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Description

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semi-grimdark38079 artist:santi-dleon29 princess celestia116586 twilight sparkle371809 alicorn337112 pony1712602 g42124267 magical mystery cure2978 my little pony: friendship is magic269128 blood33547 chloroform110 cotton balls11 duo209265 female1913205 floppy ears78147 hallucination197 mare814910 music notes5098 prone38431 scene interpretation11455 singing9060 surgery135 swirly eyes3751 thought bubble6062 twilight sparkle (alicorn)155332

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Background Pony #C332
At least Celestia knocked her out first. So many painful, not-instantaneous alicorn transformations have the poor victim completely aware of the new bones growing and ripping themselves out of her back.
Barry Tone
My Little Pony - 1992 Edition
An Artist Who Rocks - 100+ images under their artist tag
Artist -

Needs to know Hebrew.
“Frothing” tag removed. I asked the artist and it is a Cotton-Ball with Chloroform, not frothing at the mouth.
bigladiesman
Non-Fungible Trixie -
My Little Pony - 1992 Edition
Not a Llama - Happy April Fools Day!
Speaking Fancy - For helping with translations

El retorn de Jan
Twi is my fav mane 6, as we are colleagues (librarians), and now she’s even more, watching what she had to endure for a prrrrrromotion XD
MetaKnight145

>grimdark  
Okay now I know you people can’t handle the slightest shit.  
There is nothing grimdark about this image.  
Dark, maybe.  
If she was cutting off her wing yeah but she is giving her one and even clearly gave her anesthesia.