Preparing for Facial Feminization Surgery

Here are the basics of getting prepared for facial feminization surgery. Most of these guidelines are applicable for going under general anesthesia for surgery of any kind. There is also a detailed guide of how to set yourself up for success before FFS. Check that out here.

Getting Physically Healthy Before Facial Feminization Surgery

Going under general anesthesia can be rather physically intense, so we recommend maintaining a balanced diet and consistent physical activity prior to surgery. Because patients are often sedentary for a short while after surgery, maintaining physical health will help your body to better recuperate after surgery and may help increase your overall mood during recovery.

Here are a couple ways our patients have been able to maintain a healthy lifestyle before and after surgery:

  • Avoid Fad Diets: A ‘fad diet’ is a term that promises quick weight loss (usually through an unbalanced or unhealthy diet). An unbalanced diet means you’re usually cutting out one food group (or multiple), which means you could be losing out on important vitamins. Losing weight quickly may be appealing but can be dangerous for a number of reasons.
  • A Balanced Diet: Focus on eating whole foods, vegetables, and fruit. Avoid sugar, fried food, and processed foods. If you’re currently using government assistance for food, look into your local farmers’ market. A lot of farmers’ markets have a service where you can use your EBT debit card in exchange for coins you can use at the vendors’ booths to buy food. 
  • Personal Trainer or Workout Friend: Finding a trans friendly or trans identified personal trainer or workout buddy can be a great motivator. If financing is a challenge, ask the personal trainer if they offer a sliding scale. Sometimes attending just one session is enough to gain some confidence in different exercises you can do on your own. Don’t forget, you can work out virtually from the comfort of your home.
  • Vitamins: Vitamins help your body heal, which is especially useful when recovering from surgery. We recommend patients start taking 500mg of Vitamin C daily starting at least one week before facial feminization surgery. Vitamin C can irritate bowels, so start slow. Additionally, you’ll have to limit your Vitamin E intake 7-10 days before your surgery.

Emotional Help & Support Post Facial Feminization Surgery

Here we’ll go over briefly how to set yourself up for success before facial feminization surgery and the level of support that may be most beneficial to you post-op.

  • First 24 hours: With any surgery during which you are put under anesthesia, you need to have someone pick you up and stay with you for the first 24 hours. This can be really challenging financially or for other reasons. 
  • After the first 24 hours: The reality of recovering from facial feminization surgery is that you’ll want someone around for at least the first couple of days, if not the whole 7 days after surgery. This is not to say that you will need their assistance 24 hours a day (except for the first 24 hours after surgery), but company throughout the week can go a long way in a happy recovery. If you have a support network, reach out and let them know what you need. Remember that patients usually have some swelling around the eyes and will likely experience other activity and lifestyle restrictions following facial feminization surgery, so the more help you have, the better. If you don’t have a support network, check out some content on support groups here.
  • Dr. Facque will give you instructions on how to reach our office after surgery if any urgent needs arise.

Stop Hormones Before Facial Feminization Surgery

  • Because of increased risk of blood clots and deep vein thrombosis (DVT) after surgery associated with feminizing hormones, we ask all of our FFS patients who are on HRT to stop the use of estrogen and progesterone 2 weeks before surgery. We also ask that all patients walk a few times each day (as soon as you’re able) to further reduce the risk of blood clots and DVT. 
  • Patients can resume their HRT regimen one week after surgery, or, if flying for surgery, once they have returned home. Spironolactone can be continued up until surgery and afterwards but must not be taken the day of surgery.
  • We understand that stopping the use of estrogen and progesterone for this period of time can be accompanied by emotional changes and other short-term physical and mental side effects. If you are concerned about this, please speak with Dr. Facque to learn more.

Stop Smoking Before Facial Feminization Surgery

  • All cigarette smoking and nicotine use must be discontinued 6 weeks before and 6 weeks after facial feminization surgery. If you’re a nicotine user, please read this content.
    • No smoking, no patches, no vaping, etc.
  • While different surgeons have different policies about the use of medical marijuana, we ask our patients to switch to edibles or tinctures for the 6 weeks before and after surgery to eliminate any smoking during this time.

Stop Drinking Alcohol Before Facial Feminization Surgery

  • You must stop alcohol one week prior to surgery and may not resume drinking alcohol until one week after surgery. Drinking alcohol while taking prescription pain medication is extremely dangerous and is not permitted.

Stop Other Drugs Before Facial Feminization Surgery

The following drugs have to be stopped 6 weeks before and 6 weeks after FFS unless approved for medical use by a doctor. If necessary, stick to the prescriptions your surgeon supplies you with for pain management. 

If you use or your doctor has prescribed any of the drugs listed below, talk to your surgeon and primary care physician about how they will affect you before, during, and after surgery. Additionally, always disclose the drugs you are currently using (whether prescribed or un-prescribed) to your surgeon or other medical healthcare professionals who ask for your drug use history. We strive to remain judgment-free and our first priority is your continued physical mental and physical health.

  • LSD & Psychedelics
  • Meth
  • MDMA (ecstasy & molly)
  • Cocaine
  • Ketamine
  • Oxymorphone
  • DMT
  • Carisoprodol (Soma)
  • Lorazepam (Ativan)
  • Morphine
  • Buprenorphine
  • Heroin
  • Zolpidem (Ambien)
  • Diazepam (Valium)
  • Clonazepam (Klonopin)
  • Methylphenidate (Ritalin)
  • Methadone
  • Tramadol
  • Alprazolam (Xanax)
  • Oxycodone (OxyContin)
  • Amphetamine (Adderall)

If you’re struggling with substance abuse and need assistance, please contact the 24/7 national hotline SAMHSA (Substance Abuse and Mental Health Services Administration) at 1-800-662-HELP (4357).