FFS suggestions?

[phoenix83]

Hi all.

I have been on hormones since 2006, and have gradually worked towards transition. Last year I finally had enough money to have FFS with Dr Chet, and was so excited thinking it would help me to pass so much better like it has for so many others. Unfortunately my results were not satisfying. While I do look less masculine, I feel like my face looks misshapen and weird. My features look quite asymmetrical especially my chin. Also I feel my eyebrows were lifted very high up which I will probably have to correct with a transplant.

What would people suggest I could do to feminise my face more? To this day I have had forehead revision with browlift, jaw and chin reduction, and the rhinoplasty. I have spoken to Dr Chet since, and he has suggested that there is no more that can be done for my chin and nose as they are. I'm sick of looking so angular and weird is some places, yet puffy and saggy in others .

[kariann330]

I would suggest contacting Dr. Rumer in PA. I have herd nothing but great things about her FFS results. I have also herd that her staff is very nice and very helpful, and if revision are needed she is very understanding and very helpful. Im sorry your surgery didn't go 100% but i will say that do you pass very well.

[Donna Elvira]

Hi there,
Sorry to hear you are not fully happy with your results following what must have been a very big personal investment form every point of view. Like Kariann, I also think you look pretty good already and sugget you be very careful about adding more surgery to what you have already done.
I have also done a very complete FFS including a sliding genioplasty (almost 1cm reduction in height and about 3mm setback). It worked out really well, just right in terms of proportions and perfectly symmetrical.
I mention this because looking at your photos the only thing I might be tempted to redo is the chin, notably a set back. Surgeons who are good at this are Dr O. (but very expensive) and the surgeon who I went to, Dr Van de Ven in Belgium.
A mid-face lift might also be worth considering to give you fuller cheeks. Again this is the type of very targeted intervention that Dr Van de Ven is excellent at.
Wishing you all the best!
Donna

[Nicolette]

Your cheeks do look rather flat. Cheek implants could possibly improve the balance between up and lower face. Personally, I don't like the hairline. It looks unnaturally straight across. But this looks like a consequence of hairline lowering and is exacerbated by dark roots growing through. It could do with some rounding off at the corners. Do you have a fringe?

[phoenix83]

Thank you all for the comments and suggestions so far!

I mention this because looking at your photos the only thing I might be tempted to redo is the chin, notably a set back. Surgeons who are good at this are Dr O. (but very expensive) and the surgeon who I went to, Dr Van de Ven in Belgium.
A mid-face lift might also be worth considering to give you fuller cheeks. Again this is the type of very targeted intervention that Dr Van de Ven is excellent at.
Wishing you all the best!
Donna

I've just sent an email off to Dr Van, his work looks great, especially if your face is anything to go by Donna!

Your cheeks do look rather flat. Cheek implants could possibly improve the balance between up and lower face. Personally, I don't like the hairline. It looks unnaturally straight across. But this looks like a consequence of hairline lowering and is exacerbated by dark roots growing through. It could do with some rounding off at the corners. Do you have a fringe?

I used to have a fringe, I usually wear my hair down so you can't really the sides. I agree about the hairline, I think maybe a hair transplant might be necessary. I have heard cheek implants can be risky though? I've been thinking about just having fat injections, apparently thats what Carmen Carrera did.

[Nicolette]

I used to have a fringe, I usually wear my hair down so you can't really the sides. I agree about the hairline, I think maybe a hair transplant might be necessary. I have heard cheek implants can be risky though? I've been thinking about just having fat injections, apparently thats what Carmen Carrera did.

It's the upper cheeks that perhaps need more volume. I don't know if fat injections have a tendency to migrate due to gravity. I had hard silicone cheek implants myself. I didn't encounter many risks in my research pre-op, apart from the rare instances of infection that affect any type of surgery. Just be careful not to overdo fat injections as this often leads to 'pillow face' and isn't attractive.

[evecrook]

I don't know you look all right to me.

[Donna Elvira]

It's the upper cheeks that perhaps need more volume. I don't know if fat injections have a tendency to migrate due to gravity. I had hard silicone cheek implants myself. I didn't encounter many risks in my research pre-op, apart from the rare instances of infection that affect any type of surgery. Just be careful not to overdo fat injections as this often leads to 'pillow face' and isn't attractive.

I have medpore implants too, inserted just below my eyes on the outer edges of my face when I did my upper face surgery in 2011. The biggest risk with such implants is that they protrude too far outwards giving a rather harsh outline. This can be attenuated by burring them down to adapt them to the contours of your face. I learned this the hard way as I had to have them burred down after the initial surgery which required a second intervention through the inside of the cheek. Happily this was done when I did the lower face surgery in 2012 so no specific intervention was required but it is better to be aware of this risk up front.
I also had fat injections, twice, but am not sure if this had much permanent effect. Against that, the simple facelift, eventually combined with the midfacelift, as proposed by Dr Van de Ven (I only did a simple facelift), definitely gives more volume to the cheeks while maintaining a natural appearance.
Wishing you all the best.
Donna       

[Jill F]

Today I had my first consult with a plastic surgeon in Beverly Hills.  He is not known for specializing in FFS, but has literally written the book on certain procedures and teaches plastic surgery at UCLA medical.  I wasn't even close to the first transwoman he's seen, as he often does BAs while another surgeon does GRS.  I met him in the ER last year after a misadventure with alcohol when he stitched up my forehead.

You can sort of see what's going on with mah face in the avatar pic...

Anyway, I wasn't terribly surprised when he said I don't really need much in the way of feminization, nor do I need a specialist in that department.  My brow ridge is smaller than my wife's and he told me it doesn't need ground down.  I have no adam's apple to speak of, my jaw isn't super dudely and my hairline isn't obviously male looking either.

That being said, he said I could best benefit from the following procedures:
Endoscopic brow lift and scar revision
Eyelid skin bag removal
Mid-face liposuction and possible excess skin removal
Neck lipo
Mole removal (several)

And I thought possibly:
Nose reduction
Cheekbone implants

But he wasn't too sure about that.

He also told me I don't need anything lifted (yet), and told me his rough guesstimate for the whole job was about $20K, give or take, and that's the "going rate" in Beverly Hills.  This is all also outpatient surgery with a shorter recovery time, which I like the sound of.

Any thoughts?

[Donna Elvira]

Jill,
There are some basic rules when it comes to giving an opinion about facial surgery, both for before and afters. Photos should be from straight in front, left and right profile and eventually left and right oblique (45°) all with hair tied back.
They should also be taken with good light and from far enough away, 3 to 4 yards, to minimize any distorsion of facial features.
That's a fairly round about way of saying that I wouldn't dare give an opinion/suggestion on what might be a good idea for you based on your avatar photo.
However, what is interesting to note is that all the procedures proposed are standard cosmetic surgery procedures so all you can reasonably hope is that they will have a rejuvenating effect. Apart from that, feminisation will be almost certainly be pretty minimal
Also, for your information, when I did my forehead surgery, at my own request (I didn't want any scars below my hairline) , a coronal incision was used. Because of this, the browlift effect was pretty minimal. Afterwards I decided I wanted more of a browlift and looked at the option of doing an endoscopic browlift. I was advised by a very well respected cosmetic surgeon that the effects were generally little better than those obtained with botox injections and that the best way to proceed was by doing an incision, eventually just behind the hairline, and really raising the muscles. This is what I ended out doing.
Hugs
Donna