"Sex change" surgery for MTF transgender women is not just limited to SRS (aka "The Operation"). Another common type of surgery that's very helpful in appearing feminine is facial feminization surgery, or FFS. For me, having FFS was a big step because I had previously decided that I wouldn't transition until I had had it.
Depending on your existing facial features and your budget, FFS can include hairline advancement, forehead recontouring, brow ridge removal (men have a prominent eyebrow ridge, women don't), brow lift (women's' eyebrows are more arched than men's), rhinoplasty, cheek implants, lip lift (which rotates the upper lip to make it appear larger and thus more feminine), jaw and chin recontouring (because women have a pointier chin and less prominent jawbone), and adam's apple reduction.
Based on my surgeon's recommendation, I had all of the above done back in October. (The cost? Let's just say that I'm trying my best to forget it.)
I was in the OR for a full seven hours, and when I woke up my face was horribly swollen. (The resident training under my surgeon said something like "believe it or not, there are actually people with worse swelling that you". This was followed by a moment of silence, during which I assumed that the fellow training under my surgeon, who was also present, was glaring at the resident :) ) My right eye was completely swollen shut, and my left eye was close to it. I was wrapped up in ace bandages (one vertically from my chin to the top of my head, one horizontally around my forehead) to help control the swelling.
I spent that night in the hospital, with ice packs all around my face. Surprisingly, I had almost no pain. The next day, I left the hospital and holed up in my hotel room for the next week to recover. This mainly involved sleeping and near constant icing with packages of frozen peas over my eyes (which are the best thing to ice with because the conform to your body's contours.) At the end of the week, I saw my surgeon to get all the stitches out and then flew home. I still have some numbness on my forehead, under my nose, and around my chin, but that's all starting to go away.
The results: interestingly, the procedures which were most noticeable in the mirror to me are the lip lift and the brow lift. It seems that my mind almost immediately made the new shape of my face its normal, so it strangely doesn't look to me that I really had much done to the structure of my face! I have to look at a picture of myself before the surgery to really see the difference. But weirdly, it's different when I feel my face- _then_ I can sense the dramatic differences from what it was like before.
I'm not quite done with my FFS. In February I'll be getting hair transplants to cover up the scar at my hairline from the incision which they made to a) peel back the skin to do the forehead and brow ridge work and b) where they did the hairline advancement. If I hadn't had the hairline advancement, I probably wouldn't need the hair transplants, but the tension from that procedure left a bigger scar which is outside my hairline.
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