This post is a follow up to my first one on Appearance after Facial Feminization Surgery. This one focuses on my wife’s second surgery, the procedures done on her lower face included modifications to her jaw and chin, as well as cheek implants. I began to write this six weeks after her surgery and finished it about five weeks later.
At six weeks the bruising was gone and had been so for at least a week. Once it started to recede it disappeared rapidly. I could see Marcie beginning to reappear. At the seven week point, I wondered if my earlier assessment had been wishful thinking. I should have only said that the bruising was gone, the swelling markedly reduced, and her face was much slimmer. But the Marcie I’d known before her transition was not yet beginning to reappear. What had happened? She was now an attractive female but not anyone I recognized. Her surgeon had created a beautiful, age appropriate, woman. But she no longer resembled her previous self or her sisters.
In pictures following her first surgery, I could still see her, as well as a similarity to youngest sister. In another picture, she looked more like her oldest sister. The facelift, lip lift, eye lift, (a lot of heavy lifting here, LOL) and brow resection hadn’t modified her overall appearance. Her face was softer, younger, and more feminine but still the same person.
After the second set of surgeries, however, her face had lost what I termed familial similarity. She no longer looked like either of her sisters. I believe this difference is what contributed to my inability to recognize her face, although I couldn’t describe exactly what features had changed.
I also speculate this loss of “familial similarity” is why I had such difficulty in adjusting to her appearance. The intensity of my negative response surprised me. I found myself repeatedly staring at her, trying to find her “old” self. When she first changed her presentation from male to female with clothes, jewelry, and makeup, then after her first surgery, I didn’t have this strong emotional reaction. I could still see my spouse underneath all her modifications. This time around was much different.
What was most upsetting was that we weren’t warned about the differences we would see post op. The surgeon and nurse described the bruising, the swelling, and the narrowing of her face but they hadn’t mentioned an overall transformation of her appearance. Not knowing personally the women featured in before and after pictures on his websites and those of others, I wasn’t able to appreciate the subtle but overall significant outcomes of these surgery. With Marcie I recognized the changes on an emotional level.
My impression wasn’t the only one that mattered. The small modifications in the measurements of Marcie’s face, jaw width, chin position, etc. were such that she doubted computerized facial recognition software would be able to recognize her either. For this reason, she felt the need for a new passport. She submitted an application once her face had healed and her features stabilized, allowing us to travel on short notice should we so desire. She decided against obtaining a new driver’s license. That need is less urgent unless she plans an encounter with our local law enforcement agents.
Luckily she is not having the same difficulties with her new face that I am. Her goal for after surgery was to look like an age appropriate, not unattractive woman. She didn’t need to recognize herself in the mirror, just perceive herself as a woman. She now feels she looks on the outside the way she feels on the inside. She has told me she is much more comfortable walking out in public, even without makeup. She no longer believes she looks like a guy. In her mind the surgery was a success.
She does continue to recognize residual effects of surgery. She can tell her cheeks are still swollen. She remains cognizant of the edema above her cheek implants. She understands that complete healing will take 6 – 12 months and is patiently waiting for the end result. Her surgeon has also been satisfied with her progress. I’m not able to recognize these subtle markers of healing yet to come, thus I’m not able to imagine her appearance in a year.
I originally planned to attend an early post op visit with her but was unable to do so. I asked her to thank her surgeon for his obvious surgical skills, and to ask why I could no longer see a familial resemblance in her face. What was it about what he’d done that didn’t just make her more feminine but had changed something much more global?
I was interested in whether he or other surgeons ever look at photos of family members to help guide them in reconstructing the face of a patient. His response was vague and implied this is not something he’d ever discussed with patients or considered. From my observations he tends to leave issues of patient and family education to his nursing staff. Had I been there, the conversation might have been different. Because of my underlying personality and healthcare background I would probably have pushed him harder on these questions.
I should add that for this surgeon, his primary patient population is women desiring a facelift. He works with trans women, but much less frequently. Thus the concerns I raise and the questions I ask are probably not as common in his practice. They could be issues he hasn’t previously considered. If someone we know were to plan facial feminization surgery, I would suggest they add frequency of treating trans women to her criteria for selecting a provider, not just overall educational background, surgical experience, and patient evaluations which Marcie considered.
That said, I don’t know how complex it would be to consider previous appearance when planning FFS or if it would even be possible. If not feasible, I would have appreciated a heads up that her face was going to change more dramatically than with the first set of surgeries. Being warned I might not recognize her, and that similarities to other family members might disappear, would have been helpful.
Thankfully, I have been able to adapt to her new appearance over the last few weeks. I stop and stare at her less frequently, although at times I still attempt to identify a bit of her previous self. Just when I think I glimpse her, she slips away. She remains beautiful, although a different beautiful. I retain the hope that some of the changes I perceive are related to residual swelling and she may yet regain some of her previous facial characteristics.*
While I continue to adjust, my major ongoing concern is for her sisters. They didn’t respond well to her announcement regarding her change in gender identity. Although at one point they admitted they were “probably overthinking things.” They demonstrated greater but not complete acceptance when they visited a year ago.
Since then the three of them have not been together in person. They have only talked on the phone. Her gender identity is not a frequent topic of conversation. The one time, of which I am aware, that it came up, was in the context of me referring to Marcie as their sister. The next time they talked her oldest sister requested that Marcie tell me not to do that again. They still consider her their brother and I should reference her as such.
Initially Marcie and I accepted this suggestion, but we have since reconsidered. I’ve decided not to stress over what terms I use to reference her and just use the word or words that come to mind first. I’ve worked so hard to use feminine terms of reference, I don’t want to break my new habits.
We are planning a trip to visit them in six months. I’m concerned about their response when she walks out of the airport. In preparation for this, Marcie has told the oldest that she won’t look like she has in the past. This sister, the more assertive of the two, responded that she knew this.
I don’t know if Marcie will send pictures ahead of time, but I’m pleased she has started to prepare her sisters for the changes. I know how hard it has been for me to adjust. I’d like to do what we can to help them adapt more quickly so they can enjoy our visit. I recently suggested Marcie consider using Face Time when she talks to them, although they have not yet started to do so.
In conclusion, the primary goal of this post has been to give folks a heads up before a spouse or significant other has FFS. I knew about most of the changes ahead of time, but not the fact my spouse might no longer be recognizable. Although desirable, I don’t know that computer technology is at a point where the surgeon could have drawn a picture of what he expected to ‘create’ ahead of time. Maybe in a few years this ability will be available. In the meantime, knowing your spouse might look quite different, even after the major swelling has resided, may be helpful. I’m sure this information would have eased my post-surgical adaptation to her new image.
*It’s been 14 weeks since her second surgery and I’m no longer concerned when I think about her. I envision her as she now looks. I’m used to it.
My next post will be in approximately three weeks. I have invited a guest blogger for my next post on October 11th. More information will be coming in the future.
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