Facial Feminization Surgery Recovery

As with any surgical procedure, there are recovery milestones that patients will go through following facial feminization surgery. Because there are many procedure options available under the umbrella of facial feminization surgery, the following is an approximation of what one is likely to experience. Please contact Dr. Facque to learn more about the post-op recovery milestones as they apply to your specific set of procedures.

VERY IMPORTANT: If you have excessive bleeding or pain, call Dr. Facque at (415) 780-1515. You can reach Dr. Facque day or night by calling the normal office line.

YOUR FIRST 24 HOURS: A family member or friend must drive you home from the hospital. Someone should stay overnight with you for the first few nights. If you have any questions, please ask one of our nursing staff members.

DRESSINGS: Keep your dressings as clean and dry as possible. Don’t remove them unless instructed to do so.

ACTIVITY: Take it easy and pamper yourself. Try to avoid any straining. You may go to the bathroom, sit and watch TV, etc., but NO MATTER HOW GOOD YOU FEEL, DO NOT CLEAN THE HOUSE, REARRANGE THE ATTIC, ETC.!  We do not want you to bleed and cause any more swelling and bruising than is unavoidable. It is possible that this could result in an emergency that would require treatment in an emergency room or even the operating room. Importantly, in the long term, bleeding after surgery can lead to complications that may affect your result!

ICE PACKS: Cold or ice packs help to reduce swelling, bruising, and pain. Use frozen peas in the package or crush ice cubes and put the ice into a zip-lock bag. This should help, not hurt. If the ice feels uncomfortable, don’t use it as often. Before placing against the skin, put a cloth between your skin and the ice. Also, check the temperature on the back of your hand before placing it on the area you were operated on; sometimes you can inadvertently hurt your skin if you don’t check the temperature before placing it on the affected area. Some areas of the face and neck will be numb after surgery, which can also lead to injuring yourself with ice packs without realizing. So, do not use ice packs for more than 20 minutes at a time. Set a timer if necessary.

SHOWERING: You may shower after surgery as long as you keep the face and neck dry. Water splashing on the face is ok, but do not run your hair or face under the water until after your first visit with Dr. Facque. At that time, he will take down your dressing(s), inspect the surgical area(s), and give you the go ahead to gently wash your hair.

SMOKING: Smoking reduces capillary flow in your skin. We advise you not to smoke at all or consume other nicotine products during the first 6 weeks after surgery. Marijuana use should be restricted to edibles or tinctures during this time.

ALCOHOL: Alcohol dilates the blood vessels and could increase postoperative bleeding. Don’t drink until you have stopped taking prescription pain pills, the combination of pain pills and alcohol can be dangerous. Wait at least one week to drink alcohol after surgery.

Practical Milestones After Facial Feminization Surgery

First 7 days:

We recommend sleeping with your head elevated and keeping snug compression garments on the face as much as tolerable for the first week after surgery. This will help reduce swelling, although some swelling will still occur and will last to some degree for up to  6-18 months depending on the amount and types of procedures performed. Please maintain a low-sodium diet. You may notice swelling and bruising develop around this time, likely around the eyes, cheeks, and nose. It may feel hard to see, breathe through your nose, or consume more than liquids during this first week. Swelling and bruising may get worse for the first few days before they start to resolve.

It is also important to go on daily walks to reduce the risk of blood clots. For the first week, just walk around your house. Take care to avoid stairs, cluttered areas, loose rugs, and any other obstacles that could result in slips, falls, or injuries while you’re taking narcotics or have increased swelling around the eyes.

Be sure to go to your first post-op appointment approximately 7 days after surgery.

Once you’ve passed the 1 week point, you may be able to drive as long as you are off prescription pain medication and feel safe doing so.

First 14 days:

As your incisions heal, you may use Aquaphor, Bacitracin, or Vaseline to keep them lubricated. Refer to our scare care instructions for more detailed information on helping your scars heal. Plan to continue going on several short walks per day. This will help your body recuperate from anesthesia and help prevent any blood clots from forming. If you have incisions in your mouth from jaw contouring or other procedures, please eat a soft diet for two weeks to help your mouth incisions heal as quickly as possible.

First 21 days:

No heavy lifting or bending over should happen within the first 3 weeks of healing. If you had a frontal sinus setback, you will be on sinus precautions for the first three weeks, which additionally includes no nose blowing during this time.

Once you’ve passed the 3 week point, you may begin to treat your scars with silicone. At this point you may also resume light physical activity. You may get in a pool and bathe as long as your incisions are closed.

6 weeks post-op:

Patients may resume full activity at this point, other than competitive/contact sports or any yoga/stretching with prolonged inversions. While some patients may return to work sooner than this point, Dr. Facque recommends patients begin resume work and other lifestyle activities at this time. Generally speaking, Dr. Facque will not write a work notice for longer than 6 weeks after surgery.

Continue to care for your incisions using our facial feminization surgery scar management guide. Keep scars out of the sun, continue to massage them, and continue use of silicone gel.

After this point, your body will continue to heal, swelling will continue to go down, and incisions will continue to fade. If anything feels painful, strange, unexpected, or just “off,” please get in touch with our office to talk about what you’re experiencing.