"I paid to have my face cut off and reattached": Facial Feminisation, Liposuction and the Hope of Change.

NSFW: This article contains graphic images and descriptions of medical procedures.

An edition of this article without medical images can be found »HERE

Note: This piece is part of a larger work. I wrote this introduction before undergoing Facial Feminisation Surgery and scheduled it to be sent automatically. By now I’m likely lying in bed recuperating, but as I say later, “I just wanted you to know all this, should something happen.”

Two Liters of Fat

The first “Gender Affirming Surgery” I had was liposuction in 2023. Oh, to have been blessed with those sumptuous curves, that hourglass figure of a classic golden-era-cinema femme fatale. Alas, I was robbed in the “gender lottery”, so instead I went and had two litters fat siphoned from my waist.

It was done under twilight anaesthesia. Which means I was semi-conscious for the vigorous stabbing through the sixteen holes poked in my abdomen. Conscious enough to move, to roll my body to the side to expose each flank, but not so conscious that I would remember it or fully feel it. There are only flashes, shadows of memory of during the procedure.

But I remember before it, obviously.

I remember standing completely naked in the operating room. I remember thinking that despite modern looking equipment how apt it was that the beige-toned walls betrayed the true age of the clinic. A delightful irony for a facility that leverages our desires to remain young and beautiful. I remember thinking the absorbent medical pads I stood on were the same ones I’d liberally distributed throughout my house when toilet-training my dog. I remember the nurses. Both twenty-something and stunning (as the staff of these places always seem to be?) whose first task it was to disinfect me. I remember shivering in the cold, my arms outstretched as they worked the solution into every fold of skin, my buttocks, my genitals. They joked about giving me “the worst fake tan of my life” as they hastily swabbed me, staining me Betadine-orange-bright from my neck to my knees. I remember the doctor holding up two compression girdles, asking me which one I wanted and feeling completely bamboozled that this was the moment I had to choose a garment that I’d need to wear 24/7 for the next six weeks. I remember laying down and having my arms sticky-taped to the gurney so they wouldn’t flop out into the open air. I remember crying before the aesthetic hit. I always cry a little just before the aesthetic hits.

Afterwards, the bruising was brutal.

The numbing anaesthesia injected into my abdominal cavity via the sixteen incisions leaked for days. My body wept blood and plasma and fluids into everything. My clothes, the bed sheets, the compression-wear holding my flesh tight against me so that everything could knit back together. The fluids that didn’t leak out of me seeped down to the bottom of my abdominal cavity to form deep purple and black bruising at my pubic bone. It looked like it’d been kicked just above my penis. The compression girdle, not permitted to be off me long enough to be effectively washed, turned sickly brown as the blood stains became permanent. I couldn’t move. I couldn’t bend. Unable to wear pants, unable to dress myself without assistance.

In the lead up I was deeply unsure. Had I known what it was going to be like I can’t say with certainty that I’d have gone through with it. However, the amount of pain and discomfort was not the main source of my anxiety.

No, it was something else.

The morning of surgery I left a letter to my wife, open on my desktop for them to read should it all go horribly wrong:

I know the odds of me being fine are large and the odds of things going badly are infinitesimal, but I’m still afraid and I wanted you to know. I’m afraid that the procedure will be fine, but I’ll still hate how I look. I’m afraid that I’m ransacking a perfectly good body for no reason.

All the platitudes that the world proclaims of “love the skin you’re in” still sit alongside images of traditional beauty. I feel like neither of these messages connect to me. I can’t love this body, nor can I ever look how I was supposed to.

I remember being about ten or eleven? My mother was away in Ireland and my brother and I spent that summer school holiday with my father. Four weeks of sitting on the couch eating chocolate biscuits and doing nothing. When my mother got back, she exclaimed “you got so fat!”. I hadn’t realised I’d put on so much weight.

I don’t know if this thing I’m doing today is related to that or to my gender. Probably both. And because it’s probably both it feels like I’m doing it for the wrong reasons? But also, the right reasons? I don’t know… maybe this is all just misguided, and I’ll still hate myself afterwards but in new ways? Or maybe I won’t and it’ll have been worth it.

I just wanted you to know all this, should something happen.

Turns out it was worth it. Best $7,000 I ever spent.

While not the waistline I want, it is no longer the waistline that I DON’T want.

So now I’m paying $38,000 for a surgeon to effectively cut away my face. To slice a channel around my ears and up my hairline, to lift away my cheeks, to flay my neck. He will rearrange, pull and reattach the underlying structures for a deep tissue lower face and neck lift. While he’s in there he’ll reduce the fat pads in my cheeks to give me the impression of cheekbones. He’ll also take a blade to the underside of my nose. A “bullhorn” or “moustache” lip lift (owing to the shape of the incision). Shortening the length of the cupid’s bow so that more lip protrudes, and you get a fuller effect.

I write this like it’s something on the horizon but in reality, by the time you read this, it’ll have already happened. All of the above is just prelude to the fact that right now I’m likely laying sprawled on a bed enjoying the closest thing to a holiday I’ve had in three years. It’s a shame that all I needed to do was have my face removed and reattached.

All this so I can maybe look more feminine… Maybe.

I use that word specifically. Some of these procedures are explicitly feminizing. Others are more… renovations… to a body, to a face. I will never have the face or body that I want. But at least it will no longer be the face and body that I DON’T want.

I can’t wait to show you the surgery photos. I hope you have the stomach for them.

–S