Making my decision-need help!

[androgynouspainter26]

Hi all,

I'm finally at this point: This winter, I'm having FFS.  I'm very excited, but also a bit worried-I can't seem to make up my mind as to which surgeon I really want operating on my face.  Everyone I've considered has plenty of drawbacks, and I'm hoping that you all can help me shed some light on the situation.  I've attached my pictures to give you a better idea of what sort of work I need done.  From the consultations I've had so far, my major points of concern are my ears, forehead/brow, chin, jaw, and cheekbones.  Everyone is also trying to make me have a lip lift and tracheal shave, but I'm not sold on either, mostly because I have little to no adam's apple and my front teeth aren't anything special. 









So here are the doctors I've been considering-I've already had consultations with two of them, and I'll probably consult with others soon.

Zukouski: Right now, he's probably one of my best options.  His results are good, his prices are very fair, and he doesn't exactly have a bad eye aesthetically speaking.  However, I have two huge concerns about his work-firstly, I want to have a more angular appearance, and he wants to go for a more "rounded" look-he says that's what I should do because of my cuban heritage, and of course I disagree with him about this-but I don't entirely trust him to listen to what I want.  Also, everyone I've spoken too has confirmed that his endiscopic techniques are simply not very effective on someone who needs heavy forehead work-which I do. 

Speigel: His work is inconstant, as we all know.  Some of it is fantastic, and some not so much.  His prices are positively exorbitant, and he isn't fond of the idea of me having breast augmentation at the same time.  This is a problem because I am not going to be able to find time to have surgery for many years after this coming winter, and this may be my only chance.  Aesthetically, I like his work when it's successful.  His jaw work is exactly what I want-a more angular, slightly androgynous face.  He does heavy forehead, which I need.

DiMaggio: I have mixed feelings about DiMaggio's work-he does good, and very involved work on each part of the face, but aesthetically they don't really seem to fit together.  I think his faces are often feminine, but they usually just aren't that attractive.  Plus, the idea of traveling to Argentina-and if I require revisions, I might not be able to get them. 

I'm open to considering other surgeons, but right now I think that these three would be the best fit for me, seeing as cost isn't a primary factor.

I want to keep a more severe, angular face but also to pass-I'm so tired of being stared at, and wanting to smash my mirror every time I see my reflection!  Anyhow, I don't really know what to do, and any advice would be really appreciated.

Thanks,
Sasha 

Edit: I want the most aggressive, radical option I can find right now-It's such a shame that Ousterhout is gone now, he left every single girl he touched looking like a model.  I wish there was someone out there who could do that for me.  I don't care if I look anything like I used too-I want to look like a girl, and a stunning one at that.

[luna nyan]

Looking at your photos I would prioritise the forehead followed by the chin.  I'd pick the surgeon who you feel most comfortable with dealing with these areas.  The other areas that you mention aren't so much gender markers, rather they are your own genetiic predilections.

The lower jaw probably needs a minor genioplasty, the deep fold under you lip is more likely what you are conscious of.  Stick a bit of cotton wool behind your lower lip and take a profile picture and see if you like how that looks.  That will help you decide with the surgeon what you want done.

The upper lip is probably more an orthodontic issue.  You have venous pooling under your eyes - do you find that you breathe through your mouth a lot?

Good luck making your choice!

[androgynouspainter26]

Luna,

I think we're on the same page vis a vie what I need done-although I'd also like a rhinoplasty, otoplasty, and brow lift.  Frankly, if I can have the option to not only look feminine but actually look attractive, why should't I take that chance?

I've already had braces, so I don't think there's much to be done-I still have an overbite, but it's not such a huge deal, is it?  I've never felt especially insecure about my mouth, or my lips-should I?  I'm fairly certain that I know what I want done, my question is actually which surgeons you/anyone else would recommend.  Thank you for the advice though.

As for the eyes-no, I don't breath through my mouth.  I can't find any way to get rid of them unfortunately, and staying hydrated tends to lessen the problem-that being said, I usually wear concealer anyways.  Beside that, I don't know what else I can do about them.

[Sabine]

I don't think you need that much, but it's really about what you want changed.  The chin looks good to me in profile, but perhaps frontally I can see you might want to narrow a bit. It's not essential though. The lip is probably more about shaping and distance to nose, but not that noticeable. I did mine, but I have a long face and needed it. You want to do brow I know. You might want to look at hairline. I am not sure why you want to do cheekbone. Are you looking for more definition?  All in all it looks really promising.

As for surgeons. Everyone has their fave, and often we want to suggest who we went to (some of that is validating our choices probably). I think you are probably wise to approach it based on who is better at the features you want addressed. I had Spiegel and he probably wasn't as aggressive as he should have been in the areas I needed (nose and chin), but he goes for a harmonious full -face. He makes you look like a female version of you rather than a new face. He tends to do less and in more places.  He is good for softening, which does seem to be want you want. On that basis, I'd be comfortable with him, but he is not your only option as you say.  I had just about everything you can think of with him, but no shave (I didn't need it).  He did do a great brow and hairline for me and his technique was such that I have virtually no scarring anywhere. I still feel I look like a masculine woman. Then again, he had to deal with what I had to offer. Meh... It's a major improvement though.

Spiegel really doesn't like for someone to have BA at the same time as FFS is so intrusive and a LOT of surgery. When I saw him, it wasn't even an option and I wanted it. Depending on what you have done, FFS can knock you flat for a few days and adding the BA may be too much.

I can't really speak to Dr. Z beyond that I felt he tended to impose what he wanted to see, and had a very strong notion of what a female face should look like. His results tended to look similar to me. Spiegel at least had me looking like my mother's daughter. I worried Z would make me look too much like someone else.

[JLT1]

I had FFS with Dr Z.  I needed far more forehead work that you do and the endoscopic technique worked for me.  I didn't want a lip lift but he did a small one and he was right - I needed it.  He did a small trachea shave but I really didn't need it.  We disagreed on the final size of my lips - in the end, he did what I wanted.  We disagreed on eyebrow height - they ended up right where I wanted them (for better or worse).  Just be firm.

You can see my before and after in the before and after thread of MTF - transsexual talk - Susan's. 

In the end, the decision is up to you.  I've seen good results from everyone you mentioned.

Hugs,

Jen

[androgynouspainter26]

Thanks for the replies so far-I'm fairly certain at this point that I have absolutely no interest in looking even remotely like I used too.  I'm thinking of just asking Speigel to be as aggressive as he possibly can, and hoping for the best...but then, I don't know when/if I will be able to get my breasts done.  This coming winter is literally the only time I am going to have for literally years-my collage has very intense internship requirements.  I feel like I'm caught in a lose-lose situation, and there aren't any options out there that will leave me satisfied.  I want to pass-and at first I didn't think that was too much to ask for, but all of a sudden I'm realizing that I might never pass, even with FFS-that my entire transition might have to end in failure.  Sorry if I seem a bit depressed here-this is just a difficult place to be in. 

[Donna Elvira]

Hi,
If you are willing to travel to Europe, I would definitely suggest you look up Dr Bart Van de Ven who, if required, does some of the most aggressive surgery on the block. What he did for me was pretty unbelieveable. If this is an option you are open to, I'm  quite happy to send you before and afters by PM.
Best regards.
Donna

P.S. You have a really cute nose but I agree you would benefit a lot from surgery to forehead and chin/jaw.

[luna nyan]

Luna,

I think we're on the same page vis a vie what I need done-although I'd also like a rhinoplasty, otoplasty, and brow lift.  Frankly, if I can have the option to not only look feminine but actually look attractive, why should't I take that chance?

I've already had braces, so I don't think there's much to be done-I still have an overbite, but it's not such a huge deal, is it?  I've never felt especially insecure about my mouth, or my lips-should I?  I'm fairly certain that I know what I want done, my question is actually which surgeons you/anyone else would recommend.  Thank you for the advice though.

All well and good if that's your aim!  Just be aware the more done, the more risk, and the longer the recovery, but that's what we all know going into these things.

If you still have an overbite more than 1.5 mm deep, then your orthodontic treatment either under corrected or you have had relapse.  (Depending on where you started).  Another profile check you can do for yourself is to slide your front teeth to he correct overbite and see if you like how it looks.  The deep fold should reduce, but you will find the chin is more prominent - but if it this fold that you don't like, then that is another final position to consider.  (Yes, I read a lot about faces as I find it v. Interesting)

[Sabine]

Thanks for the replies so far-I'm fairly certain at this point that I have absolutely no interest in looking even remotely like I used too.  I'm thinking of just asking Speigel to be as aggressive as he possibly can, and hoping for the best...but then, I don't know when/if I will be able to get my breasts done.  This coming winter is literally the only time I am going to have for literally years-my collage has very intense internship requirements.  I feel like I'm caught in a lose-lose situation, and there aren't any options out there that will leave me satisfied.  I want to pass-and at first I didn't think that was too much to ask for, but all of a sudden I'm realizing that I might never pass, even with FFS-that my entire transition might have to end in failure.  Sorry if I seem a bit depressed here-this is just a difficult place to be in.

I did find Spiegel very responsive to my concerns. I'd have a second consultation, even if it's by phone with photos in hand at each end. Lay it out and also keep reminding him as it gets closer. Ask Katie to make sure it's noted. They really do want to get you the result you want.

While I know it seems difficult to pass, you'll be amazed what even small enhancements and refinements will do. I really don't think you'll have to worry. I didn't mean to sound hard on Spiegel's outcomes. I seem to go about my daily life passing. You are starting from a better place than I am! When I place old and new pictures side by side, it's amazing how different I really am. But I know I am seen as a masc looking woman. I doubt you will have a problem. Also, Spiegel DOES do revisions. I can't imagine you'd need them, but they are there.

Also: he asked me to contact the woman in the UK who does virtual FFS using your photos. You may want to try her to get a better sense of what an outcome might look like. She's easy to find. I think the website is Virtual-ffs. She was fast, but it's not cheap. I did a photoshop myself, but not knowing how the procedures were done at that point it wasn't as helpful. If you can do this before your consultation, it helps. It was not a 100% predictor of outcome, but it was reassuring. I had NO confidence that I would pass, but I did.

Remember, passing really is a combination of things from confidence and self assuredness, to appearance, appropriate clothes, voice and mannerisms. We don't put it all together in a few days. I think you will be just fine.

[androgynouspainter26]

Sabine,

Thanks!  I hope it's not too much to ask (and if it is I completely understand) but I'd love to see some photos of a patient of his that he personally hasn't put up on his website.  If not, I totally understand but it would really help me out. 

I did contact Alexandra a few months ago (virtual FFS)-and I really really really HATED the results.  She rounded my chin and jaw down to a sphere, and my face looked completely shapeless.  I can honestly say that I looked a lot better in the before picture-at least there I had some attractive features.  I really hope that her results aren't the only ones I can expect, because she really made me look dreadful!

Also, I feel like I should just say this-passing is not about confidence or self assuredness.  It's about recognizable physical features that we unconsciously read as female.  I don't know why everyone thinks I'm new to this-I've been on hormones for sixteen months down, and at six feet tall with hands the size of dinner plates my chances aren't nearly as good as I wish they could be.

[Sabine]

I certainly didn't mean to imply that you were new to it. It didn't sound that way to me.  I think I just try to write in such a way that anyone reading it can walk away with something -- one ear to you one to others I suppose.

Alexandra rounded me as well, in ways that Spiegel didn't suggest. I think it's a case of how she sees an ideal face. To me, what she did was not a guide, just an idea. I had mixed feelings about the result and I went over it in detail with Spiegel.

I hear you about the unconsciously read features, and that was one reason Spiegel was helpful as he had an eye for the little things that make a lot of difference. I have Hepburn cheekbones, which is not as good as it sounds on this face, but they can't be changed. Alexandra somehow softened them (I suppose she had a filler in mind). Spiegel saw them as assets and worked with them as he shaped the rest, almost keying off them like a cornerstone.  Nothing can replace the face to face with the surgeon, who also has to approach the work with a sculptor's eye. Like any commissioned artwork (!), there is a little tension between the patron and the creative mind.   I think the more you share with him the better, and reinforce it.  He wants to please you and tries to make the most of what is presented to him. He also gives your face an consistency or logic so that the features work in unison.

To be honest, I had to be an annoying madwoman as I had something like four consultations, though only two in person. I needed some hand holding.  I was skeptical that I could be helped, and wary of wasting money. Above all, for me it really was what would determine if I felt confident enough to go full time. It sounds as if you are experiencing a similar angst.  It was a bit confusing to me. Spiegel was not 100% firm about what he had in mind. What he recommended changed over time (I had a stack estimates from him, and others, and I felt like I was dealing with a pack of bodyshops circling their prey at times). There were some items in common each time, but I didn't take the whole list. I think that some of that was the difference between interpreting my face 2D vs 3D, and in different situations. I did add something the day before, when he did his last consult. I also think that he doesn't totally decide until he is in there and see's what he is dealing with. For example, there are limits to how much chin or jaw he can file away. 

FFS is very subjective and I agree with others that no matter who you see, be firm about what you want but listen with an open mind (as he should as well). That's true for any of the cosmetic surgeries we do of course. It's YOUR face and you get to look at it the rest of your life. :-)  Still, he has some insight from experience into how to get the most from what you have.   One thing to consider is taking a cumulative approach, adding things later. I have known some women to do this as they were afraid how changing one feature would affect the rest. Spiegel was good about explaining how he envisioned how each change interacted with the others he was proposing.  I had a slight advantage in that I have an arts background and understood what he was getting at from my own work.

As for my photo, let me think about it. I haven't posted or shared it on any site. I also am not sure I am a good example, as I had heavy features and you don't, but I suppose the extent of the change might be helpful. 

[angel0202]

I honestly think you should choose spiegel from what you've described. Your forhead will be totally feminine and your jaw will be exactly as you want it. I think if you go to dr Z you will regret it from what you've said. You might just have to sacrifice getting breast augmentation... I hope you come to a conclusion. As far as passing... You totally will be passable and beautiful trust me when I say that. Subtle changes are actually often best.

[androgynouspainter26]

Well, I've chosen Speigel and asked him to be aggressive-he seems very receptive to what I want aesthetically (angular, sharp, runway modelesque) not doughy and rounded.  Here's to hoping this works out!

[ClaudiaLove]

Congratulations on your choice    . 

I am sure you will get the results you want , he is a great surgeon  . 

[luna nyan]

Alright!  Decision made!  No mor second guessing!

Good luck! 

[Celia0428]

Well, I've chosen Speigel and asked him to be aggressive-he seems very receptive to what I want aesthetically (angular, sharp, runway modelesque) not doughy and rounded.  Here's to hoping this works out!

Good choice. Your forehead will appreciate it.

[Dash]

Good luck Androgynous Painter. : )