I had Spiegel do just about everything as I really needed it (apart from tracheal). I passed "sometimes" before, and my impression is that I do generally now. I say impression, as it's not just face that determines passing and also people are not really honest about telling you whether you do or not (which is not the humane encouragement they think it is. One wants a realistic evaluation, not validation of your choice.) Much depends on what he is working with, and your whole body package (chest and shoulders , posture, musculature). He tries his best to make you look a female version of you, and does well with that and understanding how each portion of what he does influences the whole outcome. But there are limits with what he can do with jaws and strong features. He can't reduce a jaw beyond a certain point, or a nose. That's just reality. Still, I have never had an incident or problem about passing (apart from some who knew me before and can't deal with the change -- which means they won't even use the correct pronouns.) Whether that means I pass enough that at worst they are not sure if I used to be male or that I live in an area that is more tolerant, I can't say. I remain very self conscious which probably doesn't help. I keep waiting for some sort of epiphany or a moment that "proves" passing. I suppose that will pass. I know I am vastly different postop, but my situation regarding passing is different than most as I was "known" in my town and a lot of people just interact with me as usual as I am no stranger. For what it's worth, I do get treated as female in discriminatory ways, which I suppose is a backhanded affirmation.
I have heard from a several people postop from Spiegel. Some expected too much and were disappointed, some didn't feel he was aggressive enough, some are very happy. I would caution that all plastic surgeons speak in soothing tones about what they can do for you (and their office gatekeepers are really in sales TBH). Spiegel will soften you and make your face more feminine which will help passing. Unless that's really all you needed to pass (which is understandably very rare) don't expect a magic bullet. I don't think I would or should have chosen anyone else to do it, but I think I was realistic about what to expect: I am not among those on his office wall or on the website gallery.
He wants to please you. Do your best to explain to him exactly what you want, and have him explain how all the work he'll do will act in concert. If you did the virtual FFS with Alexandra, talk about it. The outcome won't look the same (mine doesn't), but you can get a general idea of how the changes work. It sounds as if you had specific work in mind, which helps guide him. I also gave him pictures of my mother (my only close female relative) which help him understand what were family traits. Most people who know us both see her in me, but only enough to show the relationship -- not a clone, thankfully. The more you interact about it with him the better. I did several times.
I would only add (for anyone else reading this, really) that if your transition is pinned to passing and FFS as part of that, be cautious. You have to want to do it even if the FFS doesn't do all you secretly hope it will. If you are committed to transitioning, and want or need FFS as part of that, Speigel is a reliable choice.
