VFS after SRS and passBility

[Ritana]

Hi everyone,

I am new here so excuse me for any possible awkwardness. Not sure if this is the right section to post or whether I should have posted elsewhere.

I am a few years post-op, and I always thought SRS was the last procedure in my transition. I recently realised my voice causes me lots of dysphoria. I.work in a call centre, and my voice doesn't normally get clocked with the exception of a couple of times when two.older women sirred me (one of them asked me if I Was a man or a woman). I strain a lot and I use an elevated voice to achieve passability on the phone,  and from.what i heard, straining is bad for your vocal cords. However, i have no choice.

Physically I'm very passable, blessed with long blond.hair and a feminne figure. The only time when I got clocked, it wS by a guy who had lots of experience with pre-operative/ non-op transexuals. When i.asked him what made him think I "used to be a man", he replied that while my voice isn't particularly masculine, it isn't a typical female voice either. This combined with my height-Im 5ft8  (two masculine features) made him.doubt.

I go to church every Sunday, and when.I sing in a group, my voice drops quite a lot and becomes a bit masculine. Ihad trachea shave years ago, and unfortunately i have lost some pitch when i speak louder; otherwise my speaking voice hasnt bren affected. People normally say I have a very feminine voice, but the simple fact that a trans-lover had doubts about me partly because of my voice and the fact that I got sirred a couple of times of the phone make me think that having a female voice is imperative to eliminate any sort of suspicion. I am tired of straining. I stArted thinking of having vfs to be more relaxed atound people.

Here are some questions tk be answered by some post-vfs ladies please. Please, try to answer them individually.

1. Did straining pre vfs negatively affect the results you achieved?

2. What is a vical tremor?

3. Those who lost some pitch following trachea shave, did you achieve a high pitch post vfs?

4. What vocal exercises did you practjse post vfs?

5. Is straining bad for you post vfs?

6. How many times did u need botox injectins post-vfs?

7. Do people who knew you pre-vfssuspect you had something done to your voice? Do you get instances where people you know dont recognise your voice on the phone?

8. Can you shout, laugh and cough without sounding male?

9. For yeson patients. What hotels did you stay in in Seoul? Can you recommen any that are close to Yedon and still cheap?

I am so.sorry for asking so many questions. I appreciate your replies to the above questions each separately please.

Many thanks

Ritana

[Dena]

Welcome to Susan's Place. The voice form is were we talk a  good deal about this and if you would like it, the thread can be moved there. If you had damage to your voice, I would consider Dr Haben because the CTA procedure might allow him to restore the damage and a VFS could add additional pitch if needed. Any regular pain in using your voice is an indication you are doing damage to your voice. Some of the scaring can be corrected at the time of surgery but you may need a month of no speaking and possibly longer with light usage. Speech therapy should be considered if you don't already know how to use your voice.

While both doctors have turned out very good results, and normally I don't bias a person one way or another, Yeson might not be the best place for you to go because he doesn't offer the CTA  procedure which you might need to correct the damage done to your voice.

As for other noises, it depends on if you will need the trained voice after surgery or if your chest voice will still produce a feminine sound. In my case I have to us the trained voice so I would need to learn how to do those action in a trained voice and still sound feminine.

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[Ritana]

Thank you for your reply.

Yes, i would appreciate if you could move my question to the right vfs section (which I didn't know existed)

Can I ask what a CTA is?

Just to put you in the picture, I don't get tired when I speak. I meant to say I am tired of having to strain my voice to pass on the phone (especially that I work in a call centre). I hope.this makes sense.

I lost high pitch after trachea shave. My speaking voice has remained the same. In fact,  People haven't noticed any changes in my voice after I had trachea shave.  however, when I sing/ shout my pitch automatically drops. I cannot hit that higher note that I used to be able to hit.

I would appreciate if any people who the same

Thanks

Ritana

P.S. How much dkes Dr Haben cost?

[Dena]

CTA is a surgery where an incision is made over your adams apple and and the larynx is squeezed in from the sides to stretch the vocal cords. This surgery combined with VFS will give you additional pitch. The reason I think of this for you is your past surgery appears to have removed to much material causing a weakness and releasing some of the tension on your vocal cords. CTA might be able to correct the damage and combined with VFS give you all the pitch you might need. Just warn Dr Haben of the issue before you make the trip so he can give you an honest assessment of how it will work out.

He was was worried about the same thing with me but there was no need to worry. The plastic surgeon who did my adams apple was very careful not to take off to much. The result was I still have a very small bump but not enough to be an issue.

If you are straining when you talk, you aren't using a proper trained voice or your voice lacks the range to generate the proper pitch. In my case, my voice was so low I couldn't hit the right pitch. Even after surgery I need to use a trained voice but I can comfortably hit the lower end of the feminine range.

The link is Dr Haben's site which will give you far more detail. He does many more surgeries that this one and the links will show you some of his other work. The voice form has examples of several other doctors works and I have written a thread about my trip but I only had the VFS as CTA has some limitations to it.
http://www.professionalvoice.org/feminization.aspx

[anjaq]

Hi, Ritana

Your reasons to consider VFS are similar to the ones I had (except the part about the trans lover). And for me it helped a ton being just confident and natural now without contantly thinking I am faking something or without the constant reminder of that "maleness" in the voice. That said, if your voice is good now and just needs some finetuning and a way to speak without straining, voice therapy might be able to help. The target of therapy is largely to use a feminized voice without straining. For me this did not work properly as in order to eliminate straining, I had to go down a bit in pitch which put me right in the male pitch range and this was not helping.

1. Did straining pre vfs negatively affect the results you achieved?

I believe yes. Dr Kim saw my pre OP recordings and voice assessment and said I should first do voice therapy to get rid of some issues as they would negatively affect recovery.

2. What is a vical tremor?

Its muscles in the larynx being activated involuntarily and this can distort the voice. It seems to be common with people who strained or tightly controlled their voices for a long time

3. Those who lost some pitch following trachea shave, did you achieve a high pitch post vfs?

4. What vocal exercises did you practjse post vfs?

Yeson gives a set of exercises to do. Additionally I did voice relaxation exercises and exercises for singing. We did very little feminization exercises, mainly just exercises for voice health and to speak clean/clear.

5. Is straining bad for you post vfs?

Sure - straining never is good

6. How many times did u need botox injectins post-vfs?

I had one, I wish I had done a second one instead of taking the medication

7. Do people who knew you pre-vfssuspect you had something done to your voice? Do you get instances where people you know dont recognise your voice on the phone?

People who know me often say that my voice is the same , just a bit higher pitched and with other subtle changes. They know I did something to my voice because I told them, since I was not able to speak for a month and then for another couple of weeks limited voice use and hoarseness. People I meet less often do not always recognize I did have a surgery as my post OP relaxed voice is similar to my pre OP trained voice except it is a little bit higher pitched, but a bit more breathy, but also more relaxed now and it has a bit different timbre. Some people however say there is a clear difference now. It seems to be dependent on the individual and what they are watching for in a voice.

8. Can you shout, laugh and cough without sounding male?

I believe so

9. For yeson patients. What hotels did you stay in in Seoul? Can you recommen any that are close to Yedon and still cheap?

I stayed at Phil House. Its cheap if you are travelling with a companion, you have own kitchen and washing machine there. You will be at the clinic only 3 times, so being close to the clinic is not essential at all.

[Ritana]

Thank you so much for your reply Anjaq.

Can I just ask:  if you've had trachea shave in the past and this affected your voice?

How far from the clinic is the hotel you stayed in?

I have quickly looked into cta method and it seems too invasive for me. It also seems to involve some risks. Some people claim it has  caused their voice to be deeper which subsequently required more surgery to fix it.

Any thoughts on this?

[iKate]

Dr Kim does not recommend a trachea shave. Jenny had one though. Email Jessie and ask: english@yesonvc.net

[Ritana]

Thanks but the issue is not whether or not to have trachea shave. I have already had it. I only wanted to know if kim patients who had lost some pitch after they had had trachea shave  managed to get it back after vfs?

[anjaq]

Can I just ask:  if you've had trachea shave in the past and this affected your voice?

No, I never had a trach shave and will not get one, so I cannot comment on that. Dr Kim does not like trach shaves, but he can compensate for a lowered voice due to a trach shave by shortening the vocal folds a bit more than usually, if that is needed

How far from the clinic is the hotel you stayed in?

It was about 20-30 minutes by public transport and about 20 minutes by taxi. For the examinations I went with subway which is cheap and reliable but involves some walking. For the surgery day I took taxi because I did not want to walk much that day. Taxi was only $10 or $15 maybe.

I have quickly looked into cta method and it seems too invasive for me. It also seems to involve some risks. Some people claim it has  caused their voice to be deeper which subsequently required more surgery to fix it.
Any thoughts on this?

I think it is rare that the voice is getting deeper with CTA, but it will create a fresh scar on the neck and it will limit vocal range. Basically it will simulate your attempts to speak at a higher pitch by putting one of the two pitch controlling muscles on "max" permanently. If you are totally happy with your trained voice as it is, it may be ok, but it can do little else. Glottoplasty has the advantage that it also changes the mass that is involved , so it will alco change the sound of the voice somewhat. Some people want a combination of both to get maximum pitch increase and also get a trach shave at the same time, Dr Haben does that. Dr Kim only does glottoplasty (VFS-AAC) and discourages from doing trach shaves as they are known to lower pitch.

[Ritana]

Thanks Anjaq,

You've been very helpful, snd i appreciate that. I have read that a member here called jennygirl had the. Same issue prior to vfs i.e. she lost some of her pitch following trachea shave. Apparently Dr. Kim compensated for it by shortening her vocal cords further.

Does anyone know if she's regained the lost pitch after vfs? Unfortunately I cannot send her a private msg as i am new here and I don't have this option yet.

Thanks

Ritana

[iKate]

1. Did straining pre vfs negatively affect the results you achieved?

I believe that extensive attempts to get your voice higher pre op is detrimental. A lot of the girls who have had unsatisfactory results from VFS had trained voices. The problem is that you have to un-learn plus the brain has to figure out that something happened. It does this by feeling that there is some change in how the vocal folds are operating. If you had a good trained voice before, in some cases the brain really sees no change and makes no effort to change. This is why I say that if you start your transition and figure you are getting the surgery, just do it. Don't train your voice and then figure out from there.

2. What is a vocal tremor?

It is where your voice cannot hold a steady tone. It wavers. It's because of involuntary muscle spasms. Better explanation is here.

3. Those who lost some pitch following trachea shave, did you achieve a high pitch post vfs?

Some surgeons like Dr Kim do not recommend trachea shave. Some like Dr Haben will do it as part of the procedure if you want. Jenny, who is pretty much the one who got the ball rolling, has had a trachea shave and her pitch is feminine.

4. What vocal exercises did you practjse post vfs?

These.

5. Is straining bad for you post vfs?

It is never good for you. Don't do it.

6. How many times did u need botox injectins post-vfs?

Once, then you take muscle relaxant medication once botox wears off. However botox is only required if there is vocal tremor which is nearly all patients.

7. Do people who knew you pre-vfs suspect you had something done to your voice?

Well, yeah. I never used my "trained" voice. It was just awful, besides I was always afraid I'd damage something. So when I came back with a new voice people were surprised. But many of my colleagues know I had surgery and it may have been voice surgery.

Do you get instances where people you know dont recognise your voice on the phone?

All the time. In fact, even in person. People often think I'm my wife.

8. Can you shout, laugh and cough without sounding male?

Absolutely. In fact it sounds extremely feminine.

9. For yeson patients. What hotels did you stay in in Seoul? Can you recommen any that are close to Yedon and still cheap?

I stayed at Phil House and took the subway. It was cheap and efficient. I went with my mom.

[iKate]

Thanks Anjaq,

You've been very helpful, snd i appreciate that. I have read that a member here called jennygirl had the. Same issue prior to vfs i.e. she lost some of her pitch following trachea shave. Apparently Dr. Kim compensated for it by shortening her vocal cords further.

Does anyone know if she's regained the lost pitch after vfs? Unfortunately I cannot send her a private msg as i am new here and I don't have this option yet.

Thanks

Ritana

She definitely has good pitch. However, remember that we're not playing "Hertz wars." When you do your consultation with Dr Kim or Dr Haben or whoever they'll discuss with you the options and how high your pitch needs to be. You don't want a mickey mouse voice if you're a size 14 for example or a low voice if you're a size 0 and 5'2". You want a voice that sounds natural and matches your look.

[iKate]

Thanks but the issue is not whether or not to have trachea shave. I have already had it. I only wanted to know if kim patients who had lost some pitch after they had had trachea shave  managed to get it back after vfs?

When you do your consultation, Dr Kim will take that into account and shorten the vocal folds appropriately to give you a voice that matches your appearance. I have not had a trach shave (don't need it, my apple is very small and not visible) though.

[Ritana]

Many, many thanks for your helpful reply hun. I appreciate it. I hope jennygirl can can reply to me with regards to vfs results after Partial loss of pitch through trachea shave.

[Dena]

Jennygirl is now somewhat irregular in her visits to the site and most often works on her own threads. It might take as much as a week for her to give you a response.

[anjaq]

I believe Jenn reported in great detail in the first Yeson thread on this site how her pitch and voice developed. She is now basically Yesons "poster child" - he shows her voice as an example in his consultations - And she was totally happy with it, so I think it can be taken for granted that the surgery did not only give her back what she lost with trach shave but changed her voice much more to the positive in addition to that