looks like Dr. Spiegel is now offering glottoplasty

[kwala]

Just nosing around on the net today, I noticed that Dr. Spiegel outlines his glottoplasty surgery and has an excellent youtube example from a patient posted on his website. M.drspiegel.com (click the FFS tab and select voice surgery)

Seems he uses dissolvable stitches like Dr. Haben instead of the permanent ones Dr. Kim employs and advises 2 weeks complete voice rest. 

I've already had my surgery with Dr. Haben but thought I would put this out there so others can see.  It looks like we may have two options in the states for a glottoplasty procedure and hopefully more examples will follow.

[iKate]

Any results examples?

[Myca]

Spiegel example: here's one uploaded recently:

www.youtube.com/watch?v=cA_AN7o45t4

I can't get over how crystal clear her voice sounds after only one month post-surgery.  Very impressive result.

Apparently this is offered along with his FFS procedure.

That this is catching on in the TG medical field is not surprising now that a methodology that actually works (finally!) has been established.  It will no doubt be offered by other doctors in the near future.  I do fear that we may have doctors who are not qualified otolaryngologists jumping into this, as some of us will have larynx issues that may not be easily handled.

(My first post here, will post again and introduce myself sometime soon.  Am 5.5 weeks post-op from Haben.  Still healing, not anywhere that clear as in that Spiegel example, but I have my own pre-surgery situational reasons for a slow(er) recovery.)

[Dena]

The original voice was pretty high for a male voice so the surgery didn't need all that could be done such as CTA. I is possible that therapy could have moved the voice enough to be passible and the original voice had enough inflection in it that vocal training post surgical wasn't needed to make the voice sound feminine.

[kwala]

Spiegel example: here's one uploaded recently:

www.youtube.com/watch?v=cA_AN7o45t4

I can't get over how crystal clear her voice sounds after only one month post-surgery.  Very impressive result.

Apparently this is offered along with his FFS procedure.

That this is catching on in the TG medical field is not surprising now that a methodology that actually works (finally!) has been established.  It will no doubt be offered by other doctors in the near future.  I do fear that we may have doctors who are not qualified otolaryngologists jumping into this, as some of us will have larynx issues that may not be easily handled.

(My first post here, will post again and introduce myself sometime soon.  Am 5.5 weeks post-op from Haben.  Still healing, not anywhere that clear as in that Spiegel example, but I have my own pre-surgery situational reasons for a slow(er) recovery.)

Nice to meet you, Myca.  I'm about 1 week ahead of you out of surgery and if you've read my posts you know that my recovery has also been on the slow side.  Here's to hoping we both recover well and are happy with our outcomes. 

[Lyndsey]

Hi All

This is a very ugly subject with me as I tried doing this two times with Dr Haben and i'm not happy at all and now I have a very close range For high and lows. From my experience you are rolling the dice. It is not horrible but it is not good bye any means.

Lyndsey

[iKate]

Hi All

This is a very ugly subject with me as I tried doing this two times with Dr Haben and i'm not happy at all and now I have a very close range For high and lows. From my experience you are rolling the dice. It is not horrible but it is not good bye any means.

Lyndsey

That's true. Every surgery has risks. I went to Dr Kim in Seoul, South Korea and I have a very feminine, passable voice now. But some have been frustrated. Some have seen no change. Some still get "sir" after months. It is a hit or miss. There is also the issue of resonance which isn't fixed by glottoplasty.

[Lyndsey]

No it is not
I have that but not the pitch. All it did for me was make my kids happy 2 time for about a week and a half each time because I couldn't yell at them. LOL

Lyndsey

[Myca]

Nice to meet you, Myca.  I'm about 1 week ahead of you out of surgery and if you've read my posts you know that my recovery has also been on the slow side.  Here's to hoping we both recover well and are happy with our outcomes.

Hi kwala,

Nice to meet you too.  I had my vfs a week after you, and I'd been quietly lurking here for a while, so I am aware of your slow recovery.  I am very glad to hear that there are now signs of recovery for you.  It is frustrating, isn't it?  I can speak now but it's still weak and unclear (i.e., that laryngitis voice).

I will post a thread of mine soon.  I was intending to do this earlier, but I learned from my pre-op consult the day before surgery that I had an extremely compromised situation in my larynx, so much so that it wasn't clear what Dr. Haben could do for me before he went in.  I decided to wait until I had an idea if I would have an outcome that I would want to comment upon or not.  I think I may have reason now to post soon.

Of course, thanks to all the earlier posters.

Best,

Myca

[jollyjoy]

That is a great result from Dr. Spiegel, sounds amazing actually, but isn't he known only for FFS and not for VFS? I would not feel comfortable going to a surgeon that's just starting to do VFS based on one great result online.

[anjaq]

Thats a pretty amazing result indeed! Its almost unbelievable that this is a 4 weeks post op recording. I still would like to hear more reports and recordings before I would call him to be a good VFS surgeon. After all he is mostly a plastic surgeon who did facial reconstructions and feminizations before, right? doing surgery in the larynx is a new topic... not sure if this really is that good. but one cannot deny that the recording is pretty neat - she has full female resonance as well, when most others at week 4 have still a weak resonance and hoarseness...

[anjaq]

One thing I just noticed: They are comparing the voice 3 months BEFORE TRANSITION to the one one month after surgery. So there is no timeframe given. I would assume that between the initial recording and the second recording not only voice surgery did happen but also voice therapy and training. I noticed this because the inflections and resonance in the second sample are much different, which adds a lot to the femininity of the voice in the second sample.

This is a bit like what some people do for FFS - use a male pre OP picture with short hair and all - sometimes pre-hormones and then compare it to a post-FFS picture (which also includes transitioning, hormones, maybe even makeup)...

I usually would always prefer comparisons directly before surgery to after surgery...


Regarding Dr Spiegel - on his website he says he is doing VFS since 1995, which is quite a long time.

[kwala]

One thing I just noticed: They are comparing the voice 3 months BEFORE TRANSITION to the one one month after surgery. So there is no timeframe given. I would assume that between the initial recording and the second recording not only voice surgery did happen but also voice therapy and training. I noticed this because the inflections and resonance in the second sample are much different, which adds a lot to the femininity of the voice in the second sample.

This is a bit like what some people do for FFS - use a male pre OP picture with short hair and all - sometimes pre-hormones and then compare it to a post-FFS picture (which also includes transitioning, hormones, maybe even makeup)...

I usually would always prefer comparisons directly before surgery to after surgery...


Regarding Dr Spiegel - on his website he says he is doing VFS since 1995, which is quite a long time.

Yes, the example is great, but I agree with Anja and Jolly that personally I wouldn't be ready to commit before getting more information and hearing more examples.  I read that bit about him doing the surgery since 1995, but it certainly raises a lot of questions.  If he has been doing this surgery for 20 years why so few examples?   All that being said, this is just me offering caution to anyone who is looking into surgery.  It may very well be that he is proficient in this technique and will continue to bring success to many patients. 

[Lagertha]

Well, glottoplasty has been around and used regularly since the early 90s. So its not exactly something new... I wouldnt be surprised if he started doing it in mid 90s. I personally wouldnt go to a plastic surgeon who does it. I would go to ENT doctor who is specialized in phonosurgery who has been doing this surgery for years...

I found it really funny that people think that there's really just two surgeons in the world who do this. Or that people are willing to fly to Korea from US to have this done, while there are probably at least ten phonosurgical specialists in New York area alone who do it on a regular basis.

More and more are starting to smell easy money trans women are prepared to pay, and more and more are starting to advertise it as "voice feminization surgery" , and charge three times more for it.

[Myca]

Well, glottoplasty has been around and used regularly since the early 90s. So its not exactly something new... I wouldnt be surprised if he started doing it in mid 90s. I personally wouldnt go to a plastic surgeon who does it. I would go to ENT doctor who is specialized in phonosurgery who has been doing this surgery for years...

I found it really funny that people think that there's really just two surgeons in the world who do this. Or that people are willing to fly to Korea from US to have this done, while there are probably at least ten phonosurgical specialists in New York area alone who do it on a regular basis.

More and more are starting to smell easy money trans women are prepared to pay, and more and more are starting to advertise it as "voice feminization surgery" , and charge three times more for it.

I do recall in the mid to late 90s that CTA was pretty much the only thing offered to the TG/TS community at the time for surgical voice modification.  Very much hit or miss back then.  I'm guessing that Spiegel may have been offering that if he was treating TGs back then.

I can recall after that there was the LAVA procedure to thin the cords with laser, a few years after the heyday of CTA.  That also seemed to be not so reliable.

That the Wendler glottoplasty has been around for a few decades is not the point; it has only recently been considered for widespread use in the TG population (less than the last 10 years).  If you follow the research papers (Remacle has a lot of them), this is relatively new for us as a viable option.

I agree that a lot of current phonosurgery specialists (who may have been treating androphonia for cis-women among other things) will now make this jump to offer their services to the TG clientele.  That would be a good thing, I would think.

[kwala]

Well, glottoplasty has been around and used regularly since the early 90s. So its not exactly something new... I wouldnt be surprised if he started doing it in mid 90s. I personally wouldnt go to a plastic surgeon who does it. I would go to ENT doctor who is specialized in phonosurgery who has been doing this surgery for years...

I found it really funny that people think that there's really just two surgeons in the world who do this. Or that people are willing to fly to Korea from US to have this done, while there are probably at least ten phonosurgical specialists in New York area alone who do it on a regular basis.

More and more are starting to smell easy money trans women are prepared to pay, and more and more are starting to advertise it as "voice feminization surgery" , and charge three times more for it.

While there may be some truth to this, it's my understanding that other glottoplasty surgeries, at least in the US, have been done to correct asymmetry, damage, cord paralysis, and androphonia in cis-women as Myca mentioned- but not specifically for pitch gain in trans-women.   As such, for most conditions they suture the bare minimum and attempt to keep the natural state of the voice as much as possible.  Many ENT'S  may consider doing it for the trans community more of an elective surgery.  Of course, this would vary from practice to practice.  While there are certainly some other ENT's with the know-how, I still don't think you could just call any one of them up and request an exam and a surgery date.  It's worth a try if it is a name you trust and can save you money, but I don't know anyone who has gone this route.  For now, I'd prefer to go to a doctor who has the same post-op goals that I do and has performed the surgery on others who share that goal.

[Lagertha]

That the Wendler glottoplasty has been around for a few decades is not the point; it has only recently been considered for widespread use in the TG population (less than the last 10 years).  If you follow the research papers (Remacle has a lot of them), this is relatively new for us as a viable option.

Widespread use is because one surgeon and his office decided to advertise themselves online and use youtube to their advantage. If not for them 99% of trans women probably wouldnt know about this "voice feminization surgery" for another decade, or until someone else would decide to advertise it and put information out there.

You could say the same for facial feminization and forehead reconstruction. Nobody used type3 reconstruction, as a miracle surgical procedure it is today, until dr. Ousterhout got brilliant idea, and started doing it. It doesnt mean that same technique wasnt available for trans patients before for 50 or *** knows how many years. Only a really smart patient would go in medical school library and read through some books on facial surgery, and start asking around where to find a craniofacial surgeon.
I know about one transwoman who had glottoplasty done in 1996, with a local ENT phonosurgeon. How did she know? She was smart and she went to local ENT clinic, and asked if she could have consultation with a doctor who does phonosurgery. So it was very available for trans women 20 years ago, but it was only available for smart patients.   

Glottoplasty as procedure for treating cissexual population isnt any different than glottoplasty for transsexual population. Every decent phonosurgical specialist who does it understands in what way it can be used for pitch increase. Its not that complicated procedure. Its very delicate, but ist very straight forward and simple procedure, with very low risk and very predictable results/outcome. Complications are almost always related to pre-existing conditions, and can be predicted and expected. 

[iKate]

No it is not

What is not?

I have that but not the pitch. All it did for me was make my kids happy 2 time for about a week and a half each time because I couldn't yell at them. LOL

Most of the "bad" results I've heard are due to resonance issues. Their Fo as measured in Praat and other software is well within the female range yet their voice still sounds masculine.

I've noticed that older patients also have a harder time with voice surgery. Could be many things accounting for it.

In the end even with surgery a voice needs work to sound good.

[iKate]

One thing I just noticed: They are comparing the voice 3 months BEFORE TRANSITION to the one one month after surgery. So there is no timeframe given. I would assume that between the initial recording and the second recording not only voice surgery did happen but also voice therapy and training. I noticed this because the inflections and resonance in the second sample are much different, which adds a lot to the femininity of the voice in the second sample.

Could be. That definitely sounds like a trained voice, meaning it sounds too "perfect" to be just an off the cuff sample of normal talking. The spacing between words and sentences sounds deliberate and is something a speech-language pathologist would tell you to do.

That's not to say the surgery result isn't amazing. It is! Pitch is really good, resonance is really good too.

[iKate]

I found it really funny that people think that there's really just two surgeons in the world who do this. Or that people are willing to fly to Korea from US to have this done, while there are probably at least ten phonosurgical specialists in New York area alone who do it on a regular basis.

As with SRS, there is a reason you go to a particular surgeon, otherwise Brassard and Suporn wouldn't be so popular. The basic surgery is the same but the difference in result is different.

Also I know one woman who had a glottoplasty in New York (at a plastic surgeon on Park Ave) and she lost her voice. That's not to say it won't be possible. I don't trust many of them as far as I can throw them.