Well I have no idea where to postt this so here will do I think ive got the image thing right now
First I have to say I'm so glad I had Ukffs do these virtuals Alexandra is very experienced
and as you can read from her assessment pays attention to fine details
these virtuals just show the basic FFS procedures applied, as you can see no make up or skin procedures which I intend to have... the wig was superimposed on the image
For me it gives myself and the surgeon I work with something to work with as to be quite honest I could not visualise what an outcome could be and the idea of just going into surgery in mystery did not appeal to me
and it also gives me hope where I thought there was none as I've said before this would suit my frame I'll not be pretty or beautiful but I can have the handsome woman look which will suit my size
Alexandra was very patient with me... I had an extreme meltdown after my psychologists
Clumsy handling of me regards my masculine looks etc... so I was quite erratic
Needless to say my money was well spent and what I got in return far exceeded what I paid
Truly an invaluable service.
Here is the link to FFS UK site.
https://www.google.com.au/search?client=ms-android-oppo&ei=HQKuWeLYKsfK0gSo-pO4CA&q=virtual+ffs&oq=virtual+ffs&gs_l=mobile-gws-serp.1.0.0j0i22i30k1l2.28481.39658.0.44822.17.15.0.2.2.0.1007.5134.2-2j5j1j1j1j1.11.0....0...1.1j4.64.mobile-gws-serp..8.9.2293.1..41j46j0i67k1j0i131k1j0i46k1j0i10k1.gaOgHUYKPcI
Hello Mark.
Please remember that these virtuals are not and could not be 100% accurate but I hope they will give you a good idea of the possibilities and take you a long way towards planning how best to proceed.
Also remember that just like a surgeon, I am fallible and although I take quite an obsessive amount of care over virtuals, I will inevitably make a mistake every so often.
Working from photographs is not the same as seeing a person in real life. Camera lenses can affect the facial proportions to some extent and the lighting in a photograph can also affect how a face looks.
Facial surgery is not an exact science and while I can control the changes I make in Photoshop completely, a surgeon may not be able to control things with quite so much precision in real life.
The eye takes a little while to tune-in to facial changes so you may be disappointed at first glance. It is best to spend a few days getting used to the pictures before you make any decisions.
I have created 4 different versions of your pictures (a) to (d) adding extra procedures for each version. Here is a list of changes in each version:
(a) shows eyebrow plucking, brow bossing removal and rhinoplasty.
(b) includes lip lift, jaw narrowing and reduction, and chin narrowing and rounding.
(c) includes a face and neck lift.
(d) includes hormonal effects and beard removal.
I have also included an extra version of the 3/4 shot (e) with some hair and make-up added to help you visualise the possibilities. I managed to take the wig from one of the of the other pictures you sent me. I hope it gives you a clearer idea of the possibilities.
Hair:
Your hair has receded to the point that it is probably not going to be possible to regain a useful head of hair. There are some really good wigs available. Human hair is the best I believe and it is usually worth spending money on a good quality one. A more advanced wig option would be the "Cesare Ragazzi CNC Hair Prosthesis System". I have heard good things about it, but haven't seen it myself in real life. I suspect it is expensive and you have to visit one of their specialists every few weeks to have it reattached. Here is a video about it, but beware - this is clearly an advertisement so watch it sceptically and do your own research to confirm that the system is as good as they say.
There are some experiments going on at the moment into curing baldness and these may be an option in a few years time. Here are a couple of links:
http://www.nytimes.com/2012/07/29/business/baldness-battle-fought-in-the-follicle.html?_r=0http://news.bbc.co.uk/1/hi/health/7431092.stmForehead:
The forehead is by far the most important area in facial gender. The male forehead usually has a bony ridge running across it at about eyebrow level called brow bossing, It also tends to have vertical ridges either side of the forehead ("temporal ridges") and often has a bump on either side of the upper forehead ("frontal eminences"). The female forehead is smoother and flatter with less pronounced ridges and bumps, and it usually has either no bossing, or very little bossing.
In your case there is no strong ridge of bossing - it's more a case of your whole forehead being somewhat projected. This means that from the front you don't see a strong ridge, but from the side, you can see that your forehead stands well forwards of your eyes making them a little deep-set.
I have set the bossing area back and taken a little off the upper forehead to but because your bossing does not look strong, the effect looks fairly subtle. I have also opened out your orbits to give you a more open, feminine expression. This is done by removing a little bone from the underside of the orbital rim.
You also have frontal eminences. These can be smoothed down as part of the forehead feminisation and I have simulated the effect.
I generally recommend that people find a surgeon who can do a forehead reconstruction which sets the bone over the frontal sinus back. The other method, where the bone is only ground down, can be very limited as most people have quite thin bone here. According to one study, the thinnest part is, on average only between 2.6 and 2.9 mm thick. It is difficult to know how thick a patient's sinus wall is in advance, even if you take an xray.
One thing to keep in mind is that forehead surgery requires a long incision - usually from ear to ear over the top of the head. This scar would be visible if you were not wearing a wig or hat. Facial Team, who I collaborate with are able to put the incision round the back of the head where there is usually good hair to hide it under. It would still be visible if your head is shaved of course.
It is easy to get confused about forehead surgery and the various options, so I recommend that you have a read through my web page on the forehead:
http://www.virtualffs.co.uk/Forehead.htmlFrown Lines:
You have some vertical frown lines between your eyebrows. Reducing vertical lines is rejuvenating but it's also feminising because it softens your expression. I have simulated the effect. The lines may be reduced by the lifting of the forehead soft tissues during forehead surgery, and can be further reduced temporarily with botox. For a more permanent botox effect you can have the surgeon work on the underlying muscles during a brow lift or forehead feminisation surgery. However, like botox, this does reduce the lines but may also limit movement of the muscles to some degree.
Eyebrow height:
Your eyebrows sit in medium position. They will lift a little with forehead surgery and I have simulated the effect. The lift that comes with brow bossing removal tends to be reasonably subtle, but it does help to emphasise a more open, feminine expression.
Eyebrow shape:
Women tend to have thinner eyebrows than men. Yours are a little thick so I have plucked them, mostly along the underside to give them a thinner and more feminine shape. This also increases the distance between your eyes and eyebrows and that has a feminising effect. The natural underlying shape of your eyebrows is really good.
Eyes:
I don't see any problems with your eyes or the soft tissues around them. You have large eyes in proportion to your face - this is feminine and a good asset.
Nose profile view:
From the side, your nose is somewhat large and the bridge of your nose is humped. The hump is not technically a masculinity, but removing it to give the bridge a straight profile will have a feminising effect. I have lowered the bridge to reduce the size and remove the hump. Removing the hump will also cause the tip to lift a little as I have simulated. This also has a feminising effect.
Nose frontal view:
From the front your nose is already good. You should see a slight narrowing of the upper bridge and a slight lift to the tip in the simulation.
Nostrils:
The width and height of your nostrils is fine. You do not need to make any adjustments.
Cheek bones:
I don't see any problems with your cheekbones, and I don't recommend any changes.
Apple of the cheeks:
The apple of your cheeks (the soft part) would become fuller and rounder on hormones and I have simulated this for you. It is impossible to predict exactly how the hormones will affect you (everyone's different) but I've given you an idea of the kind of change you can expect.
Naso-labial folds:
These are the creases that come down from the corners of your nose and they tend to get a little deeper as we age. They are gender-neutral and have no masculinising effect.
Yours are completely normal and you don't need to worry about them. I only mention them because some surgeons recommend filling them, even in cases where they are not at all deep or are barely visible. All that would do is make your surgery more expensive.
Upper lip to nose distance:
The distance between the top lip and the nose tends to be shorter in women, and they also tend to show some of their upper teeth when their mouth is open and relaxed.
Your lip to nose distance is long and you don't show any upper teeth when your mouth is open. I have given you a lip lift to correct this. This procedure is both feminising and rejuvenating but it does leave a small scar at the base of the nose.
Lip fullness:
Your lips are quite thin. You could fill them a little if you wanted to for a mildly feminising effect but it would probably be best to see how the lip lift looks before you make any additional adjustments. I have not tried to simulate lip filling on top of the lip lift.
I recommend non-permanent fillers at first so that you can see the effect. If you like it, you could consider a fat transfer which can become permanent after a few sessions. I also recommend that you take a fairly subtle approach because over filled lips do not look good.
Chin height and shape:
I think the height of your chin is about right but the shape is wide and square. I have shaved off the corners to give it a narrower and more rounded and feminine shape.
Chin projection:
Your chin projection is good so you do not need to move it forwards or backwards.
Chin soft tissues:
Some people have very thin soft tissue on the chin. This means that the chin bone shows through well and so will any changes you make to the bone. Other people have very thick soft tissues on the chin. This means that the chin bone is hidden under a thick blanket of tissue and that can make it more difficult to see any changes to the bone structure. It is not possible for me to know how thick the soft tissues are from your pictures so I have adjusted your pictures on the assumption that the thickness is average. Just keep in mind that it is possible that the result would be more limited in real life if your soft tissues are thick.
Jaw:
Your jaw area is a little difficult to analyse. It looks like your jaw is wide and heavy. However you appear to be extremely muscular and that makes it likely that your chewing muscles are large. This can add a lot of width to the jaw. It is also possible that your soft tissues are quite think here. If the soft tissue is thick, it can make it difficult to see ay changes to the underlying bone.
The technique used to narrow the rear of your jaw would depend on whether the width is due to bone or muscle or both. If it is muscle then botox is a good and non-invasive way of reducing it. This is much safer, much cheaper and much less painful than trying to reduce the muscle surgically. If the width is due to bone then you would need surgery to reduce it. If the width is due to both muscle and bone, then you might need a combination of both. However, the chewing muscles will reduce on their own if some of the bone is reduced.
Estrogen reduces muscle mass all over the body so if you have large chewing muscles, you may see a notable reduction in the size of your chewing muscles. Wait at least a year on a full dose of estrogen to see the effect.
I have narrowed and reduced your jaw but because of the uncertain elements, there is some guesswork involved. You may find that in real life the reduction is greater once all the effects of hormones, bone reduction and lifting come together.
Chin and jaw surgery incisions:
Some surgeons work on the jaw and chin by making external incisions. This is completely unnecessary and leaves very visible scars. The best place to make the incisions is inside the mouth - this means that the scars will be invisible.
Adam's apple:
You have a visible adam's apple and I have simulated a tracheal shave to reduce it for you.
There are two ways of approaching the adam's apple when you do a tracheal shave. The old-fashioned method involves putting the incision right on the adam's apple. There are 2 problems with this - firstly it leaves the scar in a very noticeable position, and secondly. you can get adhesions where the scar tissue sticks to the adam's apple. That means that the skin can be tugged in an unnatural way when your adam's apple moves, such as when you are talking or singing.
The more modern method involves putting the incision under the chin and then tunnelling down towards the adam's apple. This means that the scar is in a much less noticeable place, and you avoid the adhesion problem. I strongly recommend that you find a surgeon who uses the under-chin approach.
However, there is a chance that what looks like an adam's apple in the pictures, might only be loose soft tissue.
Hormones:
I have simulated hormonal effects for you - mainly narrowing the jaw a little and filling the cheeks but they also soften and feminise the skin texture.
Simulating the skin softening is difficult and there is a lot of guesswork involved but I have made a cautious simulation on the effect for you.
These changes can be very powerful, especially when combined with beard removal.
Face lift:
I have given you a lower face and neck lift. This procedure is more about rejuvenation than feminisation but having said that, younger faces do tend to look more feminine than older ones for various reasons. There are various benefits like tightening up the cheeks, giving a nice definition to your jaw line, reducing the naso-labial folds and tightening up the soft tissues of the neck.
It is very important to have any lifting done after jaw/chin surgery and not before or during. This is because jaw and chin surgery cause a lot of swelling and this works against the lifting. It is also impossible to know in advance how much swelling you will experience or how well your soft tissues will re-adapt to the new bone and that means it is not possible to know exactly how much to lift. It is best to wait a few months for the swelling to go down, and then you can see clearly exactly what needs to be done with the soft tissues. Some surgeons will offer to do both jaw/chin surgery and lifting at the same time. I advise against it.
Beard:
I have reduced your beard shadow for you. Beard removal can be achieved with electrolysis and/or laser. People have mixed results with laser but there are many different types. Laser does not work on grey, white or very light hairs. Electrolysis is also an option either for a complete beard, or just for the pale hairs that are left after laser. As far as I know, "galvanic" electrolysis is less likely to cause scarring.
Priorities:
Your facial structure is not strongly masculine. What gives you a masculine look is more to do with the shaved head, beard shadow and heavy musculature. That's why you look so good in the make-over pictures. I think the forehead, nose upper lip, jaw and chin changes are all useful feminisation for you. But of course, it is just as important to focus on the secondary changes - hormonal effects, beard removal, eyebrow plucking, wig etc.
A good way to view your pictures is to use photo viewing software like Windows Photo Viewer. This will allow you to jump from the before to the after/s and back again by using the arrow buttons on your keyboard. However, you might have to rename the pictures if you want them to flow in a different order.
If you have "Photoshop" or "Photoshop Elements" you can load up a before and after picture at the same time and then by holding down "Ctrl" and pressing "F6" you can flick between the two. This often works for other photo software too.
I have improved the photographic qualities of your pictures (contrast, focus, colour balance etc.) so I am sending you copies of the before shots with the same improvements to make them easier to compare with the after shots.
The pictures are yours so feel free to share them and the assessment with any support groups you are member of if you want some second opinions. Do take prints to your consultations with surgeons or email them in advance - most surgeons welcome them.
Please email me to confirm that the pictures have arrived. If you have any questions about your pictures and your assessment please feel free to email me.
Let me know if you want any surgeon recommendations.
You can find out more about facial gender and FFS by reading through my website.
Please note that I regularly collaborate with Dr Simon and Dr Capitán of Facial Team. Some of the procedures I simulate are based on my discussions of surgical technique with them and on watching them operate. However, not all surgeons take the same approach, and not all surgeons have the level of skill required for all the changes I simulate.
The changes described in this assessment and illustrated in the pictures represent my opinion as an artist. You and/or your surgeon/s may disagree with my opinions. I cannot guarantee that my opinion is good or that the pictures are accurate so if you act according to my opinion, you do so at your own risk.
Thank you very much for entrusting me with your virtual FFS - I very much hope the pictures are helpful.
If you are pleased with my service, please consider writing a short testimonial for me that I could put on my website. It could be a single line or several lines. You can be completely anonymous if you prefer, or just use an initial. A location is useful but it doesn't have to be any more specific than listing what country you are from. It's entirely up to you though so please do not feel any obligation to write one or even to give a reason for not writing one.
Good luck and best wishes,
Alexandra.
