Although the name might deceive, Facial Feminization Surgery (FFS) is no singular thing. 

FFS encompasses a range of different procedures, all united under the goal of making a transfeminine person’s facial structure more feminine in appearance. Someone undergoing FFS typically opts for several procedures simultaneously, or in consecutive rounds. These include surgeries such as forehead contouring; rhinoplasty; V-line surgery, which tapers the jawline into a “V” shape; and tracheal shaves, which reduce the size of the thyroid cartilage, or Adam’s apple. 

In cis women, some of these procedures might be described as cosmetic. For transfeminine people, research has shown that these procedures can significantly impact quality of life, mental health and even sense of purpose. 
 

How quickly and efficiently a person’s body recovers from surgery is always an individual affair, and that’s especially true for something like FFS. Recovery from rhinoplasty is going to look quite different from recovering from forehead contouring. Dr. Eric Bensimon, a Montreal-based surgeon who has over 20 years of experience with FFS, says the level of post-surgical discomfort can vary, depending on the procedures a patient opts for.
 

“What’s more uncomfortable is the jaw surgery, because it involves scars inside the mouth that can be uncomfortable for eating. Also, swelling tends to be more pronounced with jaw surgery than anywhere else.” 

Dr. Bensimon says that for all FFS procedures, pain is mostly concentrated in the first few days following surgery. Most patients who undergo the full set of the four most common procedures Dr. Bensimon’s clinic offers—forehead, jaw, nose and thyroid cartilage—can expect to be “reasonably functional and presentable” after 10 days. Jeanne Roberge, a Montreal-based PhD student who underwent FFS last December, echoes this.
 

“It was really shitty for the first week. But after that, it’s really fine.” 
 

What recovery looks like can depend on the patient, with some reporting longer and more involved periods of recuperation. Sophie Abromowitz, a New York-based writer, says that she found recovery “relatively substantive,” particularly the procedures involving chin and jaw work. “Everybody’s body heals differently,” Abromowitz says. “I also think [surgeons] don’t want to overly frighten people, or present a ghastly picture, so they tend to err on the more straightforward and short side of things.” 

After the acute healing period is over, it takes several more months for all the swelling to subside and the final results to be achieved. 
 

Preparing your home and other helpful recovery tips

Dr. Bensimon says that in the days following surgery, it’s important to sleep elevated and to use ice packs or cold compresses, particularly for the jaw, to lessen swelling and discomfort. For patients who undergo rhinoplasty, a humidifier in the home can be an ally. “The humidifier is important to compensate for dry air—especially in winter—after a nose job, because of the swelling … and the limited nasal obstruction that occurs,” Dr. Bensimon says. 

You should prepare your home prior to surgery, so that when you return, you can focus on recovery, and not worry about things like cooking dinner or running to the store. “I went to Costco [before surgery] to buy spaghetti sauce and tortellini,” Roberge says. “So I ate a lot of that in the first month.” 
 

Abromowitz spoke to friends who were disabled or living with chronic pain to help her better understand how to set up her life to recover from surgery: “I got tips coming from a different direction, about being in essentially a state of temporary disability.” With these tips, she invested in small, helpful items to make her daily life more comfortable: a rice cooker, an over-bed table on wheels, a modular wedge pillow system and a little basket that she used to bring things from room to room easily. 
 

Supporting someone after FFS

Rest and food aren’t all you’ll need for a smooth recovery. Social support can be very important in the weeks after surgery. Research has shown that with any type of surgery, a robust social support system has concrete impacts on how quickly a person recovers, and even on things like the amount of pain medication taken and quality of post-operative complications experienced. 

Having support is particularly important in the acute period of recovery immediately after surgery. “We don’t want patients to be alone,” Dr. Bensimon says. “They have to have somebody with them, especially for the first couple of nights. It’s important not to be alone at home or in a hotel.” Taking care of someone following FFS doesn’t really require specific nursing skills or medical knowledge; the most important thing is to provide “tender loving care,” Dr. Bensimon adds—and to be around to keep an eye on the person.
 

“What was invaluable for me, honestly, was seeing my friends and thinking about something other than surgery,” Roberge recalls. “I’d spent so much time thinking about it … when I was in recovery, I was just like, ‘Come chill at my house and I don’t want to talk about it that much.’” A month after her own surgery, Roberge spent a couple of days supporting a friend who had also undergone FFS. “My plan was just to be a comedy relief, I was just there to cook food for everyone and show her some shows,” she says. “She was very well surrounded with friends and family. It was sweet.” 
 

Emotional effects of FFS: Recovery might bring up all sorts of feelings

Recovery from surgery might come with emotional and psychological effects in addition to the physical ones. Post-operative depression and anxiety are relatively common after any type of operation: The cumulative impacts of anesthesia, medications, stress and diminished energy can bring on challenging emotions. 

Abromowitz believes that post-operative depression might also be influenced by the necessity of living your life after surgery as though you are depressed: “Spending all day between the bed and the couch, not really eating or sleeping according to your regular rhythm, wearing soft clothes all the time … and then re-engaging with my life while not being at full capacity, and feeling frustration and impatience.”
 

Challenging emotions post-surgery might be more complicated when the operation is transition-related. Trans people may place profound emotional weight on a gender-affirming surgery, which can shift their relationship to their bodies and change how the people around them perceive their gender. This significance, in combination with the anticipation of needing to wait to see what your face is going to look like, might bring up all sorts of feelings. Even when recovery is going well, and they are happy with the results, some people may experience feelings of impatience, or even sadness and grief, because of the intensity of the experience. Roberge says it’s difficult to conceptualize not being able to see what the results will look like until several months after the surgery: “It’s very liminal right now. It’s like restarting a transition. I know the effect is there, but I’m still swollen and tired all the time.” 
 

Reliable information on FFS can be hard to find. Here’s where to look

Finding information about transition-related surgeries can be challenging. Like all transition-related healthcare, the research gaps are significant. It’s typical for trans women to attempt to fill these institutional-knowledge gaps through informal community-based methods like online forums and word of mouth. “I was afraid because it’s a lot of research, and there’s not a lot of information out there,” Roberge says. “You need to look at a lot of Reddit forums, from time to time there’s a podcast … it’s a lot of talking to other trans women.” 
 

Community forums are, of course, imperfect ways to gather information. “I tried to strike a balance in terms of my Reddit exposure because I think that is a great way to do serious harm to yourself,” Abromowitz says, noting that the intense and sometimes conflicting opinions of online users can be overwhelming. “There is a strong bias in terms of who speaks, and what about, on those platforms. When it comes to trans surgeries and gender-affirming care, people can end up with very strong feelings about the route they took being the correct route, and can claim a level of authority that’s unmerited.” 

Consulting with other medical professionals or former patients can be helpful in forming a more complete picture of what to expect from recovery. But it is important to exercise healthy skepticism, particularly with information that comes from people who are not medical professionals. Suggestions and ideas can be brought to your surgeon to get a sense of what they do and don’t recommend. “There is a sort of genie logic to professional practices in the medical field where they won’t be withholding the information if you ask for it, but you need to know what to ask,” Abromowitz says. 
 

Finally, it pays to make the most of your follow-ups. Your surgeon doesn’t cease to have responsibility for you once you exit the operating room: throughout recovery, you shouldn’t be shy about bringing any questions or concerns about your healing directly to them. “I tried to swallow any embarrassment or discomfort that I felt about bothering or burdening anyone, and just be like, ‘I and my insurance are paying a lot for this service,’” Abromowitz says. “This is my body, and it matters a lot to me.”