Choosing an FFS surgeon on a budget

[Apples Mk.II]

It has taken me months to make the my choice, but in the end I will be blowing my SRS savings on FFS. Being realistic, I can look at my dick, do the friggin' helicoper while singing "In the rain", but not having a feminine face is my biggest source of Dysphoria and anxiety, since it dismounts any intent of presenting female through voice, movement.... A vagina will get me to nowhere if I keep being read as transsexual or worse, despite the other issues I can work on.

I got an evaluation some time ago and I know my critical points are Nose, Forehead (brow, hairline), Trach Shave, and Chin (sliding genioplasty was recommended). In that particular order from worse to less of an issue.

My original plan was to do it with Chett since I would be doing SRS with him and that would save some money on trips, but since I am putting SRS in the "to do later" list in favour of FFS (improve passability, better chances of finding a new job) I am open to choosing more surgeons. As far as I can tell:

- Low cost alternatives are out of the question. Cardenas, Femilife. It's a personal issue.
- The expensive ones (such as suporn or a few U.S. names I have heard of) are also out of my budget.
- The national option, Facial Team, nope. They are quite know for doing a very minimaslistic job.

The prices with Chett came out as 16.000€ without the chin, and 21.000€ with chin and maybe jaw line reshaping. Travel, hotel, etc included (2.500€ counting a three weeks hotel stay). I should calculatete a bit higher since ->-bleeped-<- tends to happen. As far as I can tell, this is more or less a standard medium price, and what my budget would be. My plan was like this: In the moment I go into unemployment, book a surgery date ASAP. Since I could be some months or even a year without a job, it's better to use the time rather than waiting for a new job and having to ask for a month leave. If I meet the 16.000€ goal (unless something happens), I would go with everything but the chin/jaw. If I reached the 21.000€ (very hard), I'd add that lower part.

For the people living in the U.S., I will say that Right now I have a guaranteed $ 22.000 budget, and if I am lucky and don't get fired or resume work, I can increase it to $30.000. After that amount I would go back to saving for SRS again.


I can travel to nearly any place in the globe, although Thailand was going to be my main choice. I can try some european surgeons, But they may be well over my budget. Regarding South America, I only know of Dimaggio, and I am supposed to be getting the name for another one in Brazil (I've seen the woman that has gone to him and the results look very good). Haven't thought about U.S.


So, what options do I have? Right know Chett is my main choice because of the SRS, but I really don't know if he is good, or somebody here has done it with him before. I want the surgeon to be fairly aggressive with the supraorbital, and specially with the nose (http://www.facialsurgery.com/ClkoffTPgt3_2011_09_04mh.html). See the first two photos? I have that issue with the nasal spine, which added to the really big and long nose and supraorbital arch, make my side profile look like a rat. Also, to adjust a bit the septum since we are there.

Currently, I'm checking the surgery directory here, but still unsure. Thailand still seems like my first choice.

[sh1982]

If i were you i would do a bit more research regarding chett and foreheads before going to him, i have no doubts about going to him for srs but i would think very hard before i would do ffs with him.And for your lower end amount your only option would be femilife but you count them out so there are not much other choices in that price range if you want to do the whole face plus chin and jaw.Maybe if you reach your upper end of your budget you could go to Dimaggio or even Zukowski.

[Apples Mk.II]

If i were you i would do a bit more research regarding chett and foreheads before going to him, i have no doubts about going to him for srs but i would think very hard before i would do ffs with him.And for your lower end amount your only option would be femilife but you count them out so there are not much other choices in that price range if you want to do the whole face plus chin and jaw.Maybe if you reach your upper end of your budget you could go to Dimaggio or even Zukowski.

The chin / Jaw are more like a bonus right now, since it is not something that will improve passability for me. I am on a sticky situation, and once the flow of cash stops coming, I need to do as much as I can afford, even if it is only a half face, since what I need is improvement in order to avoid job discrimination. I look too weird in male presentation right now. Reaching the high end would take me a minimum of eight months, and that if I am not fired, which can happen anytime. It's better if I get the surgeries while in the time out, since once I am in a new job a month of leave would get me fired again. Also, remember that in my budget travel and hotel expensed are included (2500€), so the whole 30.000 would not be meant for surgery.

I'm starting to question Dimaggio a bit. I just got some photos sent from a few girls that turned into complete disasters over time. She looked ok three months from surgery, but as she healed she now looks as a complete mess, and she had a full FFS with him.

I still need to send the photos and receive the prices on each of the surgeon.

[sh1982]

I am not a big fan of Dr DiMaggio myself to, i think he does a nice job but he seems a bit conservative specially with for example the hairline.You might wanna look into Dr Spiegel in Boston he is not cheap but not massivly expensive, i think i got a quote from sometime ago for forehead and nosework for about $20000 or little more.Can i ask why you ruled out femilife, there are actually my second choice(after Ousterhout if only money would allow me to go to him) because they seem to do a good job in my opnion as good as say Dr Spiegel or Suporn but at a fraction of the price, while price isnt the deciding factor it does play a role at least for me.

[Apples Mk.II]

I don't have a magic pot full of money at the end of a Rainbow. As things are, in the moment I go into unemployment I need to use that time to do the surgery with what budget I have at that moment. In order to afford a better surgeon, I would adjust the desired FFS to just the barebones for passability: Nose, forehead with scalp advancement, and trach shave. The trach shave could be skipped and done later with a national professional. I just got a directory of specialists in the country and there is one specialised in the Adam's Apple that will do it for 1800€. Transplants for the temples if the advancement can't do the trick would also be done locally.


Regarding femilife, it's personal. Also, I can't find a lot of info or before / afters from them, same as with Cardenas. I like Spiegel's before and afters, but the costs from travelling to the us can get rather high. I will send my photos to four surgeons, get the pricing and see what I can do when the moment comes.

In europe, I may check with Van der Pel from facialfeminization.eu

[castle of glass]

Dr Van de Ven would be a very good choice. He was very nice and professional when i met him last year for a consultation. His portfolio is also very impressive. I know a few members on this forum have been to him and are very happy with his work.

[Apples Mk.II]

I may think seriously about them (or at least consult them). The most interesting is their portfolio, which could be describe as fairly realistic. There are some surgeon sites that only show the best cases, but this ones seems give some sort of "realistic expectations", showing patients with all sort of initial phases, and which results can be obtained depending on the starting point.

Right now I'd go with Spiegel, if he can be considered a "medium price" alternative. I like the B / A and there are a lot of girls showing the results and oppinions, and I guess I'd have less issues with directions in the U.S. than in Belgium I'm bilingual with english ("american english" as one crazy brit told me, that hurt), but no freaking clue with french. Still, everything depends on how much they ask. So, right now:

- Spiegel (US). If I have to do an extra trip for the consultation, we have a big issue
- Van de Pen (EU). Cheapest trip, no need to even use my passport. I don't even need to juggle with currencies. Charges 50€ for the proposals, although I already know what I need. Probably one of the best sites explaining everything.
- Femilife (SA): Not really interested in this one right now, but I will leave it for now.

What I need know is more recomendations. And what's the deal with that Zukowsky guy? I remember hearing something like "Used cars Salesman".

[Hikari]

Zukowski is a character alright, a personality that endears him to many, and repulses many as well. I know a few girls who went to him who spent between 20-35K. I like his aesthetics, but many do not. If you register on his site and look at the pictures you will notice that he generally tends to try and give every girl the same sort of nose for example, and while it works on many; it can't look right on every face.

McGinn and Leis also both do FFS in Pennslyvania with prices that are not all that high, but the results I have seen for both of them are not very dramatic. Realistic perhaps, but if you want severe changes then they wouldn't work.

FWIW based on the yahoo FFS group photos I think Bart van de Ven has the best overall results that I have seen, and he isn't Ousterhout level expensive either.

[sprouts]

Thanks for creating this topic, AppleJack!  I definitely relate to your situation, and like you, I prefer Spiegl's B/A over what I've seen of other's work.  I presently have 12.5k (US) available, and I'm immensely eager to have FFS.  I've considered possibly doing nose, forehead, and trach. first, and then saving for lip, chin, and jaw.  Honestly, I'm quite afraid of jaw work. 

[Dahlia]

And what's the deal with that Zukowsky guy? I remember hearing something like "Used cars Salesman".

Well eh, except for creating piggy noses and stratospherical eyebrows....he recommends unnecessary procedures like cheekimplants that not only look out of proportion but also tends to leave a 'wooden' face when animated...barely able to open the mouth when speaking.
Lipaugmentatiod with fat transfers...he also recommends often...and I can't believe patients have their faces voluntarily mutilated and paying some $35.000 for it!

Some FFS surgeons tend to make this fairytale 'the new clothes of the emperor' come true for their MTF patients.
For many MTF having had FFS acts like a 'token'.

[Apples Mk.II]

Well eh, except for creating piggy noses and stratospherical eyebrows....he recommends unnecessary procedures like cheekimplants that not only look out of proportion but also tends to leave a 'wooden' face when animated...barely able to open the mouth when speaking.
Lipaugmentatiod with fat transfers...he also recommends often...and I can't believe patients have their faces voluntarily mutilated and paying some $35.000 for it!

Gladly, I got my evaluation with VFFS some time ago and I got told which things not only were not necessary, but would worsen my face. That a lip lift would  make look like Bugs Bunny since my front teeth could show off slightly (Damn, I really want this one). I am pretty clear that this time I only want the most important fixes. Forehead with  scalp, nose and adam's apple. After that the next big saving will be again for SRS, and after I am finished... I will destroy my face with unnecesary surgery... Or at least do the sliding genioplasty I got recommended.

[helen2010]

Dahlia.  Disappointing comments re Mark Zukowski.  He is a great guy, does brilliant work and is an artist. If you have had ffs with Mark and didn't like the results then you have a point.   It does not sound like you have.  I did and like many, many others was delighted with the results.

[helen2010]

For those who wish to see a recent example of Mark's work and hear a first hand account see enigmatic fluffs thread on ffs and recovery with video.   Selecting a surgeon is a very personal decision and aesthetics are somewhat subjective but please take a look and judge for yourself.

Aisla

[Apples Mk.II]

For those who wish to see a recent example of Mark's work and hear a first hand account see enigmatic fluffs thread on ffs and recovery with video.   Selecting a surgeon is a very personal decision and aesthetics are somewhat subjective but please take a look and judge for yourself.

Aisla

Still, Enigmatic Fluff / Harmonic Dissonance was nearly perfect before FFS, and much much younger when she started HRT, than practising FFS in a less than optimal face already ravaged by full puberty and 30 years of testosterone. IMHO, results are fairly dependent on the starting point, and I doubt those ones can be pullled on any person. Not mentioning that I suffer from facial assimetry and my funds are fairly limited, I don't have high hopes on what can be achieved, even with that Zukowsky. In any case, you can't sell me extra stuff if I have a limited budget...

[helen2010]

AppleJack
Mark is quite expensive.  There are certainly other options.  A good FF surgeon should be able to make a big difference even if you have a lot to address.  You are doing your homework so will be able to compare cost, recommendations and results.  At the end of the day you need to be happy with your decision and I wish you the very best. 
I found that most surgeons start with their standard suite of procedures but as soon as you begin talking about your objectives, the areas which you were most uncomfortable with and your budget that they become more consultative and listen more carefully.
I had a compressed cheek (from a football injury), large and broken nose, seriously hooded eyes  and bags under eyes, prominent chin and trachea, and a receding hairline which all needed work and also needed to suit my large  T manufactured frame.  I am pleased with the result even though I am not, and at 53 years of age did not expect, to be Angelina Jolie.
Aisla

[Apples Mk.II]

I got another one to check, dr. Bruno Souchère in Lyon, France. A friend put me in contact with another trans girld that had surgery with him. He is an ortognathic surgery specialist (very good and feminising jaws and chins) that works with a gender therapy unit in France. He also does foreheads, but he is not a widely known commercial name, since he seems to work more for healthcare. It's work trying to contact him hoping he can speak english.

[Melissa_fox]

I'm doing my research as well and and liking the natural look of Facial Team but... I understand why some girls want a more dramatic chnage.

[Apples Mk.II]

I'm doing my research as well and and liking the natural look of Facial Team but... I understand why some girls want a more dramatic chnage.

For me, the more overdone and more away from my original face, the better. I just want to not see my old face in the mirror. I just took high detail photos for the FFS, the same exact angles and lens I used 17 months ago, and after 11 months on HRT the only difference is that I look bleached. The rest of changes is the lack of shadow beard and reduced eyebrows.

Anyways, in the end I have two options
- Pick a medium grade surgeon with a well known name (Spiegel, van den pen, Chert...) And do just a forehead and nose.
- Pick a low cost surgeon (Cardenas) and get a full face, including other cosmetic feelings such an eyelid lift or a peeling.

Regarding Cardenas (thinking about him), He won't be a god, but we all know he is good. Only issue that he is conservative, too. I've seen results on a case that was "desperate" (manliest initial factions ever) and the result is quite incredible, given what could be done.

[Hikari]

Thinking about it, wouldn't Dr. Toby Mayer be in that price range? I am not sure if he is aggressive enough for you, but I always found his aesthetics pleasing to the eye. He has had a fair bit of coverage in the media, because he is in Beverly Hills, but I don't recall his pricing being all that outrageous despite his location.

[Apples Mk.II]

Don't know that Toby Mayer... Beberly hills sounds expensive. Far more than Thailand or Belgium.


First reply from a Surgeon: Chettawutt. Extra points for not adding any extra. Nailed it on forehead, nose and trach shave, proposed a lip lif (I want it to), and... Reshaping my jaw and chin and adding an implant to give me an V shaved jaw. It's a good idea I like, but I'm short on 8.000€ for jaw work. Still, he has pointed something really important nobody had seen before. He has detected that I have an enophthalmos (I knew it was a possibily, but did not want to think about me) in my left eye, and has proposed an eyelid lift to correct the assimetry and agive a more even appearance. On the other critics I have gotten from direct clients, he excels at soft tissue work, but they would not talk about bone work until the  was settled.

He proposes

He Proposes:
Forehead / brow ridge contouring with scalp advancement and brow lift: 390.000 TBH - 8721€
Eyelif Lift: 58.000 TBH- 1296€
Nose with Alarplasty: 163000 TBH - 3642'80€

Trach Shave: 58.000 - 1296€
Lip Lift: 48000 - 1072'59€
Jaw/Chin: 270.000 - 6.037€
Chin Implant: 58000 - 1296€

I would take the upper face, plus the trach shave I'd love to do the jaw and chin, but that can only be done with a low cost option. And honestly, after remembering a certain person hera that went over the top with FFS and lamented later, it's better to take a two stages option to avoid anxiety and depression.