Yeson voice feminization surgery 2.0

[Dena]

There is an element of risk with voice surgery and we have some fails on this site. It's possible for a voice to end up low or it could over heal resulting in a voice that sounds false. The tie can let lose or the cords may not join. I recommend that people see a speech therapist first and learn everything they can about their voice before considering surgery. Make the decision for surgery only if there is something that can't be addressed without surgery and you feel the risk of a failed surgery is reasonable. By knowing your voice and what to expect, you will be able to determine if the doctor is presenting a good solution to your problem. In my case, I knew pretty much what I needed and had a rough idea what the doctor could deliver. The doctor promised less than I hoped for but it was the best deal in town. In the end, the surgery turned out better than expected so I am happy.

If you have the money, you could book voice surgery before Suporn however if it's one or the other, Suporn might be the best to have first.

[ShannonMaher]

Hi Dena

I've done allot of voice therapy never quite managed to get it there, so thats why I was thinking of the surgery.  At the moment I cant afford to do both.  I might be able to do so in the new year if plans work out, I heard though that due to the changing of the voice box that when they ventilate for surgery then it could damage the surgery site.  Thats why I was thinking of doing it last,is that true?

Thanks

Shannon

[Dena]

We are not sure of how much of a risk there is but because the vocal folds are joined together, inserting the airway might rip them apart if excessive force is applied. I think your surgeon is aware of the risk but if you have voice surgery, you should inform them of the fact before surgery. There is also discussion of using a #6 airway which is the smallest one in order to ensure it passes past the cords without causing damage. Some people put a warning in their wallet so it will be seen if they are unable to respond before an airway is inserted.

[AnonyMs]

Dr Suporn's anesthetist has experience with women who have been to Yeson. It's mentioned in that pdf on Suporn.

Personally I'd ask the surgeon about it if I were considering voice first.

[ShannonMaher]

I think I'll probably wait till I get voice surgery and do it as one of the last surgeries just to be on the safe side

[anjaq]

Regarding the restrictions in future surgeries - yes there is a risk of vocal damage if the intubation is done improperly. A smaller diameter tube than usual should be used, ideally it should be inserted and extracted carefully with an endoscopic camera. For emergency intubations, this may not be possible, but I carry around a plastic card describing the issue in the hope that it would help in such a situation. For planned surgeries it is easier to keep to these rules. It still was helpful for me to have the emergency card to show local surgeons who did not know a thing about VFS and are prone to "know better" , so it helped to show them a neatly designed plastic card instead of just telling.
I know some trans surgeons now know about the VFS done by Dr Kim - specifically Suporn Team and FacialTeam are in close contact with Dr Kim and so they know how to do this properly. I think others know by now as well.

Regarding the lack of pitch increase after 4 weeks or less - this is quite normal. Consider the time until week 8 to be like having "surgical laryngitis". If you have a laryngitis, the pitch drops into the bottom and this basically is the same because of swelling and sore muscles. After some time, it should get better, but one will have to adapt to the new voice in order to make best use of it and actually be able to use the pitch increase. The Yeson exercises help. but its easy to do them wrong. Also if the vocal tremor or muscle spasms return after Botox wears off, it may impact the voice and pitch. Its a bit of a harder surgery than lets say FFS - FFS is hard, you have to be patient to see the final results, but basically all you have to do is wait. With VFS, you have to be patient, wait, but also be active and train and have the brain learn how to use the new voice... and not always does this work fast, easy or in some cases it seems to take forever.
The brain is "used" to expect a lower voice and identifies it as the normal voice and also as a pitch that is not straining the voice, so it tries to use thet pitch again. Post op that pitch is in the lower vocal range. Its still accessible - I can still produce a broken 120 Hz voice - but its straining the voice. Still, the brain does not know this right away and tries to go there out of "tradition"  - one has to listen to the feedback and somehow tell the brain that things have changed and now the optimal pitch is a different one, find it and use it. Its pretty complicated and sadly there are no voice therapists trained to help and there is no instruction manual for it.

[Vanessa Lopes]

Hello girls,

I'm Vanessa, I'm 36 years old. Since the beginning of my transition, in 2013, I've always followed this forum, I followed Jenny's topic, I read this whole topic, but it's the first time I post.

I had my surgery at Yeson on June 1, 20 days ago.

Dr. Kim told me that he also corrected an asymmetry and that some parameters were abnormal, such as the pressure and the amount of air I use to speak.

In the first week, I coughed a couple of times but I think it was normal, I tried not to make sounds. But I think I made a mistake: visiting a palace, while I took photos, I ran into a person and automatically said "I'm sorry" but without voicing, just coming out of the air. I hope it does not worsen the result.

On June 6, late afternoon, I went to Yeson for the follow-up and botox injection, Dr. Kim did an endoscopy and said that everything was fine (he always said that everything was fine, both good and bad results  ).

Here is the photo I received in the follow-up. On top the "before". Below, on the left the day of surgery, on the right the day of the follow-up:

I did not ask how much he sutured, looks a little more than 1/3, but less than 1/2.

I returned to Brazil and since then I used my emergency words only once on June 18th. I was sleeping, the friend who lives with me came into my room to look for something and, unintentionally, I spoke three words to her. No pitch increase. (okay, I read on the topics that no changes in the first month is normal even in the best results).

I'm trying to be patient to spend the next 9 days without talking. I worry that in the last 3 days I have sneezed a few times (it had not happened before), and it is difficult for me not to emit sound in these cases, a little bit always leaves.

Well, that's it for now. I do not know yet how my result will be but, being good or not, I think I should share here, since those who shared before helped me to make my decision.

And sorry about my English, this isn't my first language 

[Lynne]

Thank you Vanessa for sharing your experience, I wish you good luck with the recovery!

What is the wait time nowadays for a surgery with Dr. Kim? Let's say I would contact him in the near future, would I be able to get the surgery this year?

[Vanessa Lopes]

Thank you Vanessa for sharing your experience, I wish you good luck with the recovery!

Thank you, fingers crossed!

What is the wait time nowadays for a surgery with Dr. Kim? Let's say I would contact him in the near future, would I be able to get the surgery this year?

They do not schedule for more than 3 or 4 months in the future, so surely you could do this year.

Even if you want a date closer, they should have. I changed the date of my surgery with about 6 weeks in advance and I had no book problems.

[Lynne]

Thank you, fingers crossed!

They do not schedule for more than 3 or 4 months in the future, so surely you could do this year.

Even if you want a date closer, they should have. I changed the date of my surgery with about 6 weeks in advance and I had no book problems.

Thanks for the quick response I can imagine how hard it is to not make a sound for that long. I think that would be the hardest part for me. In a few days your voice rest will be over and I'm eagerly waiting to hear the results

3-4 months doesn't sound too bad. I'm seriously considering spending money on this soon if my other planned purchases fall through. I feel that having a better voice would have the biggest impact on my life for the amount of money the surgery costs.

[Vanessa Lopes]

This week has completed 1 month and I could start talking.
I said two sentences (still difficult) and it still sounds masculine.
I think it´s around 170hz:



I hope it sounds more feminine and that frequency increases in the coming months.

[Donica]

Wow! I had no idea VFS was so involved. I haven't look into it yet myself. I am going to try therapy first. I start next week. I've herd there are several types of surgery and was wondering which one was the most popular and successful? If the therapy doesn't help, I will do the research online as well but I was also curious about the cost? My insurance does not cover this, at least at this time. Thangs are always changing. Perhaps in the future, even breast augmentation surgery will be covered?

[Vanessa Lopes]

Hello girls

To update, 1 month and 27 days ago I had my surgery. My voice has been improving a bit since my last post, but it always gets hoarse at night. Does anyone know if this is normal?

Just speaking the Rainbow Passage, with no effort, Praat measures 182 hz, which is below my initial expectation.

Making a little effort, the average jumps to 213. In my best recording the average was 222, which is fine, but I wish I did not have to make an effort. Anyway, it's very cool and it makes me easy to know that I can talk on these frequencies if I need to.

My resonance is not good, it sounds masculine, but with that technique of putting the larynx up and back, it improves. But I just started doing this, I still have to train a lot.

I'm looking forward to starting Yeson's exercises next week, so I'm hoping they will help improve both resonance and frequency.

[LexieDragon]

I would imagine the hoarseness will dissipate as you get accustomed to your new voice and continue to heal. Did your doctors tell you want to expect as far as recovery times?

[Vanessa Lopes]

Wow! I had no idea VFS was so involved. I haven't look into it yet myself. I am going to try therapy first. I start next week. I've herd there are several types of surgery and was wondering which one was the most popular and successful? If the therapy doesn't help, I will do the research online as well but I was also curious about the cost? My insurance does not cover this, at least at this time. Thangs are always changing. Perhaps in the future, even breast augmentation surgery will be covered?

Voice therapy is usually the first step, and I think it is necessary.

The technique that has the best results, from what I could see, is Glotoplasty, especially a variant called VFSRAC made by Yeson's Clinic (Dr. Kim) in South Korea, which was where I and others who previously commented on this topic did .

The cost is $ 7380 (USD) + $ 400 for some botox injections (80% of patients need these injections).

Good luck with your vocal therapy!

[Vanessa Lopes]

I would imagine the hoarseness will dissipate as you get accustomed to your new voice and continue to heal. Did your doctors tell you want to expect as far as recovery times?

I also hope!
Dr. Kim told me not to worry about how my voice would sound in the first 2 months. But it's only 3 days left to finish this period.
After that, I need to do a list of exercises that they indicated, 5 times a day, but my voice is good only during the day. It will be difficult to do all this exercises. (it's about 2 hours of exercises per day in total, I think)

[LexieDragon]

If you are concerned give the doc a call. Better safe than sorry. 😁

[Dena]

A rough voice is to be expected and it's more likely that soon after surgery. There are two things you can do to minimize it. The first is don't let yourself become dehydrated. Keep water around and sip some regularly. The other is watch your voice volume. My mom's air conditioner is loud and in the kitchen. We played cards last weekend and in order to be heard over the blower, I pushed my voice to the rough stage. The drive home and some more water and in a couple of hours, my voice was clear for a long Skype session.

[Kendra]

Each patient may have different results and recovery pattern, but when I had VFS in March Dr. Kim made the following sketch showing my expected recovery rate: