In a three-part sharing of her journey, Rebecca goes into detail about her steps to get facial feminization surgery. Please be mindful of the content of this post, as it contains some surgical imagery, medical terminology, and graphic depictions of physical health and wellbeing.
Rebecca is an activist who has worked with local legislators and community leaders to advance transgender rights, acceptance, and safety in all aspects of society. She has also recently joined the Client Advisory Board at the Center for Transgender Care at Northwell Health.
The purpose of this article is to share my experience with the pre- and post-surgical process for facial feminization surgery. I’m not giving medical advice or endorsing any brand, product, or care provider. However, I’m just sharing information that happened or helped me along the way during this process.
At the beginning of 2025, I decided it was time to take the next step in my transition from male to female and undergo facial feminization surgery. During the winter of 2024, I stopped drinking alcohol for 3 months, legally changed my name, updated all my identification and documentation, and completed my second year of hormone replacement therapy.
The first step in my journey was to contact a plastic surgeon with experience in facial feminization surgery. Because I had already been a patient at Northwell Health, I chose a surgeon who not only accepted my insurance but was also among the most skilled and experienced in this specialty.
The initial consultation with my plastic surgeon took place at the end of April 2025 and lasted about 20 minutes. We discussed my goals and what I wanted to achieve, and the surgeon outlined which features he believed my surgery should include. He also explained pre- and post-surgery planning and took several photographs of my face from different angles. Finally, he explained the insurance company's approval process, and the appointment ended.
After reflecting on the appointment, I committed to getting into the best mental and physical condition I could. The procedure we discussed would take between 5 and 6 hours and require several weeks of recovery. So I started walking, intermittent fasting, and quitting unnecessary medication.
The next step in the approval process was the psychological evaluation. I was contacted by a Northwell Health professional who scheduled my appointment, which was conducted via Zoom. The psychological evaluation takes about an hour. However, I was very transparent and talkative during the process, so a second appointment was required.
From then on, there was nothing to do other than wait to hear from the insurance company.
During my consultation with the plastic surgeon, he explained that I should obtain dental clearance before the surgery to prevent any potential infections. While waiting for my approval letter from the insurance company, I had my teeth checked.
Before my transition, I was in a very self-destructive, self-hating place, and did not have the best habits. I made sure to stop anything that wasn’t important to my mental and physical health, and made a sincere effort in taking better care of myself to be in the best shape I could to have the most favorable outcome from surgery.
Proper oral care was the last thing on my mind, so I was shocked by how much dental work I needed. In the end, I had 5 teeth extracted, multiple bone grafts, and two osseous surgeries, all of which required about 30 stitches. I also switched to a soft diet. Unaware of what was to come, I gained valuable experience during the recovery from my facial procedure.
Dental surgery
Finally, during the second week of June, after my dental work began, I received my approval notice listing all the procedures covered.
Thankfully, I went to the dentist as soon as possible and had everything corrected, but the entire dental process lasted from the beginning of June to the end of August.
Tip: Get your dental work started as soon as possible when you are considering facial feminization surgery. During the summer months, it can take weeks or even months to schedule appointments, checkups, cleanings, or other procedures.
So far, the process has taken me 5 months (April through August) and 8 appointments with surgeons, mental health professionals, and dentists.
My surgeon's office contacted me at the end of August, and we scheduled surgery for November 21st, 2025 at Lenox Hill Hospital. As part of the procedure, medical clearance must be obtained within 30 days of the surgery date. I immediately scheduled appointments with my primary care physician and my dentist (for the required pre-surgery dental cleaning), reserved a hotel room in New York City for the night before my surgery, and arranged transportation.
The next step in the process was to get a CT scan. My surgeon provided me with a list of providers, so I picked the most convenient location and scheduled my appointment.
The machine used for the scan was a partial tube that covered only a small area, unlike the long, narrow, claustrophobic tube used for some tests. The entire test took about 10 minutes, with an additional 20 minutes to obtain the results on a CD-ROM for the surgeon.
Image of my bone structure
CT Scan machine
Rather than wait for the imaging center to send my surgeon the test results, I drove them to his office that afternoon to avoid any delays.
During the downtime, I continued walking, fasting, and taking care of myself. My weight dropped from 180 pounds in April to 145 pounds on the day of my surgery in November.
Six weeks before the procedure, I met with my surgeon for a pre-surgery consultation. Because my weight had changed dramatically, my surgical plan had changed and features we hadn’t considered during the initial consultation were now options. This required additional insurance approval. More photos of my face from different angles were taken, and the appointment lasted about 20 minutes.
At my surgeon’s office
Front of the building
A month before the surgery, I underwent my pre-surgical clearance examination, which included a physical exam, an EKG, and blood work. The examination took about 30 minutes and was completed at a Northwell Health facility.
Two weeks before my surgery, I had my teeth cleaned, and I was now finished with my pre-surgery preparations. In total, the process required 12 different doctors appointments and 8 months to reach the surgery date (April to November).
Next week: The Surgery
Stay tuned to hear the next phase of Rebecca’s surgical journey!