My FFS with Dr. Cardenas: June 21st, 2014

[Roni]

Hi everybody!

I'm sure I am no stranger to the FFS forums as of late. Here is a promised thread on my FFS journey with Dr. Cardenas.


My surgery is booked for Saturday, June 21, 2014.
June 19---Leave the US
June 20---Arrive in Guadalajara at 1pm. Consultation with Dr Cardenas during the afternoon
June 21---Surgery day
June 22-26---Recovery
June 27---Fly back to the US


I will be having the following procedures done:
* Forehead remodeling (Dr C claims I only need Type I forehead surgery, but I will try ask for Type III)
* Eyebrow lift
* Hairline advancement
* Rhinoplasty
* Buccal fat pad removal
* Possible neck liposuction


I am not quite sure if I have a type III forehead, but I would like the flattest and most feminine forehead possible, which I believe can only be achieved by Type III surgery. My pre-op pictures can be found below. Post-op pictures coming soon (obviously).


Pre-op Front View



Pre-op Profile View




(The following updates are edited and added as my journey progresses)

Update 1 (June 20, 2014)
So I just got back from my consultation with Dr. Cardenas.

He has agreed to perform Type III forehead remodeling on me, along with a rhinoplasty, eyebrow lift, hairline advancement, and buccal fat pad removal. My surgery will commence at approximately 5:30 am PST tomorrow morning.

I am a candidate for Type III for the very reason most of you thought I WOULDN'T be---that reason being I am ethnically Asian.

Apparently, the bridge/slant of Asian noses tend to be more "set back" and deeper at the point where the bridge meets the sinus area. That is what gives us the illusion of a flatter nose, as opposed to a caucasian nose where the bridge is more "outwards," less slanted, and more prominent, creating a sharper look. My priority is to obviously appear more feminine while retaining my ethnic appearance, and that is why Type III works for me.

Because of my deeper bridge slant, Type I will only grind the sinus area so much and still leave a protruding sinus over my nose, due to the difference in gradient between my bridge slant and the forehead.

According to Dr. Cardenas, in cases where the bridge is too slant, Type I can still be performed. However, a bridge implant must be used to connect the nose and whatever is left of the sinus area after Type I grinding. This will mask the protruding sinus area. Doing the implant, however, will diminish my Asian appearance, and could possibly make me look more Caucasian, so Type III forehead remodeling it is!

Dr. Cardenas was VERY helpful, and was very mindful of the fact that my ethnicity played an important role in the end-results of my surgery. I am thoroughly impressed. He gave me numerous options on how we can go about the different procedures, and made it clear that the decision was ultimately up to me.

Vicente (team member of Cardenas) has been extremely helpful in guiding my mom and me throughout the process also! The recovery house I am staying at has far exceeded my expectations, and the food is lovely! So far, so good. Now to just wait for the actual surgery.


Update 2 (June 22, 2014)
I am back in the recovery house after spending a day in the hospital.

Dr. Cardenas performed Type III on my forehead as planned, and has promised to show me pictures of the Type III surgery in progress. My forehead and eyes are really swollen but I can already see that my forehead is as flat as I had wanted it, including the sinus area! I can definitely say at this point that Dr. Cardenas' Type III results look VERY promising.

I can't comment on my nose results but will be able to on Wednesday once my cast is removed.

Pain wise, the entire procedure thus far is not so much painful as it is uncomfortable. The only painful experience I've had was when drinking water. The water stung the wounds left by the buccal fat removal inside of my cheeks, and boy did that hurt for a bit.

The services provided at both the hospital and recovery house are top-notch. I will update with pictures as soon as the swelling goes down.


Update 3 (June 26, 2014)
Some pics included in this update!

So this morning I had my nose cast and the tubes inside my nose taken out. I was able to see my nose for a momentarily second before they re-bandaged it. My nose is now considerably thinner all around, and sharper at the tip. Definitely a more aesthetically pleasing and feminine looking nose, but I wasn't jumping up and down upon seeing it. I think it will require me just a bit more time getting used to.

I also regained my sense of taste partially. There are certain foods I can taste, and some that I can't. Sometimes my taste comes back completely, only for it to disappear again 10 mins later. Pretty weird.

I have put together a comparison picture of my forehead results to showcase type III. Note that my forehead and face in general are still very swollen. I was able to see my x-ray's today and it's crazy how much swelling there is around my forehead still. So my forehead's final result should actually appear flatter than in the pics below.

Sorry for the bad pic qualities and lighting. I am still at the recovery house in Guadalajara and this was the best I could do for now (did this on an iPhone). After my swelling subsides and I am back in the US, I will provide some proper post-op pics (including full face) similar in quality to my pre-op pics I first posted when making the thread.




Will keep you all updated as time progresses!

[INgrid Alicia]

You look VERY FEMENINE   ... About the type III .. Most probable he will refuse to do it... :/ .. i hope he does not.. but it is the same history over and over again... if he decides to do just type I, there will be an improve anyway...  After all, you are very femenine, maybe a little improvent its all you need.. I hope everything goes fine... , i think you dont have to worry about complications since he is an experimented surgeron, neither coming to Mexico, i repeat it is not dangerous if you are not a drug dealer.

My best wishes!! Hugs!!

[crowcrow223]

I feel like the only thing You need is forehead and rhinoplasty work, and maybe an eyebrow lift, but not necessary.

Rhinoplasty more as a beautifying type of surgery rather than feminising.

When it comes to forehead, I think he won't do type III purely because You don't have much of a forehead, You do have the brow bossing, this pertruding bit above your nose bridge, but I think dr was right about saying that you only need type I forehead contouring.

I know we as trans women always think and want to go to the absolute maximum of shaving half of our skull, but first of all you don't need that, second of all Type III contouring surgery effects can be noticed, I presume, only in very masculine, caucasian faces, who have a very pertruding forehead, and You're not a candidate for that.

Thanks so much for opening this thread, You wouldn't believe how excited I am for you! Weeeeeerrrrrrrkkkkk!!

[jgirl76]

In these pictures, does not look like a type III forehead.... I agree he probably will refuse to do it. Roni do you have an oblique profile view?

[crowcrow223]

Jgirl, I presume once type I is performed on Roni's face, it'd be as type III performed on a caucasian patient.

Asian faces tend to be a bit more flatter, and I have a feeling, once the brow bossing is shaved, there will be no forehead overhanging over the bridge of the nose, but we'll see!

Good luck, thanks so much for sharing your journey once again, so valuable !!

[jgirl76]

It's not about Asian faces vs. Caucasian faces, it's really about how far the frontal sinus protrudes over the bridge of the nose, which can happen at various degrees across all races of people.  I've uploaded Roni's photo and my own pre/post op photos with a black line showing the bridge of the nose in relation to the forehead, attempting to gauge how much actual overhang of the frontal sinus there is. If Dr. C thinks he can reduce the prominence of the frontal sinus to that point with type I, then it's suitable. If not, then type III. I think Roni has a little less prominence and Dr. C might be able to shave it down, but the bone over the frontal sinus can be thin so you generally can't achieve much set back there. Does she absolutely need type III? Probably not, but would type III yield a nicer result, probably would.

Roni have you sent your pics to other surgeons? Have any of them recommended type III?




For comparison





Notice the amount of setback that Dr C was able to do for me, look at the black line... it's really not very much. I still wonder if bone cement or similar was used in my case although Dr. C insists that it was just shaving only, but looking at the comparisons I'm really doubting that is the case.

[jgirl76]

Roni, feel free to use my pics with the black line if you want to show to Dr. C how little type I sets the frontal sinus back. As you can see, mine still hangs over almost JUST AS MUCH as before surgery. It's kinda crazy. 

[Roni]

It's not about Asian faces vs. Caucasian faces, it's really about how far the frontal sinus protrudes over the bridge of the nose, which can happen at various degrees across all races of people.  I've uploaded Roni's photo and my own pre/post op photos with a black line showing the bridge of the nose in relation to the forehead, attempting to gauge how much actual overhang of the frontal sinus there is. If Dr. C thinks he can reduce the prominence of the frontal sinus to that point with type I, then it's suitable. If not, then type III. I think Roni has a little less prominence and Dr. C might be able to shave it down, but the bone over the frontal sinus can be thin so you generally can't achieve much set back there. Does she absolutely need type III? Probably not, but would type III yield a nicer result, probably would.

Roni have you sent your pics to other surgeons? Have any of them recommended type III?




For comparison





Notice the amount of setback that Dr C was able to do for me, look at the black line... it's really not very much. I still wonder if bone cement or similar was used in my case although Dr. C insists that it was just shaving only, but looking at the comparisons I'm really doubting that is the case.

First, thanks for the good wishes everybody! I'm so excited! Gahhhh! I fly out of LAX tomorrow, and it's finally starting to hit me that certain things are about to change forever.

Jgirl, you're completely right with everything you said. If my frontal sinus is too thin there is no way carving it down with Type I will help. The ideal situation would be that my frontal sinus bone is thick, that way more grinding can happen, and a flat "Type III-esque" forehead can be achieved without actually having to undergo Type III.

People who undergo Type III either have extreme brow bossing, or considerable brow bossing but too thin of a frontal bone to work with. I am not the former case, but I could very much be the latter, so Type III is still a possibility for me. Some people who fall under the latter case opt for Type II where a mix of grinding + bone cement is used to mask much of the thin sinus area that grinding couldn't completely erase. But Type II bone cement is just that---a way to mask your bossing rather than eliminate it, and for some girls this results in a "dolphin forehead" as discussed in another thread. So type II is out of the question for me. I guess we will find out during my consultation!

Edit: Thanks for the edited pictures you made. Will definitely come in handy in discussing the forehead area with Dr C.

[Roni]

Asian faces tend to be a bit more flatter, and I have a feeling, once the brow bossing is shaved, there will be no forehead overhanging over the bridge of the nose, but we'll see!

Good luck, thanks so much for sharing your journey once again, so valuable !!

I can only wish, haha. And no problem, I figured this thread could possibly help with all the negative attention Dr Cardenas is receiving lately. I am still confident in his ability, but hopefully my surgery will help answer a lot of questions surrounding "Conservative Cardenas."   

[jgirl76]

Have a good flight! XO

[EmmaD]

Good luck Roni and thanks for being so willing to be so open with us.  I will be haunting this thread over the next month!

I am planning a November trip so all the Cardenas "noise"  here over the past few weeks has been very useful.  I am grateful to everybody  for their input (without getting threads locked).

Emma

[Roni]

This post will probably be my last pre-op update while in the US.

I am getting so excited! In roughly six hours I will be taking a train from my hometown of San Diego to Los Angeles. From LAX, I will be flying to Dallas for a connect flight, which is actually not until tomorrow morning. I will be staying at a hotel in Dallas before flying to Guadalajara tomorrow! So that explains the 24-hour long travel, for anyone who was wondering. Oh, and my mom will be with me throughout the whole journey!

I'll be catching up on some much needed sleep during travel and also during my stay in Dallas (God knows I can barely get any sleep now), so I will update all of you next when I am in Guadalajara, right after my consultation with Cardenas. So you all should know by my next update whether Cardenas is willing to go through with Type III.

And thanks EmmaD! Were you planning on going to Cardenas as well?

Talk to you all very soon!     

[jgirl76]

Roni,
Tyler proactively contacted me today about my forehead... I've expressed to him that if the frontal sinus still protrudes over the bridge of the nose and you can't fix it with shaving, type III is needed. I told him I will have to get a revision... I trust and hope Dr. C will make the right call with you. Regardless, you look great and will get an improvement either way! Here's to hoping your surgery is a big success! Happy travels!

[EmmaD]

Yes, I am considering Cardenas (not looking at type 3 or jaw/chin bone work - more soft tissue and nose).  I am looking at others too including Australia but there doesn't seem to be any FFS specialists here which is understandable with such a small population.  Travelling from Australia, it will take longer than 24 hours and any sleeping will be on planes (about a 16 hour flight just to get the LAX!)! Not really looking forward to that part, not so much getting there but getting home.

All the very best over the next few days.  I will be thinking of you.

[calicarly]

You know Roni,

I think Jgirl is right, I see where you're coming from worrying about your bossing cause of the slope on your forehead but you don't have a lot of frontal sinus overhang, you seem like a type II could be appropriate for you, but like Jgirl says, type III yields the best results on just about everyone... Unless the bossing really is minor.

[calicarly]

Yes, I am considering Cardenas (not looking at type 3 or jaw/chin bone work - more soft tissue and nose).  I am looking at others too including Australia but there doesn't seem to be any FFS specialists here which is understandable with such a small population.  Travelling from Australia, it will take longer than 24 hours and any sleeping will be on planes (about a 16 hour flight just to get the LAX!)! Not really looking forward to that part, not so much getting there but getting home.

All the very best over the next few days.  I will be thinking of you.

Somebody on one of the threads mentioned an FFS surgeon in Australia, Mr. Carlisle I think, you may wanna look into that Emma...

[EmmaD]

Cost will be the big issue in getting all my desired FFS procedures done here in Australia.  I am looking at Australian surgeons but I do not hold out any hope that they are within my financial reach. Just the way it is!

[Roni]

So I just got back from my consultation with Dr. Cardenas.

He has agreed to perform Type III forehead remodeling on me, along with a rhinoplasty, eyebrow lift, hairline advancement, and buccal fat pad removal. My surgery will commence at approximately 5:30 am PST tomorrow morning.

I am a candidate for Type III for the very reason most of you thought I WOULDN'T be---that reason being I am ethnically Asian.

Apparently, the bridge/slant of Asian noses tend to be more "set back" and deeper at the point where the bridge meets the sinus area. That is what gives us the illusion of a flatter nose, as opposed to a caucasian nose where the bridge is more "outwards," less slanted, and more prominent, creating a sharper look. My priority is to obviously appear more feminine while retaining my ethnic appearance, and that is why Type III works for me.

Because of my deeper bridge slant, Type I will only grind the sinus area so much and still leave a protruding sinus over my nose, due to the difference in gradient between my bridge slant and the forehead.

According to Dr. Cardenas, in cases where the bridge is too slant, Type I can still be performed. However, a bridge implant must be used to connect the nose and whatever is left of the sinus area after Type I grinding. This will mask the protruding sinus area. Doing the implant, however, will diminish my Asian appearance, and could possibly make me look more Caucasian, so Type III forehead remodeling it is!

Dr. Cardenas was VERY helpful, and was very mindful of the fact that my ethnicity played an important role in the end-results of my surgery. I am thoroughly impressed. He gave me numerous options on how we can go about the different procedures, and made it clear that the decision was ultimately up to me.

Vicente (team member of Cardenas) has been extremely helpful in guiding my mom and me throughout the process also! The recovery house I am staying at has far exceeded my expectations, and the food is lovely! So far, so good. Now to just wait for the actual surgery.

[angel0202]

Good luck darling!! I think everyone who's seen your picture knows how beautiful your going to look after a little correction.

[Roni]

Good luck darling!! I think everyone who's seen your picture knows how beautiful your going to look after a little correction.

Thanks angel.