Facing It (Maisie Gets Facial Feminisation Surgery)

I wrote about taking a leap of faith a while back. And on the 10th February 2025, I finally did it! I flew to Marbella, Spain with my partner and let the very kind medical professionals knock me out and rearrange my face. This is the story about how it went.

It’s going to be a long post. So strap in and maybe bring a coffee or two.

An audiovisual version of this is available on YouTube, if you prefer to watch instead of read.

Why I did it

I’ve had facial dysphoria since like being a teenager. My Adam’s apple was the worst bit, it felt like a deformity as it was growing in. I’ve felt generally bad about my face since realising my gender stuff. So at least four years. FFS for me was a chance to improve this situation. Since starting hormone therapy, the situation definitely improved a bit! But the dysphoria was always still there.

So it was mainly for my own self comfort instead of feelings or wanting to pass or anything. Which is a valid reason and all! But it did take the pressure off of my outcomes in some way, since anything would be a better situation than before.

Consultation and booking

I used the online chat and booked in with Facial Team for an in-person consultation at their offices in Marbella, Spain. I’m glad I did, as I don’t think a video call would have done things justice. And seeing the staff and facilities helped me with trying to reduce my anxiety a little bit.

Once we flew in, we were taken straight to the hospital. They performed a CT scan of my head and took a bunch of photos from various angles. I then got ushered into a meeting room where one of the sales people and one of the surgeons had a chat with me. They opened up a dossier with giant A4 photos of my head and 3D renderings of my skull. This did wonders for my dysphoria as you can imagine.

They asked me what I felt dysphoric about, and then presented me with their suggestions. They recommended forehead reconstruction as the number one thing, and they explained the technique and drew on the scans to show me how they would trim down my skull bones. They recommended simultaneous hair transplants to fill in the areas of hair loss I have on my temples, especially since their forehead technique raises the hairline a little. Trachea shave was shown too, especially given I talked so much about how dysphoric it made me. The other tentative ones, were a rhinoplasty (but they explained that “your nose is androgynous so it's up to you”) and a chin implant to bring it forward (“this wouldn’t be feminising but it would improve your facial harmony”).

And those photos they took? They were sent over to a digital artist who works with the team and she edited the photos to make a simulation of what my result could look like. Based on this, I didn’t think changes to my nose would be really worth it, and the chin changes made me instantly more dysphoric. So I decided to leave them.

I think as soon as I saw those simulations I was set on getting this done. Pretty much as soon as I returned home I arranged an appointment for February 2025 (this was October, so four months’ lead time) and sent over the deposit.

Pre-op and absolutely bricking it

Surgery time rolled around far quicker than I was expecting honestly. Before long I was sent the full schedule of my trip, including what days to book flights, my hotel information (I booked through Facial Team’s partnered hotel), and the blood tests I needed to get done before travelling. I had to pay for the blood tests privately, which was a little pricey honestly, but not too much in the grand scheme of things.

And then it was time to fly.

I flew out with my partner, Jon. Leading up to the day, I was feeling super panicked. But as soon as we were in Spain and the clinic’s taxi driver picked us up at the airport, I was feeling a lot calmer. The flight was on Thursday and the surgery was Monday, with a pre-op appointment on Friday. There was a lot of time to relax, destress, and try to enjoy the local area.

The hotel room was absolutely giant for two people. It came with a whole extra bedroom for some reason? But it was nice and peaceful and comfy and had a balcony looking over the street opposite a taberna. It was maybe a little pricey for what it was, but it was nice and really convenient.

The pre-op appointment rolled around and I was once again whisked off to the hospital. Facial Team (I’m going to refer to them as FT now for brevity) had someone waiting for me as soon as I got out of the taxi and led me straight downstairs to the imaging area for a chest x-ray (checking heart and lung health). As soon as that was sorted I was led upstairs to another room and a bunch of nurses wired me up and recorded an ECG (checking heart health some more). Then I was led over to the FT offices in the hospital grounds.

They took even more photos of me, recorded a video of my face moving as I talked, then I was speaking to a surgeon again to get all the specifics sorted before the big day. They suggested trying to raise my left eyebrow a little higher, since I have a lazy eye and tend to open it less, with the caveat that it might not work out. They talked specifics and answered any last questions I had.

I then had a weekend where I walked around the city, took photos, ate a lot of delicious food, and cried a lot. The big day rolled around faster than I had expected.

Surgery day!

My alarm was set for an antisocial 6:45 AM and somehow I managed to sleep really well. After a quick shower and removing all my piercings, me and my partner headed out onto the street and into a waiting taxi. We were swiftly brought to the hospital, serenaded by 70s soft rock.

We arrived and then a nurse was waiting to take us up to my room. It was maybe the most modern hospital room I’ve ever seen, but as soon as I was given the mini tour, the nurse already had a paper gown, surgical stockings and grippy socks waiting for me. With nothing underneath. 😳

Then a parade of staff came in to pop a bracelet on me and take down some details. The hair transplant surgeon came in to measure my hair using a fancy magnifying glass and mark out where the best place on my scalp to make the incision was. She drew lines on my forehead to show where the hair transplant techs should make their hair line. Another surgeon came in to measure and mark on my neck where they should make the trachea incision so that it would be best hidden in the fold of my neck. Before I had a chance to panic and run away in my arseless gown, a nurse was ready with a wheelchair to take me down to the theatre. I still have no idea why they insisted on a wheelchair. It was literally a four metre walk. Gave my partner a kiss and away we went.

Once downstairs, I was taken into the prep area with multiple bays. I just caught one of the other FT patients being wheeled away to an operating theatre, while the other was being fitted with her cannula so I shouted an encouraging “good luck!” before she was taken away too!

FT operate on up to three patients on a time it turns out, with the named surgeons able to dip in and out of theatres to where they’re needed. I had six surgeons able to work on my case, for instance (ended up just being two). The nurse spent such a long time trying to get the cannula into the tiny lil veins in the back of my hand that I felt faint, so they had to wheel me into theatre, pale and sweaty, on the bed, past one of the surgeons and a bunch of nurses waving at me. I felt kinda embarrassed haha. In the theatre there were nurses prepping tools and equipment and medicine, the operating table itself, and on the wall, giant photos of my face and skull with lines and markings drawn on. It was like I had just entered the lair of my arch enemy.

They set me down on the operating table with various bits of foam supports, set me up with monitoring wires and then the oxygen mask. The anaesthetist (lovely fella) loaded the propofol into my cannula line, and as I realised it kinda hurt, the room was getting fuzzy and I was falling asleep…

I was woken up by (I think) one of the hair transplant techs, telling me that they were about to start their work. They wake you up for this to limit the time you’re under anaesthesia. I think I fell asleep again quite quickly, woke up a few times but missed most of it. They moved me to a different room at one point, had to get a footstool as I was too tall for the bed, and I felt a bit sick but they loaded me up with some kind of antiemetic to sort me out. Then eventually I asked how long left, and they replied “just 20 minutes and we’re done”. Finally, I was wheeled back upstairs to my room, where my partner was waiting for me. I promptly fell back asleep.

The first night was uncomfortable, I was nauseous a few times, and when I tried to eat dinner later in the evening, I threw most of it back up. I was equipped with a cooling mask on my face which was pumped full of cold water, to help with any swelling, which helped a lot. I was given a sleeping pill but I didn’t take it (I should have honestly).

I was in hospital for one night and most of the next day. Not too late in the morning a nurse came by and removed my drain. This is a thin strip that was inserted just under my skin to help drain out fluids and stuff into a little plastic bottle. It looked a bit like kool-aid. I was advised not to drink it.

They also removed my catheter at this point. Thankfully I’ve had experience of this before (bottom surgery) so I knew what to expect. A little uncomfortable but it was over nice and quickly. I was set down in a wheelchair and wheeled downstairs to have my skull scanned inside the radiation doughnut (the CT scanner). I was told that it all looks good!

I got some breakfast and I was able to gently take myself for a walk outside. Getting up out of bed for the first time since surgery is a bit daunting, since you feel very weak and a bit faint, but the more you do it the more your body acclimatises. I was encouraged to not push myself or rush. Getting my heart pumping would not be good for healing and definitely quite bad for my hair transplants! On my little walk around the picturesque hospital grounds, I bumped into three or four Facial Team surgeons (a couple of them were present in my surgery). They all commented that I was looking great and to take it easy.

Pro-tip if you have a companion with you: the fold out bed in the hospital room is not great. Bring some pillows from your hotel room!

Recovery in Marbella

Because I “only” had forehead reconstruction and a tracheal shave, I was able to return back to the hotel the next day after surgery. This was great as all my stuff was here, was a bit more comfortable than the hospital, and the environment is a bit calmer. I was feeling exhausted, but I was able to at least go for the short walk down the hill to a little coffee shop. As a caffeine enthusiast, this was a huge boost to my morale.

The following week was dedicated to just relaxing as much as possible, getting gentle walks in, and taking good care of my surgical sites. Because I stayed at the hotel recommended by Facial Team, I got daily nurse appointments where they cleaned my incision lines (one across the crown of my head, the other on my neck), checked my vital signs, cleaned my transplants, and sometimes have my hair a wash too. This took a lot of the stress out of the post operative care.

I needed to keep my transplants moist and healthy. Which involved spraying them with a spray bottle every thirty minutes in the day time, no matter where I was. Cafe? Spray. Tapas bar? Spray. Lying in bed? Spray. It was a little relentless but it was only for a week. I also needed to spray rosehip oil on the transplants before bed and it would just drip everywhere and stink. I was given a cocktail of medicine to take to make sure everything would heal up fine:

• Antibiotics - to prevent infections from forming at the surgical sites
• Paracetamol + ibuprofen - stopped headaches from being too bad.
• Omeprazole - help keep my tummy settled, and also safe from any effects from the ibuprofen I guess.
• Biotin supplement - this is a tablet that literally tastes like hair. You have to take it for six months. It’s meant to reduce the amount of “shock loss” your hair gets from being under anaesthetic and surgery, as well as increasing the chance of the hair transplants rooting successfully.
• Hydroxizine - an antihistamine to help with sleeping

Marbella is a gorgeous town with so many sights to see, little streets to walk down, and fantastic food. I highly recommend trying to get out if you’re able to. I needed to use an umbrella to keep the sun off my head at all times—my hair was clipped back so that my transplants were able to have space to breathe or something I guess. I was a bit of a sight with my red transplants, big bandage on my neck, and a bruised and sore face. I had a couple of quizzical stares from people but I never really had any issue and didn’t feel too self conscious. Some Finnish guy in a bar asked if I was okay but it was very much in an inquisitive way, rather than a judging way.

The swelling seemed to hit a maximum on day 2/3 and I massively ballooned up, but this seemed to settle down really quickly and going for gentle walks helped a lot. I wasn’t allowed to wash my hair until the FT nurse did it later in the week and my gosh I was starting to get really self conscious about how stinky and crusty my hair was. The accumulated blood and rose oil and betadine shampoo was really adding up!

However, when they finally gave it a wash and a scalp massage—it felt angelic. One of the top experiences of my life I swear. I felt like a million bucks afterwards. I couldn’t feel a lot on my scalp but I smelled and felt so much cleaner than before.

Sleeping was also a bit of a challenge in the week. I was required to sleep on my back, with my head at a 45º angle. I am a side sleeper. I was not prepared for how rough this would be. Thankfully the sleeping tablets helped, and the hospital had stronger stuff in case it wasn’t helping enough. I ended up a throne of pillows. Stacking them up behind my head, on my sides, and a pillow under my knees to stop me from rolling over. Jon told me I looked like an upside down turtle trying to roll onto my side while I slept… the plan worked and I was able to keep my transplants mostly clear.

Results after one week

The day before I had my post op consultation with the surgeons, I got the most cryptic message from my FT coordinator:

As well as my surgeon consultation, I’d be having my post-op photos taken for my case file. Facial Team offered to do a set without makeup and a set with makeup. They just so happen to have a makeup artist on retainer it seems??? I had a great time being taught Spanish words for the various bits of makeup (blush = colorete). Anyway, here’s the comparison of my before and after photos (without makeup):

It’s a complete night and day difference. Absolutely astounding. And “just” (I keep saying this!!) by removing a few millimetres of bone from my brow? Anyway this is what I looked like with the makeup artist’s work:

Not my usual style at all. But gosh it looks absolutely incredible. I was blown away by just how much EYELID that’s visible now??? That was never the case before. My face seemed more harmonious. I weirdly felt more comfortable with my nose (I guess because there was never anything about it that made me dysphoric). Feeling the reduced bump on my neck made me cry. And seeing where the hair transplants would end up filling in? This was all simply magical.

How do I feel about it all?

I’m now writing this about 100 days since my surgery.* I got a bit waylaid with life stuff so I was a bit slow getting this written up.

(*I took almost 100 more days to actually publish this!)

The first couple of months were hard, I have to admit. Once I arrived home the honeymoon period of healing wore off, and I started fixating on parts of my face. I felt my trachea scar was too visible. That my hair transplants were red and angry and looked weird. That my eyelids weren’t as visible as first thought. That my face didn’t really look different. That my eyebrows were weird. That I could see the titanium implants in the right lighting.

As I started focusing on returning to my life stuff, I stopped fixating so much on my recovery day-to-day, and my attention drifted to more pressing things. Work. Social life. My appalling mental health situation. This distance, as it turned out, helped a lot. At some point I caught myself in the mirror and noticed that the swelling had receded a lot. I started to feel gorgeous. Extremely comfortable with my face.

Ultimately, the results from my FFS is not a huge deviation from how my face was before. This is a good thing for me. Because I still look like me. My brow area is less pronounced. My eyelids are a bit more visible, allowing me to be a bit more experimental with my makeup. My face seems brighter, more open in general. It seems a bit rounder and less angular? I can actually hold my head up high and not feel ashamed about my pronounced trachea!

It’s very similar to my thoughts after getting bottom surgery. There’s not a radical feeling of joy and excitement; rather, it’s a gentle calm feeling that I feel a bit more comfortable in my own skin. It’s about not obsessing over my brow bone in the bathroom mirror. It’s about not feeling sick and dysphoric whenever I tie up my hair and see my receded temples. It’s about not feeling uncomfortable whenever I wear anything that shows off my neck. It’s about smiling with my whole face and just not consciously worrying about stuff so much.

Was it all worth it? Ultimately, I think so.