FFS in San Francisco

Hanako’s Facial Feminization Surgery trip to San Francisco.

Main Schedule

Prep Tasks

4 Weeks Prior (Oct 10)

• Get lab tests done @ Quest (CBC, CMP, PT/PTT INR)
• Stop all hair removal procedures
• Dental cleaning scheduled Oct 7
• Surgical Clearance & EKG scheduled Oct 23

2 Weeks Prior (Oct 24)

• Stop all vitamins, supplements, fish oil
• Start 2 g/day vitamin C
• Stop drinking alcohol
• Start low carb (< 200 g/day, LOL so easy) and low sodium (< 1.5 g/day) diet
• Stop eating garlic, ginger, and maitake or reishi mushrooms
• Call Hotel & clear having items shipped to them
• Order from Amazon: 45° Sleeping wedge (s.t. like this) and Humidifier

1 Week Prior (Oct 31)

• Stop using any skin creams that cause flaking or peeling (i.e. Retin-A)
• Start taking probiotics (already take)

Night Before Surgery (Nov 6)

• Do not eat or dink anything after midnight
• Shower
• Wash hair with Dandruff shampoo
• Trim nasal hair

Morning of Surgery (Nov 7)

• DO NOT SHAVE
• Wash face. Do not apply makeup.
• Remove all nail polish
• Do not wear earrings
• Take prescription meds with a small sip of water. Take evening lipitor also!
• Dress comfortably. Button-up or Zip-front top. Nothing I need to pull over my head!
• Take ID and Insurance Card

After Surgery (Nov 8)

• Expect 2-3 days of numbness, tingling, swelling, discolouration, irregularities, firmness, crusting, some bleeding, redness, and mild pain. This is the worst time as my face will swell up!
• Expect grogginess for first few days after surgery
• Expect pain with eating or facial expression, drooling, and difficulty closing lips (my, how attractive I will be!)
• Start semi-liquid diet for 2 weeks. Nothing that requires chewing. Protein & Meal replacement shakes, mashed potatoes, broth or stock, milk, yoghurt
• Ensure stay hydrated as well
• Walk at least 2 hours daily
• Rest and sleep with head & shoulders elevated 45° (semi-Fowler position)

Do’s And Don’ts

• You waited so long for the surgery, now get ready to wait patiently for the results and recovery!
• Expect crappy sleep the first week, between nose being plugged, lips swelling, and having to sleep on my back sitting up!
• No Alcohol before November 22
• Resume normal skin care routines on November 21, except NO EXFOLIANTS
• End liquid diet on November 22
• No heavy lifting or bending over before November 28
• Do not blow my nose until November 29 (Toshi’s Birthday!)
• Expect to no longer resemble a DV victim around December 5
• Can resume body laser hair removal after December 6
• Can use exfoliants and hair treatments after December 20
• No strenuous activity before December 21. (lucky me: one week before Stormy Weather)
• Can start laser and electrolysis on face after February 25, 2025
• No procedures requiring general anesthesia before April 2025
• Cheer Up!!! Don’t expect the results to settle until April or May 2025!!
• Do not expose incisions/scars to the sun before May 2025. Sunscreen and Hats!

Long Term Recovery

Phase 1: Nov 8 – 22

Slight oozing and crusting. Mild bruiising and sensitivity that resolves in 7-10 days. Swelling and numbness are moderate, peaking in 3 days or so.

Phase 2: Nov 23 – Jan 3

Formation of early aqdhering (“disorganized”) collagen tissue, pink to light red in colour. Itchiness and tenderness and some thinkinging of the incision line. Swelling resolves 60-80% by the end of this phase. Rare bruising or discolouration may persist.

Phase 3: Jan/2025 – July/2025

Formation of mature and strongly supportive (“oragnized”) collagen tissue. Scars lose their redness, itchiness, and tenderness. Incisions flatten and red colour starts to fade. Swelling resolves 80-90% during this phase.

Deeper sutures which add strength to the incision closures will be absorbed. This may cause firmness, lumpiness, or even sutures coming to surface. Normal and should resolve.

Phase 4: July/2025 – Dec/2026

Tissues and scars become softer, looser, smoother, and flesh coloured. Should see most of your final results. Should be little swelling or numbness.