Questions regarding VFS with Dr.Remacle

[JaniceNL]

Hey,

I am looking into getting my VFS with Dr.Remacle because flying to the US or Korea is financially not feasible because I am also getting FFS.

I have a few questions regarding Dr.Remacle and his technique. He advertises his surgery as "Yeson style" but when I googled Yeson VFS and quickly skimmed through their page I did notice that they are somewhat different. However it's hard to definitively say what because they both use the same terminology but differently.

Can someone explain what the essential differences are between Dr.Remacles technique and Drs. Haben and Kim?

And also does it matter if I haven't had any voice training whatsoever? I plan on starting with this after the surgery.

[anjaq]

I did not know they advertise it now as "Yeson Style" - lol.
Apparently Yesons reputation goes up well enough to use it as an advertisement to do something similar.

There are some differences in technique that are noteable. Remarcle uses dissolving threads for the sutures and glue to protect the suture and give additional hold while healing. He uses AFAIK laser to cut the vocal chords before suturing. Yeson use permanent threads that ensure stability for a longer time during healing and that can be tightened more. They use microscalpels instead of laser to cut the vocal fold membranes , so they can put the cut off pieces back in place after surgery. There are probably also differences in where the threads are placed. The post op care is different, but that is up to the patient anyways.
the results from Yeson are widely spread on youtube and susans and on facebook. Prof Remarcles results are somewhat less numerous, but so far they seem to be good. As with all surgeons doing this procedure, it seems that some patients come out with a very feminized voice and average pitch of 250 Hz while others have only little increase in pitch - no one knows up to now why this is the case... it seems to be luck...

[JaniceNL]

Thanks for the explanation, I would be satisfied with even a little increase in pitch, right now my voice is far from feminine and when I try to raise it it sounds forced and fake. Not a pretty sound lol and hard to maintain for longer periods of time.

I also noticed very little patients before and after vocal results or testimonials, which has me kind a worried but he is my only option so I will be getting a referral to go see him in 2016.

Does it matter if I haven't had any voice therapy? would you say someone who has had it before surgery would benefit more from surgery? And is there a big chance of having complications with this technique?

[anjaq]

I think you definitely need voice therapy, sometimes it is nice to have some done before the surgery, in order to know if it works without surgery, maybe. Some techniques learned in therapy are applicable post op, others are not (and may even be distracting). But be advised that in most cases a voice therapy is needed because te surgery changes pitch and some parts of timbre, but it cannot change all that makes a voice sound male or female - the surgery can maybe do 30% or so...

Complications are possible - permanent hoarseness , not enough increase in pitch, lower volume, decreased pitch range are complications that occur temprary or can occur permanently to some degree, depending on the surgeon, skill, technique and luck.
Severe complications can be a suture that rips or dissolves prematurely - in the latter case it can be corrected with another surgery (one is safe from that one with Dr Kim who uses permanent threads) - in the first case, which usually only would occur if one severly disregards post OP restrictions (no speaking for 2-4 and absolutely no shouting for 8 weeks). If it should occure, the complications can be severe though, but really , this is all about planning to be in a calm environment post op.