Calming your Nerves before Facial Feminization Surgery

Nerves before facial surgery is one of the most common issues any FFS patient will encounter as the day approaches. It requires great patience until the much-awaited day finally arrives after many months of preparation.

The decision to have FFS Surgery is not something that has happened overnight. 

You’ve spent so much time thinking about affirming your gender with facial feminization:

  • Whether or not to have FFS
  • Justifying why you need it 
  • Where to do it 
  • How to pay for it
  • When to have it
  • Who to tell 

Despite being something you intensely desire, it is not a straightforward decision. There are many necessary choices and steps to take beforehand. So it is understandable to have some nerves before facial surgery.

It is precisely this waiting that makes us feel like a bundle of nerves at different times before the surgery, even weeks before.

Signs that you are Nervous Before Surgery

Sometimes, we do not realize that we are nervous about an upcoming event. It helps to pay attention to the physical and emotional signs that may appear while waiting for the day to come. 

Recognizing signs of stress and nerves before facial feminization surgery makes it easier to manage these; 

Irritability and Sensitivity

Who hasn’t ever felt irritable or sensitive? It’s normal! There are moments when everything feels wrong or we cry for any minor mishap that we would’ve typically overcome without further ado. This irritability is to be expected when something worries you. 

Just be aware of it so you can try and control your reactions. It becomes easier when you see your reactions are a product of nerves.

Hyperactivity or Over-stimulation

Another sensation, a more physical one, is to feel that you are over-activated. Your heart is beating fast, you can’t even relax on the sofa. This state of over-stimulation is the natural, instinctual “fight-or-flight” response that your mind and body generate to face any unknown or big event. 

If in your case, you have had other surgeries before, surely you’ll feel accelerated because you know what the postoperative period and general anesthesia entail. 

If it is the first time you’re having surgery, you might experience hyperactive thinking about the process.

Insomnia and Nerves

Due to over-activation, irritability and nervousness, another common symptom that can appear is insomnia. Difficulty falling asleep or staying asleep through the night is frustrating as many know. This is nothing other than a signal that your body and brain are alert, preparing for what lies ahead.

In order to deal with this kind of insomnia, try to stick to healthy sleeping routines, such as getting to bed at the same time each evening to fit in the recommended 6-8 hours of rest. 

Also, avoid copious evening meals and drinks with stimulants, like coffee or tea. If you like reading, use an actual book or other relaxing activity in bed that doesn’t involve looking at screens. Many people benefit from practicing simple relaxation and breathing exercises.

Nervousness vs. Anxiety

There is a big difference here. We must distinguish all these physical and emotional sensations related to nervousness, from those that accompany surgical anxiety. Anxiety is more intense than just plain fear of the unknown and it makes you feel worse physically. 

Depending on the person, the level of anxiety may vary, and it is common for people to suffer preoperational anxiety. The manifestations of anxiety before surgery may include: 

  • Chest tightness
  • Palpitations
  • Cold sweats
  • The urge to escape
  • Intense fear that something bad will happen
  • Shortness of breath
  • Dizziness

There are many ways to control nerves or anxiety before FFS surgery yourself with short-term solutions;

  • Listen to music you like
  • Meditation
  • Breathing exercises
  • Call someone you trust to share your feelings

If feelings persist over time or if you experience intense anxiety before your surgery, it is helpful to speak with a mental health care professional and even consider joining a support group. We recommend seeking help from a professional as it is probably not just related to the surgery, but a combination of factors.

Anxiety can develop into a crippling emotional disorder. If you are affected by undiagnosed anxiety, you should not underestimate its impact. 

Stress to Anxiety among Trans Identities

Chronic stress may lead to developing anxiety. Research shows that stressors such as gender dysphoria, gender incongruence and internalized cis-sexism contribute to growing anxiety.

In addition, the intersectional aspects of minority stress exacerbate the situation, due to the intense and chronic stress that people within stigmatized minority groups face. The lack of privilege experienced by trans or nonbinary BIPOC is not the same as a white, cis-passing trans professional who has easier access to healthcare, for example.

In addition, our binary trans colleagues’ mental health is affected by significant environmental stressors, such as discrimination and social exclusion, and more likely to suffer internalized cis-sexism. Also, expecting rejection has a much more negative influence than imagined.

Combine this with the social stress of trans and gender nonconforming people to find that, unsurprisingly, they eventually succumb to mental health problems due to the incessant pressure of stressors. Studies report that trans folx are three times more at risk of an anxiety disorder.

Reach Out for Help Managing Nerves

It is perfectly human to feel nervous at times, especially when it involves something like your facial features or when in the recovery period of major surgery. There are so many factors involved in facial feminization procedures that it can feel overwhelming.

Sometimes people may obsess a bit when thinking of the levels of pain or the swelling and bruising, both in the days after the operation and the weeks after surgery. The post-op period of an FFS procedure is similar to other plastic surgery, yet also different. 

The significance of feminizing surgical procedures is rooted in your survival, in your need to be you. So it cannot be compared with straightforward cosmetic, rejuvenating surgery or superficial improvements such as a facelift, lift surgery or an anti-age lip lift. 

If you would like to discuss issues with nerves before surgery (or anytime) with our psychologist, do not hesitate to ask your coordinator to set up an appointment. Have a look at our playlist of videos on relaxation, breathing exercises, and visualization that are helpful in dealing with nerves before facial surgery.

Finally, when the day comes, speak with the surgeon if you would like to discuss any pharmaceutical options to calm those nerves and get some much-needed restful sleep. 

If you are nervous before FFS and it becomes a chronic state that gets in the way of a healthy lifestyle, we recommend you seek professional medical advice.

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.