs for laboratory work, particularly if anything discovered in the medical history warrants additional testing. Surgery cannot be performed without the required laboratory results in order to ensure your safety during the operation.
  • Please be sure we have a reliable phone number to reach you in the time leading up to surgery.
  • Patients who are on hormones (estrogen and/or progesterone) must stop their HRT regimen two weeks prior to surgery to decrease risk of blood clots and deep vein thrombosis. Patients will be allowed to resume their HRT regimen after their first post-op appointment or after they have traveled home (if flying). It is ok to continue spironolactone.

One Week Prior to Surgery

  • You will receive your prescriptions about 1 week before surgery. Make sure to have post-operative prescriptions filled.
  • Maintain a balanced diet and drink water regularly.
  • No alcohol intake (including wine) for one week prior to surgery.
  • No dental work within a week prior to surgery, including teeth cleaning.
  • Arrange for transportation to and from the surgery center and your first post-op appointment. 
  • If applicable, arrange for child care, pet care, and mail pick-up.
  • Refer to the “Comfort Station” items above. Shop for regular household items and any extras you may need for your recovery.
  • Avoid coloring your hair three to five days before surgery and not until four to six weeks after your surgery, with your doctor’s approval.
  • If you are having surgery on the forehead or brows, do not get your eyebrows shaped as this can affect the post-op result.
  • Please tell Dr. Facque all herbal supplements and other medications you are taking.
  • TAKE VITAMIN C: Start taking 500 mg of Vitamin C twice daily to promote healing.
  • DO NOT TAKE ASPIRIN OR IBUPROFEN: Stop taking medications containing aspirin or ibuprofen. Review the list of drugs containing aspirin and ibuprofen carefully. Such drugs can cause bleeding problems during and after surgery. Instead, use medications containing acetaminophen (such as Tylenol).
  • LIMIT VITAMIN E: Limit your intake of Vitamin E to less than 400 mg per day.

Review this article for a list of herbals supplements not to take before surgery as they may increase bleeding.

One to Three Days Prior to Surgery

  • Set out clothing that is loose and buttons or zips up the front. A warm-up or jogging suit is ideal. No pullover tops should be used for three weeks after facial surgery.
  • Do not eat or drink anything after midnight the night before your surgery. Your stomach must be empty to decrease nausea and avoid anesthesia problems. When brushing your teeth, you may use mouthwash. You can take your routine medication with a sip of water.
  • Most FFS patients stay overnight in the hospital, so please bring the following:
    -cellphone, wallet, other essential items/documents

-all prescription medications

-small overnight bag to hold the clothing you wear to the surgery facility
-tooth brush, toothpaste, and/or mouthwash

  • It is recommended you bring the following, in the very rare event that you will stay two or more nights:
    – bathrobe, pajamas, or gown that buttons up the front, and slippers

The Morning of Surgery

  • DO NOT eat or drink anything prior to surgery. You may take regular prescription medications such as blood pressure, thyroid, etc. with a small sip of water. Be sure you do not take any aspirin-containing products, blood thinners, etc. Bring your prescription medications with you to the hospital or surgery center.
  • You may shower and wash your hair, but do not set or spray it. Do not use facial or body moisturizer. Do not shave the morning of surgery. Brush your teeth with minimal water and use mouthwash.
  • Wear flat shoes that are easy to slip off.
  • You should not wear panty hose or girdles, and should not wear make-up. In addition, please do not wear jewelry, earrings, rings, or hairpins, or false eyelashes. It’s best to leave all of these at home.
  • If you wear contact lenses, eyeglasses, or dentures, bring your cases with you. Be sure your name is on the outside. Bring your glasses if you wear contact lenses as contacts might not be comfortable to wear for the first few days after surgery.
  • Arrive in the admitting department of the hospital or surgery center two hours before your procedure is scheduled to begin, or when you have been directed. The surgery center staff will greet you and prepare you for surgery.