Bruises and Swelling

Understandably, most facial feminization surgery (FFS) patients will be eager to see their final results quickly, but a healthy and full recovery from FFS takes time, care, and preparation. By closely following our post-op guidelines, you will certainly be able to speed up recovery, but you will not be able to avoid the process entirely. It is normal for bruising and swelling to result in short-term feelings of discomfort and dissatisfaction during the initial stages of the recovery process. There are six tips our expert surgical team can offer to help you manage and reduce bruising and swelling.

Post FFS Bruising and Swelling Timeline

Swelling and bruising after any surgical procedure is completely normal. Every patient’s unique surgery plan will impact their healing timeline and the extent to which they experience swelling and bruising after FFS.

Usually, bruising after FFS peaks 48-72 hours after surgery and will last for about 2 to 3 weeks. Bruising will most often appear under the eyes, even if the patient did not have any eyelid or orbital bone procedures. This is because the bruises will travel down the face from forehead surgery and extend outward from rhinoplasty.

Swelling after FFS may last longer depending on the amount and location of procedures a patient had. Generally, swelling increases as you move down the face, in part due to gravity and other natural healing processes that happen during recovery. Similar to bruising, swelling will peak between 48-72 hours or on day 3 after surgery and will gradually start to reduce from there. About 80% of the swelling reduces after the first month, though it can take between 9-12 months for swelling to resolve entirely. This means that especially the final results of procedures like the mandible contouring won’t be visible until about a year after the operation as its form will continue to reduce until then.

Six Essential Steps to Manage and Reduce Bruising and Swelling

In addition to following the general post-op recovery guidelines, there are several steps that a patient can take to reduce the impacts of swelling and bruising after facial feminization procedures:

  • Sleep at an incline: Patients who sleep with their head elevated above their chest for the first week after surgery may experience less swelling than patients who sleep either flat on their backs or stomachs or who sleep on their side. 
  • Avoid leaning over: This will help prevent fluid from rushing to the head, which can help reduce swelling and bruising as well as hematomas and other surgical complications.
  • Stop smoking and using nicotine products: Cigarette smoke, along with use of any other tobacco or nicotine products, will delay healing and can increase your risk of undesirable scars, infection, and tissue death. Patients are required to quit tobacco and other nicotine products at least six weeks before their procedure and must continue to be tobacco and nicotine free for six weeks after surgery. Similarly, patients who use marijuana are asked to switch to edibles and oil during this time.
  • Avoid certain medications: Anti-inflammatory medications, blood thinners, and certain over-the-counter supplements can delay healing and increase the risk of post-surgical bruising. You should provide Dr. Facque with a detailed list of medications and supplements you’ve taken in the last month to determine if they must be discontinued.
  • Low sodium diet: A high sodium diet can cause your body to retain water, which can delay healing. A low sodium diet (1500 mg or less per day) in advance of your procedure and especially in the week or two following can minimize post-surgical swelling.
  • Natural healing remedies:  We frequently recommend Arnica Montana and Bromelain to patients to reduce bruising, swelling, and pain.

Expectations and Satisfaction After FFS

It will take time for your face to heal completely following facial feminization surgery. Because of the swelling and bruising that will follow surgery, we recommend you not begin to assess your appearance until about 6 months after surgery. After this point, you will have a good idea of what your face shape will look like, but it may be 12-18 months before results from facial surgery are completely visible.

Each patient responds to surgery uniquely, and we recommend that you have patience with the healing process. Some patients may experience prolonged swelling and bruising, and for the most part, this is completely normal.

Check out the following articles to learn more about the emotional recovery from FFS and how to care for visible scars after surgery.