Felt real when I said yes, I want to proceed, more so when they told me a date that was too late (August), yet more as I waited 3 weeks on confirmation of a cancellation date.
Felt real as f***-all when I decided a couple of weeks after that I wouldn't change my mind, and as I went under anesthesia.
It also felt pretty real for 6 very hard weeks of recovery. Now it feels real because things are mostly healed and starting to feel truly right.