Here's the scoop. I'll be having two FFS surgery dates, one in late August this year, and another in late 2019 or 2020. I've asked for certain cosmetic procedures to be done in addition to medically necessary work, to avoid leaving me looking sort of unfinished.
During the call Dr. Kleinberger went over what procedures would be in the August surgery, and which would be deferred to a surgery a year or two later. There is too much to do in one round. They want to avoid having me under general anesthesia for more than 8-9 hours. The surgeons get tired, too.
The first surgery will be the forehead and eye orbits work, removing the brow ridges (Osterhout Type 3) and reducing the orbital ridges. Eyebrows will be raised. The rhinoplasty will be done at the same time, as will the upper lip lift and fill. A blepharoplasty (cosmetic) will be done to fix my droopy right eye. Finally, a jawline and chin reduction will be done.
The second surgery will include the tracheal shave and a lower facelift, once the swelling from the jawline work is gone and the extra skin is loose. This should mitigate the saggy jowls common to jawline reduction in older trans women. I can get by for a while without the tracheal shave, as long as I don't turn my head too far or lift my chin. The 'wattle' of loose skin hides the Adams Apple fairly well when facing straight forward.
Putting a medically necessary procedure in along with the cosmetic work cuts the bill way down for me. The OR and anesthesia charges will be for the medically necessary procedures, so all I will have is the Kaiser standardized surgical price without all the expensive add-ins, for the cosmetic work.
