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Recovery after FFS

What will my recovery from FFS be like?

Table of contents:

After your FFS, you will stay in the guesthouse at the clinic for a week to get back on your feet. We will help you follow your post-operative instructions if necessary. During the first few days after your surgery, we will make sure you have everything you might need.

By the time you are ready to return home, no additional care is needed. Should complications arise after your surgery, we will of course provide the necessary treatment to rectify the situation, at no additional cost to you for the surgical procedure itself (only the expenses need to be covered).

Things to Expect During Your Recovery

  • Numbness—If Dr. Bart van de Ven has performed a procedure that changes the bone structure of your face, you will most likely experience some numbness in that area (such as the forehead, chin, or jaw – depending on the procedure) for a period of time. In any case, there is no need to worry, as this is completely normal. This numbness occurs because your skin is detached from the bone during the surgery, which affects the nerves beneath the skin. So it is not surprising that it takes a while to fully recover from Facial Feminization Surgery. It is not unusual for a procedure to have a full recovery period of 12 months, but after two to five weeks you will be ready to go back to work.
  • Tension—As a result of the swelling, the skin may feel very tense and warm. This is normal and will subside over time. 
  • Swelling and Bruising—Swelling is at its maximum for 2 to 3 days after surgery. Swelling and bruising may be present for 2 to 4 weeks. It may take 3-6 months to get an impression of the final result, which may not be fully achieved for 1 or even 2 years. Patience is required.
    • Location and extent of swelling—Immediately after surgery, swelling will be most common in areas of loose connective tissue (cheeks, lips, around the eyes). Over the first few days, the swelling will move downward toward the lower jaw and neck due to gravity. Swelling and bruising varies greatly from person to person and can occur anywhere.
    • Bruises are not always immediately visible. Once they are, they gradually disappear over a few weeks. 
  • Difficulty breathing through the nose—Most people find it very difficult to breathe through their nose after rhinoplasty. We will give you nose drops to open up your nose during your preoperative consultation. 
  • Eating problems—Certain procedures can cause swelling around the lips and make it difficult to eat and swallow properly. This swelling will disappear after 1-2 weeks. Don’t worry, we have adjusted our menu for you and offer special cups to help with drinking!

The day of your operation

Immediately after surgery, the following symptoms may occur. They may persist for a few days:

  • General swelling and bruising—Swelling and bruising around the eyes after forehead recontouring and hairline lowering. Vision may not be good due to swelling, which can be frightening. 
  • Double vision—May be present for several days or even weeks if the brow bone that needs to be removed is large.
  • Dry mouth and difficulty drinking—Especially after a lip lift and lip lipofilling, as the lips may be so swollen that one cannot close the mouth properly or swallow.
  • Difficulty breathing through the nose—The feeling of having a blockage in the nose, having to breathe through the mouth after rhinoplasty. The first night after surgery it will be impossible to breathe through the nose because of the packs that have been inserted. These will be removed the next day by the morning nurse.
  • Dizziness, nausea and vomiting (usually with jaw and/or chin procedures and rhinoplasty).

The first night can be very uncomfortable because of these experiences. We have several systems to help you sleep, to control the pain and to help you with all the discomfort. One of these systems is a cooling mask (Hilotherm) that helps to reduce the swelling around the eyes and jaw/chin. The cooling effect is also soothing.

Hilotherm

Day 1 after surgery

  • Early in the morning the night nurse will come by. She will change bandages, remove tampons from your nose and help you shower and/or wash your hair.
  • You can have breakfast afterwards (or at a later time). In case antibiotics have to be taken, it is necessary to eat at least something small, such as yoghurt. This will also be available to you.
  • Because the body is working so hard to recover, the patient will often feel exhausted and go right back to sleep after the nurse has finished her rounds. Compression stockings should remain on during this time to prevent blood clotting, as patients do not move much during this phase.
  • The body temperature will rise during this recovery phase. It is called “resorption” fever, caused by the body working hard to clean up the internal bleeding. This is nothing to worry about.
  • Patients usually experience little or no pain because everything still feels numb.
  • The cooling mask remains in place for use the first day, making recovery more comfortable.
  • Depending on the procedures, one may feel hoarse, have a sore throat, and have difficulty swallowing.
  • Often patients report that they are afraid to sleep because they are afraid of not being able to breathe properly. This can lead to a panic attack. If you feel this way, you can call the patient coordinator, Petra or a nurse. They will help you get through it. You will also be given sleeping medication to ensure that you can enjoy a good night's sleep.

Day 2 after surgery

  • You will likely feel exhausted and have little or no energy. 
  • Depending on the procedures one has had, there may be more swelling than the first day. One may also feel worse than the first day.
  • Since the adrenaline from the surgery has worn off and the patient is not yet able to see any of the final results due to bruising and swelling, it is possible that one may begin to feel depressed. The patient may even feel like they made the wrong choice. This is normal, and these feelings will pass. But be prepared to be very gentle with yourself, because your body is doing a lot of hard work during your recovery. Know that it may take a few weeks for your spirits to rise again.

Day 3 after surgery

  • For half of the patients this is the most difficult day. The other half slowly starts to regain some of their energy, starts to feel better and dares to leave the room more often.
  • The swelling starts to go down. Bruises start to turn yellow and start to go down.
  • Patients report no pain. Mostly discomfort.

Day 4 after surgery

  • Some patients find the energy to take a walk.
  • Patients are still swollen and have purple and yellow bruising, but are getting better. Scarves are available in the clinic if you would like to cover your face a little.

Day 5 after surgery

The final check:

  • Face masks are removed.
  • Nose plaster is removed.
  • Stitches or staples are removed.
  • Pictures are being taken.
  • The patient is allowed to return home. In some cases, the patient does not feel strong enough and decides to stay a little longer.

Below is a drawing one of our patients made explaining how her recovery went during the first 6 days!

Practical information, depending on the procedures

Jessica requested quotes for her full FFS from several surgeons before choosing to have her surgery performed with us. The price difference between the different surgeons was enormous. 

  • You may not be able to wear a wig during the first few days of your recovery (forehead recontouring, hairline lowering).
  • You may not be able to wear contact lenses due to swelling in and around your eyes; don't forget to bring your glasses!
  • Caution is advised when chewing as your upper lip may feel numb.
  • Your voice may sound temporarily different due to intubation after general anesthesia or due to swelling in the area around the voice (adams apple reduction).

Four Months After Your Facial Feminization Surgery

Four months after your Facial Feminization Surgery, you are expected at Dr. Bart van de Ven for a free check-up. This appointment is automatically scheduled after booking your FFS. It is possible to change the date and time of this appointment. The check-up will take place at the 2pass Clinic in Antwerp or in London, Munich or Berlin – depending on Dr. Bart van de Ven's schedule.

What are the possible complications?

If there are complications, they are usually:

  • Infection.
  • Each procedure has its own specific risks. Please check the page of the procedure you are interested in for more information.
  • Feeling down or depressed surgery is quite a devastating experience and it seems that many people experience post-operative depression for about three weeks after their surgery. Don’t worry, you are not alone. We suggest seeking some extra support in case it all feels a bit overwhelming.