Facial Feminization Surgery

Facial Feminization Surgery – Day 17

Day 6 after round 2 of surgery: (lowering the hairline, brow reduction (which includes “opening” eyes by reducing the orbital bones). Day 17 since the first round of surgery.

Doctor came by today and removed the nose split — yippee! I’m getting to the point where I’ll no longer scare small children, plus it’s easier to breathe.

Hard to tell exactly what shape my nose will end up — there will be noticeable swelling for at least another week or two, and the nose won’t photograph well for three months. But it seems like it might be a bit thinner with a bit more definition. We’ll see. The tip is a little saggy, but I’m sure that’s due to swelling and will go away.

They definitely did remove the “dorsal hump” (a sex differentiator in my ethnic group), as well as reduce the overall size and the angle of the tip (also anatomical sex differentiators).

Thankfully, I didn’t have a strong brow ridge to begin with, but that’s gone, and my forehead definitely now has the slightly different slope to it that females have. Males typically have a flat spot slightly above the brows, whereas females have a smooth curve.

The distance between the top of the upper lip and bottom of the nose is visibly smaller — although it’s a bit hard to say if there will be changes when the swelling goes down.

All these are the subtle cues we unconsciously use to decide if someone is male or female.

Is It All Worth It?

People have asked me if I’m happy with the changes in my face so far.

The answer is yes, definitely yes. It’s far beyond what I was expecting. Originally my hopes were just to undo what testosterone did to my face, but I’m feeling much more attractive now (while still looking like “me”).

Some people have temporary “what have I done?” reactions (changing your face is a bit primal). Not me. When I look at photos from before surgery, that’s that face which looks odd and “not quite me” now.

I’ll be interested to see what my nose looks like once the splint comes off. Every surgeon I consulted said to expect limited results since the skin is really thick and that limits how much reshaping they can do (essentially the skin drapes over the cartilage like fabric, and thicker skin is stiffer).

The changes will probably far more noticeable in profile view (which is hard for me to take photos of), since the main goal was to reduce the size to make it more proportionate, as well as removing the “dorsal hump” which is a male/female anatomical difference among people of my ethnicity, and some subtle changes to the angle of the tip of the nose, which is also a male/female anatomical difference.

Plus in general, even though the swelling goes down enough in 2-3 weeks that a casual observer won’t know that you’ve had a nose job done, apparently the nose doesn’t photograph well for up to three months (when 70-80% of the swelling is gone).

Facial Feminization Surgery – Day 16

Day 5 after round 2 of surgery: (lowering the hairline, brow reduction (which includes “opening” eyes by reducing the orbital bones). Day 16 since the first round of surgery.

Eyes are definitely getting better. Hopefully the bruising will be gone by the time I start heading home on the 31st. (On the 31st I fly to Panama, then spend a day there, then fly the remaining leg home on the 2nd.)

It’s 90 today and I’m not handling the heat + humidity that well. Sleep deprivation is adding up, although I was able to sleep a couple during the day and will go back to sleep shortly.

But I had to force myself to go out and get something to eat. It can be bit hard to tell at time whether I’m weak due to recovery, low blood sugar or just not having eaten enough. (I actually end up having to eat something at the apartment first to get enough short-term energy to walk a block or two to the nearby restaurants.)

Thankfully the sandwich I got is huge (enough for two meals), so I brought the remaining half home with me, so there’s something more substantial to eat when needed.

Facial Feminization Surgery – Day 15

Day 4 after round 2 of surgery: (lowering the hairline, brow reduction (which includes “opening” eyes by reducing the orbital bones). Day 15 since the first round of surgery.

Right eye is definitely less swollen today, although it’s got a ways to go. The other bruising around the eyes seems to be healing faster. Since much of the facial swelling has gone done, I’m guessing my body is better able to get rid of the excess fluids.

I’m annoyed by the two areas of bruising next to the side of my mouth, that have been fairly persistent. Patience, patience…

Facial Feminization Surgery – Day 14

Day 3 after round 2 of surgery: (lowering the hairline, brow reduction (which includes “opening” eyes by reducing the orbital bones). Head bandages removed, pre-shower hair #messyhairdontcare (Day 14 since the first round of surgery.)

Getting a good sense of my new face, through the swelling and stitches. I’m liking it. As mentioned before, when I look at photos of my pre-surgery face, that’s the one that now feels odd and unfamiliar.

A little surprised by the continued bruising near the corners of my mouth, but those areas have felt a bit puffy. Now that the head bandages are off, it’ll be a lot easier to start massaging them again to get the remaining fluids out.

We’ll see how well that hairline scar is hidden when my hair is forward. Also really curious to see how the lowered hairline affects my ability to style things in front, which has been difficult to do.

One of the doctors came by for a follow up exam. He said I was healing really well, removed the head bandages — and gave me clearance to take a shower and wash my hair.

You have no idea how happy that makes me.


Later in the day…

14 oz. tenderloin steak: $15
Ginormous side of fries: $5
Bottled water: $2.50

No longer wanting to immediately devour everything in sight: Priceless.

Yes, it is possible to get tired of steak.

But still headed to the steakhouse tonight anyway, my body is craving red meat.

Today, I realized that at the moment, I really need to have an extra meal each day, since the Argentines only do light Continental-style breakfasts, and that that combined with trying to have more salads and lighter lunches, wasn’t providing my body with enough heartier food needed to recover from the two surgeries.

And yeah, Argentina is a place where it’s a bit of challenge to eat healthy, since it’s basically steak and potatoes, pizza and pasta here. I pity any vegetarians here.

Facial Feminization Surgery – Day 13

Day 2 after round 2 of surgery: (lowering the hairline, brow reduction (which includes “opening” eyes by reducing the orbital bones). Head bandages temporarily pushed back so the brow line is visible.

My surgeon said he removed a bit more than 3/4-inch of scalp at the brow line, but looks like that was probably more in the “corners” of where there was receding hair on the sides, although the center is a bit lower as well. I was worried he might’ve gone a little low, since when I get back, I’ll do a second round of hair transplants to cover the hairline scar, but looks like there’s plenty of room to do that. The second hair transplant will also fill in the remaining corners to “round off” the hairline, although it’ll take months for the hair to grow back after being transplanted.

As mentioned, the brows are intentionally slightly high, since they’ll “settle” downward in the coming weeks.

Black eyes seem a bit better, although oddly I’ve now got some bruising on the side of my cheek. Go figure.

In general, it’s not really painful. (Nose jobs usually aren’t.) There is a bit of soreness along the side of my head where the brownie incisions end. Most my facial just feels odd again. Not unsurprisingly, my my forehead, and particularly the sides of my forehead feel really tight.

Oh, and can I tell you just how amazingly annoying it is to not be able to blow your nose.* Only three more weeks to go….

* This is normal post-op stuff after rhinoplasty, but in my case, it’s extra important because — to reduce the male brow ridge — my surgeon removed good chunk of the frontal bone over my sinuses, and then reset it at a different angle. So too much air pressure in the sinuses can be really problematic.

Last night was long, long night…. Woke up about once an hour or so.

Besides just being exhausted, I’m pretty weak and definitely ravenous. My body really needs energy to heal itself. After a round of cold packs and we’ll see if I can make it across the street to the cafe for coffee and croissants (the Argentines generally just do a light Continental-style breakfast).

TMI, post-surgical stuff….

This morning I discovered the hard way that it’s too soon to remove the nasal packing. Nothing particularly bad happened, just continued bleeding, so I stuffed some replacement cotton in there. Good side is that I really should’ve changed it last night, so hopefully this time wherever the bleeding is coming from will get a chance to dry out and heal.

Black eye is looking a bit better, and I took a peek at the hairline stitches, which look good. My surgeon did a nice job of lowering the hairline, but the scar is right in front of the hairline, so it’s going to be pretty obvious until the second round of hair transplants cover it up. (Hairline scars never heal well because the forehead is under tension and moves a lot — both of which are detrimental to scars healing well.)

 

Let the Healing Begin II

I was released from the hospital this morning and made it back to the apartment by 10. After minimal — and the typically bland — food at the hospital, I definitely gorged myself. Trying to decide whether I’ve got the energy to walk across the street to the cafe for something more substantial. I’m probably still a little anemic, since I’ve got a huge craving for red meat.

I do look a bit scary though. Head is wrapped up in bandages, and one eye is completely black and blue, visible stitches at the bottom my nose (from the lip lift) and my nostrils are still packed. Fortunately they’re now just packed with cotton, and if necessary I can take them out temporarily today. I’ll be able remove them tomorrow, which will be nice, since it’s uncomfortable breathing through my mouth. Not to mention I can’t smell anything, so I can’t taste much either.

I’m just really thankful that at the hospital I was able to sit up and walk to the bathroom myself this time around instead of being catheterized.

The hospital beds both time were really uncomfortable, and because I needed to keep my head raised, it put pressure on my lower back, butt and tailbone. Last time around I was confined to bed the entire time and consquently I was stiff and sore for a week.

This time, I was able to ask for an extra pillow under my butt, and because they didn’t have the inflatable leg compression sleeves (to prevent blood clots), I was able to turn on my sides, which helped, as did being able sit up on the edge of the bed. Still a bit sore, but nothing like last time.

They seemingly were less concerned about my health this time around, since they just had a translator watching me overnight in my room — unlike the English-speaking medical resident last time — and they didn’t ask her to stay at the apartment for an additional six hours like last time. Like medical resident last time, the translator thought I looked much stronger than most of the other patients she’s sat with.

Facial Feminization Surgery – Day 12

Day 1 after round 2 of surgery: (lowering the hairline, brow reduction (which includes “opening” eyes by reducing the orbital bones). Day 12 after the first surgery.

I can’t see it because of the bandages, but my surgeon said he lowered my hairline a bit more than 3/4 of inch. I’ll be curious how much he was able to fill in the male-pattern baldness recession of the side. (Still will need to do a second round of hair transplants to get back — both to fill in the hairline to give a nice “prototypical” female upside-U hairline, and to cover up the scar from the incision, which runs from ear-to-ear just inline the existing hairline.

But I’m pretty scary sight at the moment. The cotton in my nose can come out tomorrow thankfully, but there’s still the stitches from the lip lift. The lip lift looks uneven but that’s probably due to the swelling on the left of my face.

The right, which had more bruising in the first-round, really looks bad, and there’s renewed bruising under the left eye (the bruising from the brow lift usually “falls” down into the eyes.

Brows probably look a little high at the moment, but that’s intentional since over the next couple weeks/months they end up a bit lower.

TMI post-surgery stuff….

The good news is the Mucinex I took got rid of the bad sinus headache I was having.

The bad news is that it’s causing a runny nose through the nasal packing, which I can’t remove until tomorrow. Ick.

The ugly: I took a 12-hour Mucinex. It’s gonna be a long night.

Plus even when the packing comes out, I can’t blow my nose for a couple days or I risk literally blowing up my forehead.

To reduce the brow ridge, my surgeon cut out a triangular piece of frontal bone (over the sinuses) about 2-inch wide, and then reset it at a different angle. (The bone is only about 1 mm thick, so you can’t grind it down the way they do over the orbit ridges.) But because he doesn’t use screws or mesh to secure the frontal bone, it’s really delicate until the bone starts healing and too much air pressure in the sinuses can damage things.

Facial Feminization Surgery – Day 11

Doctors almost let me go home, but decided to keep me at the hospital overnight. Just really thankful about that I was able to sit up and walk to the bathroom myself at the hospital this time around.

The hospital beds both times were really uncomfortable, and because I needed to keep my head raised, it put pressure on my lower back, butt and tailbone. Last time around I was confined to bed the entire time and consquently I was stiff and sore for a week.

This time, I was able to ask for an extra pillow under my butt, and because they didn’t have the inflatable leg compression sleeves (to prevent blood clots, I was able to turn on my sides, which helped, as did being able sit up on the edge of the bed. Still a bit sore, but nothing like last time.

They seemingly were less concerned about my health this time around, since they just had a translator watching me overnight in my room — unlike the English-speaking medical resident last time — and they didn’t ask her to stay at the apartment for an additional six hours like last time. Like medical resident last time, the translator thought I looked much stronger than most of the other patients she’s sat with.

It’s good to be home — I was just released from the hospital this morning and I’m back at the apartment. A bit bruised, but the doctor said I’m healing well.

Will be able to take the packing out my nose tomorrow, which earlier than I expected. So I’m really happy about that, since it’s uncomfortable breathing through my mouth.

But…. then was that that moment when I go to put the ice packs in the freezer so I can apply cold packs to your forehead — and I realized I forgot to take them out of the freezer before going to the hospital and they’re frozen rock hard and I’ll need to let them thaw out so that they’ll bend. Oops.

Facial Feminization Surgery – Day 10

Day 10 post-surgery for round 1 (eye lift, cheek , jaw reshaping, under neck lipo, cheek lipo, neck and face lift — required when one does jaw work).

Tomorrow I undergo round 2: lowering the hairline, brow reduction (which includes “opening” eyes by reducing the orbital bones — my surgeon’s signature), brow lift, nose job, and probably a lip lift (I’d like to do it, but my surgeon said it may be dependent on the nose job, since the incisions are close to each other.)

Tomorrow also marks the half-way point as far as time. It’s hard to believe I’ve already been down here two weeks, and the mad scramble before I left feels like a life-time ago.

While I’ve been bored at times, the enforced downtime has been beneficial in other ways. For the past year, I was not only burning the candle at both ends, but also the middle, and the spaces in-between. Even though you promise yourself that you won’t let transition take over your life I think that there’s no way to avoid it. Add to that a demanding job, trying to have a performing career on the side, and other commitments… well, I’m not even sure how I did it.

So needless to say, I’ve been dealing with massive burnout. When I get back, one of the challenges will not only be navigating life full-time in a new gender, but figuring how to rebalance my life in general.

Need to get up at 5:30 a.m., so I probably should head off to bed and time to get some sleep.

Not looking forward to this one as much, because it includes rhinoplasty and the recovery from that is supposed to be fairly uncomfortable, since you can’t breathe out of your nose for 5-7 days until they remove the packing.