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Yeson or other voice feminisation options

Started by anna chan, August 19, 2014, 10:49:22 PM

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anjaq

Interesting , I always wondered why he does not inject it first before the surgery to prevent damage by contractions.

Do you think as you have a higher pitch now, the condition would improve in any case, even without botox?

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Rachelicious

Quote from: anjaq on October 08, 2014, 12:57:22 PM
Interesting , I always wondered why he does not inject it first before the surgery to prevent damage by contractions.

My thought on the 1-week post-op timing is that maybe he wants the musculature intact at first to hold everything together for the initial heal? Especially if there's swelling/extra mass inflating the now-female-sized vocal folds that would not be properly supported in the initial heal otherwise.

Regarding the actual benefit of the botox in regards to tremor, accounts I've read seem to be that it softens the mechanisms supporting/controlling the voice. But then why the extra week of total voice rest for those who have the botox? Possibly to avoid extra strain that could be induced by trying to use botoxxed vocal musculature?

It's interesting speculative theory in any case.
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anjaq

My guess would be that he also corrects assymetries andsuch, some may be caused by muscles. if the muscles relax, he would not see them maybe? German clinics seem to give the botox right away tough to ease the healing right from the surgery date

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Jennygirl

I'm very curious to hear how the botox helps you, I've noticed a slight bit of degradation in my upper upper range (C5+). I'm not sure if it's because I have ceased vocal exercises or because of the vocal tremor... All I know is that I haven't had a single botox injection since the surgery, and Dr. Kim was positive that I will need it just the same as you.. The exact diagnosis as outlined in my packet from Yeson is "focal laryngeal dystonia".

Even without the injections, I don't think I've been read since I went to Yeson. My voice passes with zero effort, it's just not even a thing for me. I do kinda want to give the botox a shot, though, just to see.
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anjaq

Why would you want the botox again jenny, does it not also make the voice a bit unstable overall? I mean, I read from many that they were having some issues with the voice post op and said it probably is due to the botox. I dont quite get if botox improves the voice or if it actually makes it harder to use it properly.

BY the way Jenny - did you make any long term vodeo or recordings? I have been looking for any long term recodings but the most long term I found was a 8 month recording of you I think - I was wondering how Sarah and Abby are doing now in the long run. I have my day in Berlin (consultation with FacialTeam, consultation with the Berlin voice doctors and maybe a lunch with Amy ;) ) in a month and after that I will have to decide soon if I want VFS and also begin to decide upon FFS as I basically cannot get much more info and need to listen to my intuition then. I also joined a Facebook Yeson patient group recently, but there are no long term post ops in there, sadly.

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anna chan

Hi Jenny and Anjaq

I had my post-op consultation with Dr Kim today, he said there was a little swelling but nothing to worry about and I have been instructed to remain silent for an extra week and he prescribed extra medication including clonazepam with is the same thing my mum takes for her Multiple Sclerosis.

My diagnosis says:

spasmodic dystonia with muscle tension dysphonia

vocal folds asymmetry with tension discrepancy
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Charlotte2

Quote from: Jennygirl on October 14, 2014, 03:08:50 AM
I'm very curious to hear how the botox helps you, I've noticed a slight bit of degradation in my upper upper range (C5+). I'm not sure if it's because I have ceased vocal exercises or because of the vocal tremor... All I know is that I haven't had a single botox injection since the surgery, and Dr. Kim was positive that I will need it just the same as you.. The exact diagnosis as outlined in my packet from Yeson is "focal laryngeal dystonia".

Even without the injections, I don't think I've been read since I went to Yeson. My voice passes with zero effort, it's just not even a thing for me. I do kinda want to give the botox a shot, though, just to see.
Hey Jenny!
Just wondering if you ever go back to see your ENT in LA? I think her name was Dr Amanda Salvado.

It still really amazes me how life changing this surgery is. People just treat me so differently now. :) :)

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Jennygirl

Isn't it wonderful, Charlotte!?

I had an appt set up but I forgot about it and never rescheduled. I don't have insurance so as well it is very expensive for me to see her.. $450.

I don't have any real issues with my voice, so it's hard to make that cost feel worthwhile!

No I don't have any long term recordings either, I suppose that is long overdue.
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martiabernathey

First of all, I want to be very careful to not step on anyone's toes. I'm not criticizing anyone's surgical result at all.

Maybe it's my perception, but I haven't seen a lot of before and after videos (I think I've been able to find about 5 trans women on Youtube) from women who have went to Yeson. Dr Thomas' website has quite a few before and afters. From what I have seen, the end result for the Yeson technique seems to be less dramatic, but also A LOT less invasive and more natural.

Sometimes the dramatic change is impressive with Dr Thomas' patients, I'd say that probably 1/3 of the surgeries I could definitely live with, 1/3 are just satisfactory, and 1/3 would be unacceptable/disappointing result for me.

I did some voice analysis myself and found that at my normal speaking voice, I'm about 122, with my highest pitch being 320 and my lowest being 108. You can listen here to my normal speaking voice. This is totally relaxed without any effort to change pitch at all.

So according to this:


122 puts me right at the cusp between masculine and gender ambiguous which kind of is my life experience. I made this for my voicemail (217 Hz) with considerable concentration, and I can't keep this up for long or with any kind of comfort.

I really do want surgery and am at a point I can afford it, so I'm looking for input. Thoughts?

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anjaq

Hi. I cannot access your voice files sadly without creating a google drive account. so I cannot say anything on that. But you seem in about the same range as I am with normal speak when I speak very relaxed. When I do enough change that it still is not too much effort, I am at about 150-160, in the ambiguous area. Its possible to live there I think, but its not always easy especially when relaxing means to go down to the borderline again.
The 1/3 ratios are what actually some surgeons seem to tell people here - 1/3 is improved and good, 1/3 is same as before maybe higher pitch but more huskyness, 1/3 actually is worse. I could not live with those odds.
I have not been impressed by many of the results from Dr Thomas, but some seem to be good. I have not yet heard any really bad voice from Yeson, but maybe those who were disappointed (according to Yesons own stats it should be some small percentage) dont like to speak up.  heard with some that the change was less than they hoped for, at least in the first months, it seems this actually does change for most of them though. I think no dramatic changes are needed. few people really need a 220 Hz voice.
The big advantage of Dr Thomas seems to be that he also changes the chape of the voice box, so resonance will change. I imagine it like this - Yeson will just take your voice, modifies it, lift up the pitch you can easily produce, cut off some lower pitches so you cannot reach them and they cannot be produced as undertones to your voice anymore. Dr Thomans on the other hand completely gives you a new voice - pitch, the way it sounds - all of it. I can imagine both procedures will be suited for certain people. If you never ever can make a feminine sounding voice, maybe it would be Dr Thomas. If you can do a feminine voice but it is just annoying and hard to keep it up, I think this is what more of the people who went to Yeson report as their experience

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Rachelicious

Quote from: anjaq on November 03, 2014, 04:44:19 PM
I have not yet heard any really bad voice from Yeson, but maybe those who were disappointed (according to Yesons own stats it should be some small percentage) dont like to speak up.  heard with some that the change was less than they hoped for, at least in the first months, it seems this actually does change for most of them though. I think no dramatic changes are needed. few people really need a 220 Hz voice.

Yeson will just take your voice, modifies it, lift up the pitch you can easily produce, cut off some lower pitches so you cannot reach them and they cannot be produced as undertones to your voice anymore.

These seem to be the main points. Having a huge part of your my voice that I cannot use, which is constantly coloring & limiting the part that I can, has just always been unacceptable to me and can finally be resolved in a next-gen way.

Indeed, among those who have not had prior voice feminization surgeries, the only bad word I've heard about Yeson's VFS are a few who "didn't get as significant a change as they'd hoped for," or something along those lines; kind of a meager complaint, really, compared to the daunting 1/3 ratios that stood up until recent years.

You have to remember, we're talking frequency and anatomical ratio. Most people's F0 is going to be within 100-150hz or thereabouts. The difference between 175hz-225hz is three adjacent white keys on a piano. It's not a huge difference considering your voice was previously six or more adjacent piano keys lower.

As the numbers grow, the inflation scales. Even 75hz upward from 220hz is only four adjacent piano keys higher (ofc nobody's voice is tweaked that high, but just to demonstrate the inflation.)

@martia Regarding resonance, yours was fine - it's clear that with that pitch range as your 'relaxed' speaking range, resonance would not be an issue. My observation from watching lots of videos is that post-op Yeson people tend to inherit their prior 'highly-feminized' voice as a natural, better-sounding speaking range - and from there, you can use that "upward reach" for inflection and prosody, rather than trying to just set your voice on that shelf and keep it from falling - that's what is actually unnatural to the anatomy of the voice, causes breathiness, tremor, etc in those of us who actually are quite good at voice feminization, but have to use no less effort than the rest in order to make it work.

Makes sense, aye?  ;)
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martiabernathey

Quote from: anjaq on November 03, 2014, 04:44:19 PM
The 1/3 ratios are what actually some surgeons seem to tell people here - 1/3 is improved and good, 1/3 is same as before maybe higher pitch but more huskyness, 1/3 actually is worse. I could not live with those odds.

I can't either. I've been stewing on both of your responses for a while and I just can't see taking that big of a risk. For me, the more I thought about it, the more I thought of it as what is the best I can do, with the least amount of risk?

Quote from: anjaq on November 03, 2014, 04:44:19 PMI have not been impressed by many of the results from Dr Thomas, but some seem to be good. I have not yet heard any really bad voice from Yeson, but maybe those who were disappointed (according to Yesons own stats it should be some small percentage) dont like to speak up.  heard with some that the change was less than they hoped for, at least in the first months, it seems this actually does change for most of them though. I think no dramatic changes are needed. few people really need a 220 Hz voice.

And the worst case with Yeson is that I spend 10k and get very little change. I have to live with the results and my job might be in jeopardy with a bad result. It seems, so far, that the bad with Thomas is a lot worse than the bad Yeson.


Quote from: anjaq on November 03, 2014, 04:44:19 PMThe big advantage of Dr Thomas seems to be that he also changes the shape of the voice box, so resonance will change. I imagine it like this - Yeson will just take your voice, modifies it, lift up the pitch you can easily produce, cut off some lower pitches so you cannot reach them and they cannot be produced as undertones to your voice anymore. Dr Thomans on the other hand completely gives you a new voice - pitch, the way it sounds - all of it. I can imagine both procedures will be suited for certain people. If you never ever can make a feminine sounding voice, maybe it would be Dr Thomas. If you can do a feminine voice but it is just annoying and hard to keep it up, I think this is what more of the people who went to Yeson report as their experience

I've read both you and Rachelicious' comments over since you posted them and let them sink in a bit.  Anja you're right, those odds with Thomas are hard to live with. I think I'm going to look into Yeson or Michael Haben.  I'm having dental work done this year (30k USD worth), so I'm looking at this as gathering information and education and saving for next year, probably towards the fall.


Quote from: Rachelicious on November 03, 2014, 06:03:23 PM
@martia Regarding resonance, yours was fine - it's clear that with that pitch range as your 'relaxed' speaking range, resonance would not be an issue. My observation from watching lots of videos is that post-op Yeson people tend to inherit their prior 'highly-feminized' voice as a natural, better-sounding speaking range - and from there, you can use that "upward reach" for inflection and prosody, rather than trying to just set your voice on that shelf and keep it from falling - that's what is actually unnatural to the anatomy of the voice, causes breathiness, tremor, etc in those of us who actually are quite good at voice feminization, but have to use no less effort than the rest in order to make it work.

Makes sense, aye?  ;)

That makes total sense, and THANK YOU for your responses. Both give me enough outside perspective to be comfortable and move forward with this.

I need to understand the techniques of each of the surgeons better. If I understand correctly there are 5 surgical methods for VFS, being cricothyrodiopexy, laser assisted thyro-arytenoid muscle resection, laser assisted voice adjustment: LAVA,  anterior web creation and thyroid cartilage and vocal fold reduction.

I'm curious about Haben. From what I've read he does a mixture of LAVA and anterior web creation? Has anyone contacted his practice to ask? It seems from this, that Yeson does a mixture of these techniques, based on the patient's vocal presentation/anatomy?  I'm wondering if Yeson does mostly anterior web creation (this does seem like the least invasive) only? The more I think I know, the less I seem to. LOL
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