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Preoperative Anxiety and FFS Surgery

March 24, 2017

Preoperative anxiety before facial feminization surgery happens just like other times in life when we need to face a situation that implies effort or a big change, so it is common for a stress response to appear.

The most common symptoms of anticipatory anxiety before surgery are:

  • Difficulty breathing.
  • Palpitations.
  • Sweating.
  • Chest tightness.
  • Discomfort.
  • Dizziness.
  • Etc.

There are protocols that clinics may incorporate to assist patients alleviate stress related to surgery, but there is also something you can do in preparation.

Preoperative and postoperative anxiety is a very common phenomenon because when we undergo an operation under general anesthesia, we know that the postoperative period could be hard and we are afraid that it will be painful. This fear can be placated in part by actively becoming informed about what to expect, by seeking FFS Practical Advice from your provider.

Thoughts play an important role in this situation. The way we think, will be the way we feel. So, if we think that everything is going to go wrong, that we won’t be able to cope with the situation, then we are going to feel nervous, overwhelmed and afraid. However, if we think that everything is going to go fine and that we will cope well with the situation, it is much more likely that our emotions will follow suit, and we will feel calm and confident.


But stress and anxiety aren’t always negative. There are also situations in which it is normal or even appropriate to get nervous, because the occasion requires us to put in a lot of effort and energy, or perhaps because it is a significant event, which many steps in transition are.  If you are about to have surgery to feminize your facial features, you´ve decided to take the step to medically transition. That choice is a big deal because it means you have probably confronted so many scary questions about your hopes for the future.

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Facial feminization surgery can make us feel very nervous or tense, since, apart from undergoing surgery with general anesthesia, we might get anxious in a positive way because we are achieving a much-desired goal. This mixture of emotions can make us feel very agitated in the days before surgery, which is why the best advice before facial feminization surgery is to try to keep calm, since this will help you get through the process in a more fulfilling way.


To help you relax before surgery, first of all you need to realize of what your mood is regarding it, what the thoughts are that you have in your mind. To that end, I advise you, for 2 or 3 days, to do a free writing exercise in which you openly express how you feel and what you are thinking in general. Just take a sheet of paper and put down everything that comes to mind in this moment. This exercise can be cathartic for anxiety and fear, and will also show you what you have inside.

Once you know what your main thoughts and feelings are, you need to analyze them. To do this, reread what you have written and see if there are any recurring themes, and try to boil them down to a few sentences. For example:


I am afraid of the pain”, “I believe that I’m not going to cope with this situation”, or “I’m worried about what others will think.


Once you have those sentences, it’s time to discuss them and see if they are reasonable or not. To do this, you need to ask yourself a variety of key questions. For example:

  1. Is this the only point of view or is there an alternative?
  2. Is what I am thinking about going to help me or hurt me?
  3. If what I am thinking about came true, would it be so horrible?
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Once you have answered those questions, you need to make an effort to cultivate alternative and more constructive thoughts. For example:

If I was thinking “I am afraid of pain”, then I need to think, “The pain probably won’t be that bad”, or “If I am in pain, I can take some pills to alleviate it”. These types of thoughts can make you feel much better and will help you cope with your facial feminization surgery in a more constructive and fulfilling way.

For more ideas on how to prepare for facial feminising surgery, please read our Health Tips for Facial Feminisation Patients