Ritana - the 3 month mark is usually where the Botox stops working and the voice gets a bit different again. So you probably are in that phase. Remember that 200 Hz are totally fine as an average pitch, even 180 Hz would be totally fine. 254 Hz is a pitch that is not really the regular average pitch after a voice surgery unless you happen to have a female pitch before the surgery already.
Breathiness/Hoarseness and lower pitch go hand in hand - same with lower volume. Its part of the process, really. I was constantly asked if I have caught a cold while people did not made any remarks about my voice sounding differently from before the surgery at month 4 and 5 even - people did not notice I had surgery, a higher pitch, a more feminine voice, but they noticed the hoarseness
If you decide to take the clonazepam, it will change the voice a bit again, and especially when that phase ends, the voice changes again. I had the impression that after the clonazepam, at about month 9 when the withdrawal of the drug was ending, my voice was really getting much better and less hoarse and had more volume - I lost a bit of that IMO when I had to restart clonazepam again, but there are long times when it is ok now, but occasionally I have hoarseness.
I believe the hoarseness comes when we use the new voice in a wrong way - especially when tensioning up some muscles that are supposed to relax - maybe out of old habits, old feminization techniques or some other reflex. I found that usually when I experimented a bit, also with the voice exercises and with my speech therapist, sometimes I would "find" a way to use my voice that sounded good - no hoarseness... but its hard to really stay in that place all the time for me somehow. Especially when I am stressed...
