Emotions after facial gender surgery | Mental Health Series

Here, we continue with the second post of a 4-part series on Mental & Emotional Health in honor of World Mental Health Day this October 2020. Our psychologist, Marina Rodriguez has compiled a list of some of the typical emotions after facial gender surgery and how to deal with them.

It’s important to look after your mental health when going through a life-changing experience such as FFS Surgery. Either positive or negative, recognizing the emotions as a normal part of the facial feminisation process will help you manage some of the more intense feelings after surgery. The sensations may be only emotional, others may have distinct physical manifestations.

Physical signs of emotions after facial gender surgery

The most intense emotions can express themselves in physical symptoms. Here we describe a few so you may be better prepared for them in the postoperative period.


After surgery, it is normal to feel tired since there are usually several hours of anesthesia 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, it is the most normal thing in the world and you just have to take a good rest to regain energy.


Inflammation, bruises, spots, pathways for medication, cold mask, nose plugs…. All are external factors that are going to make us feel uncomfortable the first days. Little by little the body gets used to it and by the time it no longer bothers, it will be time to withdraw them. It is time to be a little patient, but only for a few days.


Some anxiety may appear the day after surgery. This is due to the mixture of the first two emotions, fatigue and discomfort, which together can make a very annoying cocktail. You do not have to worry too much about this, you will always have the help of the nursing service, the support of your coordinator and your psychologist to overcome it easily. If you really need to, you could also take medication to help you relax again.

Interior emotions after facial feminisation surgery

These may be pleasant or negative feelings and may fluctuate depending on the day. Without a doubt, the FFS process includes a parallel emotional journey for many people. It will be different for everyone, depending on your levels of self-awareness and self-esteem, but it’s normal to feel a bit like you are on a bit of an emotional rollercoaster for some time, even grief. Here is why:


It is normal for a little sadness to appear immediately after the operation. Like anxiety, it appears from a mixture of other previously present emotions. This sadness is usually related to the conclusion of a goal, in this case with having done the surgery. 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. Take it as it is, part of the healing process. You will see that it will pass as you begin to go back to your routines.


This emotion is very rewarding and positive. As we mentioned about sadness, it appears because of 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.

Feelings of strangeness / 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 again to recognize itself in that image that is reflected from the mirror. In any case, the postoperative period is a coming and going of these sensations since our features will change as the healing phases of the tissues and readaptation to the new bone surface are completed.


Satisfaction appears when we return home and we realize that we return to our normal life, our routine, but with what we wanted, to have more feminine facial features. In addition, satisfaction also thrives on liking what we see when we look in the mirror. In a way she tells us: “You have fought for this, you have achieved it and it has turned out very well. Now to enjoy the results.


The illusion is that energy that leads you to plan things, big or small, more significant or less, but that fills the future with positive moments. That illusion appears along with the joy and satisfaction of having achieved a more feminine face. It can be the illusion for a trip, finish some studies, find a new job, or have new personal relationships. Or simply the illusion of waking up every day feeling more identified with yourself.

Safety in oneself

Self-confidence is a feeling that is greatly increased with surgery. You know that with your more feminine facial features you will not have a problem passing or that people who do not know you will confuse your gender. This makes you want to go out more, to face social or even work situations. It is usually accompanied by an increase in self-esteem, a desire to take care of yourself a little more and pamper yourself.

5 tips on managing emotions

This year’s World Mental Health Day is set in especially challenging times. The year 2020 has been hard for planet Earth and it’s people, in part due to the global pandemic that continues to evoke a mix of uncomfortable emotions as well as disrupt many of our day-to-day routines. How do we cope with this?

Let’s discuss some evidence-based methods for managing emotions after facial gender surgery, but also other times in your life.

  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 8 hours a day!
  4. Avoid the hermit cave. This means make an effort to stay connected with the people you love and who love you. Weekly videocalls suffice, it’s proven the that our well-being improves when we feel a part of a clan.
  5. R.A.I.N – this is about being with and mindful of our emotions.
    • 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.
    • Nuture – 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.

Self Care to Manage emotions

There are many resources to help us take care of our mental health after facial gender surgery. From professionals to your peers, it is important to talk with people in your support network if you have persistent difficulty with emotions after facial gender surgery, or anytime.

With this series, we hope to raise awareness about the importance of mental health for our wellbeing, eliminating taboos so that people are empowered to seek the tools for maintaining better emotional health. 

Check out our other posts in the 4-part Mental Health series, on the topics of nerves and emotions around surgery as well as postoperative depression.

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

Hello world! My name's Lilia Koss! With a background in humanities and diverse professional experiences, I've accumulated 11 years now working in the field of trans healthcare. Involved from the ground up when the business idea was just a seed within a clinic until it gradually transformed into the main focus of our activity. Like any startup, I have had hands in many pots: from workflows, customer journeys, social media, public relations, customer service, sales and coordination, content, web... Now life is more defined. Lately, I focus my energies on Public Relations, Social Media and copywriting of quality for our target during my day-to-day. Plus, the organization of annual educational orientation events around the world aimed at raising visibility of gender-affirming healthcare. Life is pretty complete.