Quote from: mmmmm on June 17, 2015, 12:04:14 PM
Well, that's the whole point of this... most people have FFS because it is benefitial, and some have it because it necessary for them.
Not arguing with you. I had FFS because it was beneficial, not because I needed it. But when we're looking at FFS from a "benefit" standpoint rather than a "necessity" standpoint, only the most financially well-off can ignore the economic realities of FFS. It's extremely expensive, and I would only encourage someone to blindly go to a top FFS surgeon without examining the local alternatives if that person absolutely needed a type 3 forehead procedure to pass. If they'd be happy with a type 1, a brow lift, and a rhinoplasty, then they'd probably be happy with the results of a local plastic surgeon and keeping the difference $15,000 they'd save, which is a huge step towards paying for SRS. (And jeez, a consult with a local plastic surgeon should be a common sense step anyone considering FFS takes, if only for a second opinion. The big name Official FFS docs seem rather fond of suggesting lots of minor additional procedures that aren't necessary except for helping the doc make the next BMW payment, especially during those Skype consults where there's little chance they can actually examine your face properly.)
QuoteWe talked it is necessary for OP to have type 3 reconstruction if she wants to have a result as presented on virtual FFS pictures. What kind of result she wants and what will make her happy, is for her to decide.
Of course. I thought it was fairly obvious that if she wants to look like she has had a type 3 reconstruction like in the pictures, she needs to get one. The point is that I personally don't think she needs one. Would it be great to get it done? Sure! It does make a difference in the photos, and it's a wonderful procedure. But it doesn't make the difference between passing and not passing, and many cis-women have foreheads that look just like hers does now. Therefore, it's not absolutely necessary, which was the question she actually asked.
QuoteThere isn't any significant difference in price for type 1 or type 3 procedure. If you have a chance to make it right, for an overall better and optimized result, why not do it right. That's my argument. Don't ever trust a local plastic surgeon with shaving frontal sinus wall, especially if you are his first patient with such request. Adios...
That's a bit simplistic. Sure, not much difference between the cost of a type 1 or a type 3 procedure if you're looking at any particular surgeon's price list in isolation. But there's a huge difference between going to an Official FFS surgeon who will perform a type 3 procedure and one locally who will perform a type 1, especially when additional procedures (and "FFS mark-ups" on all of those other procedures) are added in. And that's not even mentioning the cost of travel, accommodation, and the inability to have regular follow-ups because once you travel back to Hawaii from Boston, you're screwed if you need to see Dr. Spiegel again. Suddenly, basic and competent FFS performed by the local plastic surgeon (which would, for example, include a type 1 forehead and a rhinoplasty) goes from under $10,000 everything included to a $35,000 cross-continent excursion (including flights, hotels etc., and far more if you want a companion to come with you.)
Careful with the misconception about the local docs too. I'm not talking about laying down in the office of some backass town's family practitioner and asking him to shave your skull. I'm saying that in any major metro area with a good hospital (e.g. any of the top fifty cities in the US), there's going to be experienced plastic surgeons who can perform full-range FFS with their eyes closed, although they may shy away from a type 3 forehead reconstruction. Just because they haven't specifically branded their web sites around a narrow service like FFS, doesn't mean they haven't done it, can't do it, or won't do it. Remember, they make their money catering to some rather vain women who want to look as feminine as possible. They don't want to push that regular business aside by being known as the "transgender" doctor - half their regular clients would run because they don't want to end up looking like a transgender woman. But most plastic surgeons will (and have) happily and successfully operated on transgender women even if they don't brag about it online.
Again, if money is no object, then I repeat that you might as well go to the big name FFS guys. They're amazing surgeons. But few of us are in that position. For many of us, we might find that for the money we're able to afford, a type 1 forehead, a rhinoplasty, brow lift, and tracheal shave done locally will be far more feminizing that blowing the entire lot on a type 3 forehead, a plane ticket, and nothing else.
And it goes without saying that nobody should be a guinea pig for an inexperienced surgeon (although it's rumored that Spiegel lets his trainees operate, but that's not something I've confirmed.) But by the time a plastic surgeon is board certified, he or she has certainly done more than enough basic facial procedures to not screw things up.
mmmmm, I'm not arguing with what you're saying. You're right. A type 3 forehead is the gold standard. It's just that not everybody wants or needs the gold standard, and their idea of the gold standard and what constitutes perfection could well be different from yours. I almost fell into the type 3 trap, thinking that I should have it because everyone else wants one and because the pictures look really pretty. Given unlimited funds, I'd have jumped at the chance to go down that route. But on balance, I'm very happy that I stayed local, had more of my face worked on for the money I had available, and got extremely good value out of my surgeon without paying the Official FFS mark-up.
My transition budget, for example, is about $50,000, maybe a little more. FFS cost me $15,000, and I had work done that Spiegel wanted $35,000 for, and Zukowski wanted just under $30,000. When I factor in that I've also got to pay for SRS and finish up electrolysis, the high end quotes were thoroughly unrealistic. Could I have borrowed that money to pay for the fancy Official FFS? and maybe get slightly better results? Sure, and then I'd have been paying it off for a decade instead of getting out there and living my new female life while I was young enough to really appreciate it. Or I could have blown my SRS budget on the fancy FFS and then been angry with myself that I had to wait another five years with a penis to save up the cash to pay for that procedure. As it stands, my SRS budget is still in the bank, and I'm ready to take that next step and finish the physical part of my transition. I don't want to be in transition forever, nor in debt forever from trying to make every single thing perfect.
Just offering some real world practical advice here. Is it a compromise? Of course it is (depending on your point of view.) But that's life for many of us.
