Being Ready for the Ups and Down During Recovery

Being ready for the ups and downs during recovery will hopefully help you navigate your journey through surgery in a more positive way. Overall, reconstructive surgery is a hugely positive experience in one’s life. But in addition to having feelings of celebration about what’s to come, it’s important for us to touch a bit today on the possibility of a temporary feeling after surgery that is called “postoperative depression.”  This melancholy is actually common after all types of surgery but warrants some special discussion for gender surgery.

Postoperative depression does not affect everyone, but when it happens it can be confusing. This is because people understandably think that emotions after surgery should be universally positive, but that is not always the case at first. There are a variety of reasons that sadness can occur after surgery: some reasons are physiological and metabolic, some are psychological, and some can even be from having too much time on one’s hands to ruminate about life’s challenges.

If one thinks about the natural world and how animals respond to injury, a period of postoperative depression makes sense.  The body registers surgery as a type of ‘wounding’ from which it needs to recover.  In the wild, when animals are wounded, they hunker down and hide in a cave or hidden area until they have recovered and are ready to brave the wild again.   After surgery our emotions can kick in and tell us “it’s time to dramatically lower your energy output for a while so you can get better,” which we interpret as feelings of sadness and low motivation.

If feelings of postoperative depression occur for you, it’s important to note that these feelings are normal and tend to go away by the end of the second or third week of the recovery process. Shortly thereafter, those feelings will begin to be replaced by happiness and confidence.

Your support system

Undergoing an elective procedure takes courage, and it is important to have a strong support system in place to aid you through your recovery. The person or people caring for you should be warm, encouraging, and ideally not critical or afraid of the healing process, as you will truly need their support during this time.

If you have a therapist…

In the modern world, many people see a therapist on an ongoing basis. If you are currently seeing a therapist as part of your support system, then it is a very good idea to plan a session about 7-14 days after your surgery date, in case symptoms of postoperative depression occur to you. Even though these feelings are transient, it can be really helpful to talk about them.

Below are some timelines to further explain what you may experience post-surgery:

Emotional Roller Coaster


  • The Day of Surgery: Tired, ‘out of it’
  • 2–7 Days Post-Surgery: Anxiety, sadness, irritable, doubting decision to have surgery
  • 8–14 Days Post-Surgery: Hyper-critical, impatient, scared, eager for the recovery period to end
  • 15–21 Days Post-Surgery: Noticing results, feeling more positive, more confident in your decision to have surgery
  • 1 Month Post-Surgery: Boost in confidence, happy you went through with it, getting positive reactions from others
  • Beyond: Results keep improving as healing continues

Nature Healing Curve

This diagram will help you understand the timeline and pace of healing’s progress.


Physical reactions: swelling

Many patients ask when the swelling will go away. This curve will help you understand that gradual process.