6 years into transition, finally considering FFS

[deeiche]

Good to know, thanks. Yes life is pretty good.

All great info, thank you! =) How bad was the nose swelling? Dr. Mardrossian made it seem like it would swell some but not be any bigger than your previous nose or something (because the final result was smaller).

The nose swelling seems to be more internal than external, but I also had nasal valve repair.  Does that make sense?  I did not notice having a larger nose, but more a restriction in my breathing.  My breathing is much better than post surgery and continues to improve.

[SamSparks]

I don't agree that any decent plastic surgeon can do it. I don't think they'd risk implants if they could. I understand what you mean that if you come from a place of severe under development, they can both be used. I'm sure if the under development is severe enough, an implant is warranted. All surgeries have limitations, including the sliding genioplasty. However, in the case of a MtF that would mean the jaw would have to be within female standards already, because implants add mass, and most decent chin implants wrap around the jaw a little, so you really have to start from a very petite point. I have no issues with implants in and of themselves (I think Angelina Jolie's facial implants are perfection, for example), but I wouldn't get one personally. That being said, I guess I should allow room for the unlikey, but very possible, event that some of us might need a chin implant

Angelina Jolie had facial implants?  Wow I guess you learn something everyday.  Is that why she seems to have grown into such an angular middle aged woman?  Dem cheek bones and her jaw projection is insane but still pretty.

[SamSparks]

Forgive me, I meant to say do it *well*. Is it really part of regular training? I've encountered many plastic surgeons who don't offer the procedure. I suppose it's because they can't do it well. And I've seen enough before and afters from many plastic surgeons to know that many who do offer can't do it well either.

No, but it's adding width to already masculine features. If you're female, those extra mm probably won't do too much, even if you have your entire facial structure enhanced (like Angelina), but in MtF transsexuals it's just not the same. Conversely, if you already have a very defined bone structure (like Gigi Gorgeous) you may be inclined to keep your square jaw because you think it's "modelizing" but in transwomen I find it just makes us look like.. transwomen. Obviously, everyone can feel free to disagree, but that is my opinion.

The thing about medical professions is that its really up to the individual if they want to master a procedure.  Its one thing to be "trained" in something and do it a few times (or once or not at all) its another to decide you want to master that to the point where you are comfortable doing it over and over as a working professional.  Could be why you see many surgeons drop certain procedures from their skill set even if they technically received enough training to perform them.  I am really mostly speculating though, I am not in medical school or in a surgical residency ha.

[BellaSwan]

Angelina Jolie has had a plastic surgery load worthy of mist trans women haha! But she is gorgeous, yes.

[Debra]

The nose swelling seems to be more internal than external, but I also had nasal valve repair.  Does that make sense?  I did not notice having a larger nose, but more a restriction in my breathing.  My breathing is much better than post surgery and continues to improve.

Oh interesting, ok. What's the valve repair exactly?

[deeiche]

Oh interesting, ok. What's the valve repair exactly?

Revision Rhinoplasty Textbook Page 6
Nasal valve collapse can sometimes occur after rhinoplasty, I had two in the early to mid-80's.  Looking at the bottom of my nose with my head tilted back my right nasal passage was very restricted.  When I inhaled through my nose it would seal closed.  I used to wakeup with a sinus headache every morning.  About 15 years ago I started wearing breathe rite strips every night.  I went from daily sinus headaches to every couple of weeks.  On the weekends I used to wear breathe right strips for almost the entire day.

Since the surgeon was doing a rhinoplasty anyway to match my reconstructed forehead I asked them about repairing my nose issue too.  Dr Rossi said he could do it as an additional procedure as nasal valve repair required a cartilage graft.  At this point in time I am very happy with the result.  My sinus headaches have been almost non-existent post-surgery.  Of course they may also have occurred because I have almost no frontal sinus after Type III surgery. 

[marie]

With the strong $US and weaker Euro, many US girls are now travelling to Europe for surgery.

The prices are a lot cheaper to start with and results that I have seen over here in Europe are just as good or even better than various US surgeon's post-op patients I have seen while in the USA including myself and I am a 'Z' girl.

Still you have plenty of time to make your final choice and I wish you all the best.

Hugs

Paula ( from the UK )

Hi !

I fully agree with that I had FFS with Dr Bart back on March 2015, and am happy with the results look at topic St Patrick...

[Debra]

Revision Rhinoplasty Textbook Page 6
Nasal valve collapse can sometimes occur after rhinoplasty, I had two in the early to mid-80's.  Looking at the bottom of my nose with my head tilted back my right nasal passage was very restricted.  When I inhaled through my nose it would seal closed.  I used to wakeup with a sinus headache every morning.  About 15 years ago I started wearing breathe rite strips every night.  I went from daily sinus headaches to every couple of weeks.  On the weekends I used to wear breathe right strips for almost the entire day.

Since the surgeon was doing a rhinoplasty anyway to match my reconstructed forehead I asked them about repairing my nose issue too.  Dr Rossi said he could do it as an additional procedure as nasal valve repair required a cartilage graft.  At this point in time I am very happy with the result.  My sinus headaches have been almost non-existent post-surgery.  Of course they may also have occurred because I have almost no frontal sinus after Type III surgery. 

Gotcha. Glad it worked out for you, yay!

[Debra]

Alright I had a skype consult with Dr. Mayer today.

In his original email to me, he suggested: Scalp Advance, Brow Shave, Rhinoplasty, Brow Lift, Lip Lift, cheek and chin implants.

I was kind of taken aback because I just don't want to do that much. The main things for me are forehead and nose.

Anyway, we spoke on skype today and he seemed nice. He re-iterated what he suggested but he understood what I wanted to do was what I wanted to do. He kept saying that my chin was VERY recessed and even showed me how far forward it should be (to align with the base of my nose (in profile photos). But he let it go. He also confirmed it wasn't a masculine/feminine thing as much as just balancing out the face in general.

Before the consult, I was struggling with how to ask about Type III with him without being insulting but he just immediately brought it up. He said that he shaved everything down and it always worked for all of his patients that way. He said he's never had to take any sinus walls out and yadda yadda yadda....and claimed that was all just 'marketing'. The way he said it, it did all sound very believable but I've seen too many in the community comment about it to know for sure. I guess I should have asked how he dealt with really thin frontal sinus walls?

He explained a lot about my nose too but frankly it was all kind of confusing....it sounded pretty complex what all he had to do about moving this there and that here, etc.

I wasn't necessarily interested in the lip lift but I asked about it anyway based out of curiosity and he explained how it worked too. Wondering how the swelling / recovery is for that too.

Overall, a pretty good consult, I think though.

[BellaSwan]

He straight up lied about the forehead. I suggest finding another surgeon. He sounds more like a salesman than caring individual. I would find a craniofacial/maxillofacial and aesthetic surgeon,

[Lagertha]

Before the consult, I was struggling with how to ask about Type III with him without being insulting but he just immediately brought it up. He said that he shaved everything down and it always worked for all of his patients that way. He said he's never had to take any sinus walls out and yadda yadda yadda....and claimed that was all just 'marketing'. The way he said it, it did all sound very believable but I've seen too many in the community comment about it to know for sure. I guess I should have asked how he dealt with really thin frontal sinus walls?

I think you should look here and judge for yourself :  http://bevhillstg.com/photo-gallery/

I probably should keep my thoughts for myself.

[Debra]

I think you should look here and judge for yourself :  http://bevhillstg.com/photo-gallery/

I probably should keep my thoughts for myself.

Yeah that's a really good point....kinda tells all really.

Consults with Spiegal and Deschamps-Braly coming up in 2016 so we'll see how those go.

[BellaSwan]

Not one pleasing result. I'm sure he's a good plastic surgeon but he's a terrible ffs surgeon

[myfairlady49]

Not one pleasing result. I'm sure he's a good plastic surgeon but he's a terrible ffs surgeon

Looking at the web site  - - he is *NOT* a board certified plastic surgeon.  Yes... he claims "facial" plastic surgery.  But you basically can get that just for having become an Ear Nose Throat (ENT) .    That board is basically just a marketing / vanity pseudo board.

If you go to  www.certificationmatters.org - -   and look at his specialty training - -  he is an Oto-rhino-laryngologist - - that is,  an  ear nose throat surgeon.   They are not trained as plastic surgeons. Nor as craniofacial surgeon.  Nor are they trained to do orthognathic jaw surgery.

He probably does not do type III because he knows he is not trained to do that type of craniofacial bone surgery.   If he ever caught a lawsuit due to a bad result (they do happen - - even to good surgeons)  he would be in a difficult spot, even if he didn't cause the problem - -  because he would have to defend doing the surgery because of his inadequate training to do that type of surgery.

[Debra]

If you go to  www.certificationmatters.org - -   and look at his specialty training - -  he is an Oto-rhino-laryngologist - - that is,  an  ear nose throat surgeon.   They are not trained as plastic surgeons. Nor as craniofacial surgeon.  Nor are they trained to do orthognathic jaw surgery.

Oh wow well I kinda knew I probably wouldn't be going with him but now I am pretty sure haha.

[Debra]

Started setting up a consult with Dr. Deschamps-Braly for June 2016. They've sent me a referral for xrays and I had a heck of a time trying to find the right radiology place that would even do them. Hoping I can get insurance (or at least my deductible) to cover it but if not, I have my FSA too.

I figure my hubs and I are going to Santa Cruz in June for a weekend vacation anyway so making a quick stop in San Fran to see the doc seems like a good option. We'll see how this all goes.

[deeiche]

Started setting up a consult with Dr. Deschamps-Braly for June 2016. They've sent me a referral for xrays and I had a heck of a time trying to find the right radiology place that would even do them. Hoping I can get insurance (or at least my deductible) to cover it but if not, I have my FSA too.
SNIP

Hope you don't me for asking several questions.  What specific xrays did he request you have, what type of radiology facility and what is the charge?

thanks

[Debra]

Hope you don't me for asking several questions.  What specific xrays did he request you have, what type of radiology facility and what is the charge?

thanks

Panograph and Cephalometric (Lateral and PA) Xrays (2D Imaging). It seems they are dental xrays of some sort so that's why it's been difficult finding the right place. Still working on that.

[deeiche]

thanks

Panograph and Cephalometric (Lateral and PA) Xrays (2D Imaging). It seems they are dental xrays of some sort so that's why it's been difficult finding the right place. Still working on that.

[Debra]

Ok today I had a phone consult with Dr. Lee.

I have to say I liked him. He was straightforward and friendly.

He went over my pictures and negated some of the stuff some of the other doctors have said.

1. Dr. Marderossian had said that by doing a brow lift and forehead reconstruction....if he DIDNT do a scalp advance, it might actually make my forehead slightly bigger. Dr Lee said no, that was not the case.

2. Dr Mayer had said that if he feminized the bridge and radix of my nose and fixed the septum/crookedness of my nose, he'd also have to do a bunch of stuff on my nostrils because otherwise I'd end up with a 'pinched' nose look. Dr. lee didn't agree with that either.

He did however suggest a chin implant (or sliding geoplasty but he said most likely my chin is so recessed that there wasnt enough bone to work on....but xrays would tell for sure) and cheek implants.

I'm still saying no to the cheek and maybe slowly getting persuaded towards chin work. I realize I had a huge overbite as a kid and spent years in orthadontristry to fix it.....and definitely have a recessed chin (which has helped me greatly in transition/feminization) but of course I'm still worried about adding too much chin and/or making the recovery any tougher than it's already going to be.

I also asked about lip lift and he said that I could benefit from one as well.

Weirdly enough, I looked up Dr Lee on certificationmatters.org and he is not plastic surgery board certified OR ENT certified but instead he's part of the American Family Board of Medicine.

His website says he had a 1 year fellowship in Facial Plastic and Reconstructive Surgery at UCLA.

And these certs:

06/25/01 Diplomate, The American Board of Facial Plastic and Reconstructive Surgery
04/10/98 Diplomate , The American Board of Otolaryngology: Head and Neck Surgery
02/23/90 Diplomate, The American Board of Oral and Maxillofacial Surgery

Maybe he just hasnt kept up to date with them or something?

Anyway from the consult, he seemed like he knew what he was talking about.