Recover Emotionally after Facial Feminization Surgery, 5 Tips

We believe in looking after your mental health for facial feminization surgery, a life-changing experience. This means paying attention to your emotional wellbeing before and after surgery too. 

Feeling emotional after an FFS procedure is common among patients. Whether positive or negative, recognizing the emotions as a normal part of the facial feminization process will help you manage some of the more intense feelings after surgery. The sensations may only be emotional, others may have distinct physical manifestations too. 

Our team of psychologists have compiled a list of some of the most common emotions after facial feminization surgery and how to deal with them.

Common Emotions after FFS

The most intense emotions can express themselves in physical symptoms. Scientific study shows a correlation between emotional stress and physical manifestations. This is likely to be true in regards to emotions after FFS surgery, as well as the entire gender-affirming journey.

So you may better prepare for good FFS mental health, first we identify the signs that indicate you may need to reduce stress.


Before surgery, you are under a lot of pressure and this is mentally exhausting at times. After all, it is not every day that you have to confront a surgical procedure.  

After surgery, it is normal to feel tired as there are usually several hours of anaesthesia and the body is exposed to a lot of physical stress. In addition, the first night you do not usually rest very well, so the next day, the normal tendency is to be sleepy most of the time. 

There is no need to worry excessively. You may feel wiped out due to built-up tension from planning your gender-confirming surgery. Postoperative depression happens too. The first step is to get good quality rest to regain energy. If the symptom persists, ask for professional attention from your local health services and take advantage of Facialteam psychologists after your gender-affirming surgeries.


Several external factors that are going to make you feel uncomfortable in the coming weeks of healing are; 

  • Inflammation
  • Bruises
  • Intravenous tubes and drains
  • Cold masks
  • Nose plugs
  • Stitches

Little by little the body gets used to the situation and discomfort subsides. It is time to be very patient as you slowly, step by step, regain your quality of life over the weeks after surgery.


Some anxiety may appear beforehand, as well as nerves before your surgery. But be prepared too for some anxiousness that suddenly surfaces the day after surgery with palpable physical manifestations. 

The mixture of fatigue and discomfort can be an emotional trigger after ffs surgery. Our patients always have the help of our nursing staff, the support of a personal coordinator and our team of psychologists to overcome feelings of angst or apprehension.  

Don’t hesitate, if you really need, to also ask for medication that will help you relax during the most crucial moments of the FFS Surgery process. There is no shame in recognizing that you need help with emotional anxiety, our professionals are well prepared to give you the care you need.

Interior emotions after FFS

You may have positive or negative thoughts fluctuating in your mind along the days and weeks around your medical transition. 

Without a doubt, the facial gender confirming process involves a complex emotional journey for many patients and their loved ones. It will be different for everyone, depending on your self-awareness and self-esteem, but it still may feel like you’re on an emotional rollercoaster at times. 

Here are six typical emotions to be prepared for when planning your FFS surgery.


Sadness often appears after the operation. Like anxiety, it is part of a chain reaction of emotions. This sadness is usually related to the conclusion of a long-awaited goal, which suddenly no longer exists. 

The anti-climax after all the nervousness prior to the surgery, the anticipation and excitement for so many months mean it is inevitable to have a degree of sadness for a few days. It is natural to feel that way, as you are, in a way, saying farewell to a period of your life so may be compared to mourning. 

This is a part of the healing process, when it could also intensify into a depression after surgery. Feeling low may come and go as you begin to get back to your routine. Just remember these phases are not permanent and should subside in time.


This emotion is very rewarding and positive. As we mentioned about sadness, this also appears after the joy of reaching a goal that has been a long time in the making. 

Whether this emotion appears is very individual, but the predisposition to focus on the positive in each situation and be optimistic about the future helps a lot to find happiness.

Not Recognizing Oneself

Our brain is used to recognizing our face, and when after surgery, we look at ourselves in the mirror for the first time, a sensation of shock may appear as it is very swollen, with bruises and even bandages. This sensation tends to disappear over time, until our brain learns to recognize itself (again) in that image that is reflected in the mirror. 

In any case, the postoperative period is a coming and going of these sensations as our facial features will change as the healing phases of the tissues and readaptation to the new bone surface are completed.

Satisfaction or Regret

Feelings of satisfaction and regret may come and go alternately in the year while you wait for the final results to emerge. If you remember they are part of the psychosocial outcomes and process that will eventually subside in time, it is easier to be patient.

Satisfaction appears when we realize that we are back to our normal life, our routine, but with more feminine facial features. When we like what we see in the mirror and can just move on and enjoy the results. 

On the contrary, regret is that nagging feeling that something went wrong, expectations were not met, you are still too masculine-looking or that you look worse even. Gender Dysphoria triggers may coincide to make you feel regretful of your decisions. Speaking to a counselor is advisable to help you navigate when negative feelings seem to dominate. 


Hope is the energy that leads you to plan things, be it more or less significant. Having this aspiration fills the future with positive moments. 

Joy ensues when you see the potential of having achieved a more feminine face. You become one step closer to realizing your dreams: a special trip, finishing studies, finding a new job, getting to know someone or simply the satisfaction of waking up every day feeling comfortable in your own skin.

Self-esteem & Personal Safety

Self-esteem is how positively we view ourselves which becomes a self-fulfilling prophecy. Meaning, how good or bad you feel about yourself will inevitably be reflected in your self-image, communication and success. It is something we can deliberately control and choose to improve, although that doesn’t mean it is always easy.

Let’s have a look at the science that proves that the circumstances surrounding the lives of trans people influence their emotional wellness.

  • 2014 study finds a connection between low self-esteem with existing gender dysphoria and incongruence in trans people.
  • 2018 study finds that transgender youth are at an increased risk of developing low self-esteem, as well as anxiety and depression.

Self-confidence typically increases after gender-affirming surgery, although you must remember that it is not the magic solution either. You hope that with more feminine facial features you won’t struggle as much with misgendering. This makes you want to go out more, to feel more free in social settings as well as at the workplace. 

Once you feel more confident in public spaces, you’ll stop wondering if you are being “clocked” and instead enjoy that people are drawn to look at you. When your self-image improves, a desire to take care of yourself comes easier too. All beneficial for mental health. 

What is the emotional cycle of change?

Dr. Z, a therapist specialized in trans issues, spoke with Dr. Capitán of Facialteam about how gender dysphoria and transition come into play within the setting of major life changes like the facial gender affirming surgery process.

Turns out, there are some clear emotional patterns related to big changes. In the video below, Dr. Z describes a model of the 5 typical stages of any transformative journey. By identifying and naming these phases of emotions, we may better understand our internal process and handle it along the way.

5 Tips on Managing Emotions after FFS Surgery

Now, let’s discuss some evidence-based methods for managing your feelings around FFS surgery. These tools are handy also for other situations in life as they are about creating healthy and sustainable habits.

  1. Get moving.
    Exercise, if possible, with a friend. Science shows this works. Start slow, just a stroll is fine. Or pump up a jam in the privacy of your own garden.
  2. Be deliberately grateful for the good things.
    Show gratitude to yourself too, your pet, anything or anybody really. It’s hard not to smile when doing this!
  3. Recharge with rest.
    Doctors say at least 8 hours a day!
  4. Avoid the hermit cave.
    This means making an effort to stay connected with the people you love and who love you. Weekly video calls suffice, it’s proven that our well-being improves when we feel a part of a clan.
  5. R.A.I.N
    is a mindfulness methodology helping you to be more aware of your emotions and helps to manage the sometimes overwhelming feeling after surgery.
    • Recognize
      The moment an emotion arises, notice it and where it manifests in your body.
    • Accept
      Your emotions are natural reactions, it is ok. They are telling you something, so try to have compassion for yourself.
    • Investigate
      Observe and ask why you have this feeling. Exploring will help you understand it in the future.
    • Nurture
      Be kind to yourself, as if you are your own best friend. Pamper yourself a bit when needed.  Taking control over your self-esteem will help you cope with emotions in all walks of life.

Caring for your own mental health may be a contributing factor in managing the gender dysphoria and social discrimination you suffer. The unfortunate reality is that transgender people are more like to develop mental health issues than other people.

Multiple intersectional factors sadly lead to contemplating or committing suicide, such as stigma, discrimination and oppression. These daily stressors understandably trigger adverse mental health outcomes which are compounded by barriers to healthcare options.

Self-Care to Manage Emotions

So you must return home after surgery but are still in contact with Facialteam psychologists if you need assistance. You go back to work and eventually, a new normality returns. 

A year passes and you learn new ways to look after yourself as the gender-affirming process reaches new levels. Recovering from feminizing surgery is not easy, and it is not the magic wand to solve everything either. 

Despite how well you take care of yourself and do the right thing, you will still experience strong emotions along the way that are unrelated to surgery but arise in that moment of truth which surrounds the decision to transition. 

With these articles on mental health and wellbeing, we hope to raise awareness and eliminate taboos so that people feel empowered to access the tools for maintaining better emotional health. If you are a loving companion of someone in transition, do your part by accepting their gender identity so they may continue improving their mental health with your support.

Mental Health Resources

Just remember there are many resources to help us take care of our mental health after facial gender surgery or at any time. Also, you can choose how, when and to whom to disclose your trans identity, no need to rush and certainly no obligation to do so.

From professionals to your peers, it is important to talk with people in your support network if you have persistent difficulty with emotions after FFS or any point in life. Mental health complications may have a higher prevalence among trans folks, but there are ways to deal with this predisposition. Here are 5 suggestions:

  • Therapy: affirming therapists specialized in trans and gender nonconforming individuals are much more widely available online, so distance is no longer an impediment.
  • Healthcare: people of all trans identities are welcome at the new clinical services appearing at university hospitals and beyond, even online.
  • Advocacy groups: Joining regional, national and local transgender advocacy groups may help you to feel welcome and part of a larger community and better connected to the transgender support services available.
  • Community: It’s easier than ever to find other like-minded people on places like Discord or Reddit, where people often build friendships over time.
  • Activism: Being out is a big but exhilarating step. Taking pride in trans identities gives a boost to confidence and sense of solidarity, and it can be done in many little ways too if you’re not a large-crowd type.

Last but not least: be kind to yourself along your emotional journey. You are not the first nor last and definitely not alone.

Patient Relations Manager Lilia Koss, presentator of Lilia's Livestreams
About the author

Hello world! I’m Lilia Koss and I use she, her, and they pronouns. What are yours? With a background in humanities and diverse professional experiences, I have been working with the Facialteam founders and directors since 2008. Involved from the ground up, so I’ve had hands in many pots: patient coordination, orientation events on 3 continents, social media, written and audiovisual content about our gender-affirming healthcare...but now life is more defined. Lately, I focus my energies on Public Relations, community management and live streaming to help raise the visibility of trans health. Life is pretty complete.