Planning your operation
Table of contents:
Obligatory things to arrange
Once you obtain your facial feminization surgery proposal, you will receive login information to get access to our patient platform. This will be where you can arrange the following things:
- Anaesthesiology form—Fill in the anaesthesia form in your account section.
- Preoperative tests—Only operations in general anaesthesia.
- Electrocardiogram—Only when you are older than 45 and will have general anaesthesia or local with deep sedation. Please upload the report to the patient platform at least one month before the operation so we can prepare and make the necessary judgments.
- Blood test—For all ages when you're going to have general anaesthesia or local with deep sedation. Please email the results at least 1 month before your surgery. We really need the results of these investigations as our anesthesiologists won’t give anaesthesia without it. The tests we need are Hb, hematocrit, APTT/PTT, platelets, fibrinogen, creatinine, urea, electrolytes (ex. Potassium, Sodium, Chlorine), HIV and Hepatitis C. If your doctor needs a letter from us you can download it here and fill in your name and the date.
- Orthopantomogram of the lower jaw—Only when you have a jaw reduction or chin recontouring. You can bring this image with you or email it to us. Best is to ask your dentist for this. It doesn’t need to be a recent image, ask your dentist for an already existing image from your file. If your dentist needs a letter from us you can download it here and fill in your name, birth date and the current date.
- CT scan of the trachea—Only when you have a tracheal shave. This exam can not be performed in your home country. If you opt for a tracheal shave, we will arrange for a CT scan to happen in Antwerp on a working day before your operation takes place. The CT scan is included in the price of an Adam's apple reduction. These are your instructions.
- Cardiopulmonary Exercise Test (CPET)—If your BMI is between 30 and 35 we need a cardiopulmonary exercise test. If your BMI is higher then 35 we don’t operate for your own safety. When losing enough weight we will operate as soon as your BMI is lower than 35. No exceptions are made.
- CBCT Scan of the skull—Only when you are getting custom made peek implants for the cheek(s). This scan is not included in your operation and should be made at least 8 weeks before your operation. These are your instructions.
These exams are NOT included in the price, with exception of the CT-scan for an Adam’s apple reduction. All these tests need to be arranged by you in your home country. Your general practitioner could help you with this. The results should be updated to your account on our platform. Bloodtest and ECG can be no older then 3 months. They are very important as the anesthesiologist will not give general anesthesia without it.
Planning your stay in Belgium
- Duration and typical stay—You will receive a planning document with all your appointments in Antwerp 5-7 days after we receive a receipt of your booking deposit.
- Transport to Belgium—Belgium is easy to reach from all countries.
- Your stay in our guesthouse—For patients of Dr Bart van de Ven, most of the proposals are inclusive of your stay in our Guesthouse. Some patients of Dr Doornaert will have to book their stay in the Guesthouse themselves, you can find on your proposal whether your stay is included or not.
- Things to bring—We made a checklist of things you might want to bring with you during your operative stay in Belgium.
During your preoperative facial feminization consultation, we will ask you to sign an informed consent for the operation. If you wish you can already take a look at it so there are no surprises.
We will provide you with these postoperative instructions on paper in the clinic.
Frequently asked questions
How long is the waiting time to book an operation?
The average waiting time for an operation at the moment is 3 months. For big surgeries, it can be up to six months, for small surgeries, you might be looking at less than a month. You can check availability through your personal account. You will get access to your personal account after you've received your surgery proposal.
I am interested in a surgery, in which country do you perform FFS and BFS?
Dr Bart van de Ven (FFS) travels to different European cities for consultations twice a month, but surgery is only performed in Antwerp, Belgium. Dr Maarten Doornaert (BFS) will occasionally also travel for consultations, but also only performs surgery in Antwerp.
I’m a bit overweight. What is the maximum BMI for elective surgery?
In principle, the maximum BMI is 30. If your BMI is between 30 and 35 but you are in good health, your case is considered on an individual basis by our anesthesiologist. You will be asked to fill out the anesthesiology form in your personal account and we will also need a Cardiopulmonary Exercise Test (CPET). If your BMI is higher then 35 we don’t operate.
When should I stop my HRT treatment?
You can continue your HRT treatment before, during and after your FFS. We prefer you to continue taking your hormones because FFS is emotionally already perturbing enough without messing with your hormone balance.
Only for implant surgery of the buttock and hips we ask to stop one week before the surgery. The day after surgery you can continue your HRT treatment. This because this type of surgery implies some immobilisation (obliged) after the surgery. In this case the risk for blood clots is higher.
Will I be able to eat?
If you haven’t had any treatment involving your teeth, a sliding genioplasty or orthognathic surgery, you’ll be able to eat normally quite soon. Due to the effects of general anesthesia, you should only feel nausea for the first few hours. You may prefer to eat softer or pureed foods initially if you have intra-oral sutures. Our catering service provides foods that are easy to ingest, to help you with that. After a sliding genioplasty, you should be very careful not to put too much force on the lower jaw e.g. by eating raw meat (steak) or by biting an apple. This should be avoided. The jaw is really weak in the chin area and it will take about 6 weeks until it has regained its original strength.
Can I pay for my surgery at arrival using credit card or check?
No you can’t. We only accept bank transfer, debit card or cash payment (bank notes).
Can I pay my deposit with Paypal or credit card?
We don’t accept payments for operations by Paypal or credit card. The only way to pay the operation is by bank transfer, debit card or cash.
Can I pay the money back on a monthly base?
No, the full amount has to be paid before the operation. At the bank, you will find professionals that can judge if it is wise for you to take out credit. We understand you wish to have your surgery as soon as possible, but don’t underestimate the stress of a high financial obligation.
Why can I not book more than 7 months in advance?
The maximum in advance that can be booked is 7 months. We do this because we noticed a lot of things can happen in 7 months that disrupt planning (in the life of the patient but also in the life of the doctor). Dates automatically open up 7 months in advance. So if you want to book a particular date, best is to schedule in your calendar to do this 7 months before this date. As the date is blocked for everybody, you don’t have the risk somebody else takes the date (you do have the risk Dr Bart van de Ven is on holiday). Attention: Operation can be booked until 7 months in advance. Pay attention, the software uses a formula where a month is always 30 days. So at certain times of the year this can produce almost a weeks difference to direct month date method of calculating a 7 months date ahead.
What if you are ill at the moment of the scheduled surgery?
If a letter of a medical doctor saying the patient really was not able to be operated because of physical illness, the surgery will be rescheduled without cost.
Can I be put on a waiting list to be contacted just in case someone cancels her surgery?
Yes, we can put you on a waiting list if you want. You will be contacted if someone cancels. In our practice this rarely happens, though.
Is it mandatory to book the guesthouse at the clinic after being discharged after FFS?
If you live not too far from Antwerp it is not a problem to return home the day after surgery and come for a postoperative consultation with Dr van de Ven 6 days after surgery.
Are the postoperative controls obliged?
No, they are not obliged. Just let us know which control you can not attend.
I got a cold last week and next week is my surgery. Is it something to worry about?
If there is no fever above 39° or serious coughing (bronchitis), there is no problem.
Is the preoperative consultation obliged?
Yes it absolutely is. Without this, Dr Bart van de Ven cannot operate.
What if I take any coagulant like Aspirin or Sintrommitis? Do I have to stop taking them?
Please contact the doctor that prescribed this medication to you and ask him if you can just stop it for a while. Ideally we would like you to stop Aspirin from 10 days before the surgery till 3 days after the surgery. If you take Sintrommitis it should be stopped a few days before surgery, but often you will need some other anticoagulant that is more controllable to replace it. Your doctor will give you the correct instructions.
Do I need to remove nail treatment prior to surgery?
The reason this is sometimes requested is for the anesthesiologist’s monitoring of the pulse oximeter, which measures the level of oxygen in the blood. This can also be monitored and measured by attaching the sensor to the toe or earlobe, so our anesthesiologist does not request to remove gel nails.
Do I really need to stay full week with that kind of surgery?
We strongly advise you to do so.
Why you don’t ask for the blood group?
Dr Bart van de Ven needed to do a blood transfusion on a patient twice in his life so far. So the incidence is very low. If it is necessary, the blood lab will ALWAYS do a cross test with the blood of the patient before giving the blood so testing it before won't be necessary. In the case of an acute need for blood, the blood group O-negative is given which is safe for everyone. The occasion did not ever occur in our practice, but Dr van de Ven’s blood group is O neg, which means he would be able to give his own blood…:).
When should I stop my electrolysis/laser hair removal sessions before FFS?
It won't be a problem if you have a hair removal session two days before your surgery.
When do you need to have the results of the bloodtests? What if the results are abnormal?
Please send us the results at least a few working days before your surgery is going to take place, so they can be added to your patient file. In case some of the results are clearly abnormal you should ask your GP or a specialist if it has any consequences for the planned surgery. By definition, 5% of test results are out of normal range. That means that very often it is without consequence.
When will I be able to get up and walk around after the surgery?
In the hospital, once the catheter has been disconnected, you should gently work up to getting out of the bed and walking around a bit, unless your doctor advises differently. Listen to your body carefully and get plenty of rest, but don’t stay in bed all day. After a few days you’ll like to go outside, which you should do.
Wann sollte ich mit der Rückkehr an den Arbeitsplatz rechnen?
Normally our patients return to work after 2 to 6 weeks, according to the extent of surgery.
How long should I stay in Belgium after surgery?
When it is an extensive surgery you can fly home 8 days after surgery. This is what a typical one-week schedule looks like.
We are doing our very best to keep this information up-to-date. In case you see anything that no longer seems accurate, or in case you have a question, please fill out the form below!