FFS with Facial Team ARE THEY GOOD???

[anjaq]

Well, too late then, I did the VFFS with Alexandra AT the Facialteam consultation...

So far all the consultations more or less matched. Some recommended more, some less, almost always it was said my face is already mostly female and I should not have problems with "passing" as it is, so all surgeries are optional. The on presisng most for surgeries was Dr di Maggio, saying there would be significant improvements to be made. The one most conservative was PAI, who only wanted to shave a bit of the chin and orbitals. Facialteam and Dr Bart were in the middle - saying I can benefit from the "big five" but it is more subtle because not much has to be changed. Biggest change would be forehead and hairline. None of them took a 3D scan of the bones though, Facialteam and Dr Bart had the advantage of "touching" and thus at least feeling where the bones are.

So far, I liked Facialtema the best, but the VFFS they did with Alexandra did not give me a satisfying chin - so I am not sure if what I want is possible for them (or at all). I was also told they are not so great at rhinoplasty. Maybe I should reconsider di Maggio, although I know he does usually a hairline incision and hairline lowering, which I do not favour so much, because of the visible scare and the frequent complication of loss of sensitivity in the hairline region and behind that line. I am also not sure if he really would do more visible , but still natural looking modifications than Facialteam. I jusge Facialteam to be a bit more conservative, maybe rather doing too little than too much in an effort to always give natural results. I have seen some photos where I do literelly see no change in some parts of the face that they have worked on, which puzzles me a bit - usually this is with patients who already were feminine before. So I wonder if that was worth it then for those patients - very very subtle changes . But with other surgeons I sometimes see that drastic changes are possible but can look "odd" or "done", so that is the opposite fear I would have.

[V]

Well Spain is not THAT far from Germany - still, its probably about 250 EU for the flight plus 100 for hotel. I know, peanuts compared to the FFS costs, but not sure it makes sense or gives any real benefit when most decide without CT scan and all that. I have been undecisive about FFS for almost 4 years now and bugging people about it, asking uncomfortable questions, so I am not sure I want to stretch this further and towards the professionals. Its up to me now, I need to decide what I want and then if I do that, I can book this and the details of it can probably be discussed at that point then...
My measurements are much larger - lol - its 88cm underbust, about 80 waist and 106 at the hips. So while I have wide shoulders, the hips are also not slim. If I hold a thread to the shoulders, it touches my hips almost exactly, I was told this means it is a hourglass shape, except I should get a bit better waistline to make it shapely, sadly the large ribcage prevents this and I am not going for rib removal surgery...

I was lucky in that I used a budget airline (Monarch) to fly to Malaga. It cost me £100 total.
It seems you have seen many different FFS surgeons!
I can appreciate it taking you years of research.
I certainly couldn't decide upon FFS without getting scans and meeting face-to-face. I don't 'do' Skype and suchlike.
But as I said earlier, you need to do whatever you have to, to make the best decision you can for yourself. Even if you eventually decide to not have FFS, that too is a valid decision.

You might have bigger measurements, but they are still in a decent proportion to each other to give you a feminine figure. Especially your hips.
I am borderline underweight, so I daren't lose any more weight. But regardless of that, I can't do much about the shape of my skeleton. My ribcage doesn't help me either, as it isn't tapered downwards, but is quite 'straight'. So it ends abruptly and then my waist goes in abruptly too. It doesn't look great as there are no flowing curves from torso to waist to hips, rather 'jumps' from one to the next. Naked I don't look great, but with the right clothes it looks acceptable and not very masculine. I didn't know there was such a thing as rib removal surgery? Does that give you a better waist?

Well, too late then, I did the VFFS with Alexandra AT the Facialteam consultation...

So far all the consultations more or less matched. Some recommended more, some less, almost always it was said my face is already mostly female and I should not have problems with "passing" as it is, so all surgeries are optional. The on presisng most for surgeries was Dr di Maggio, saying there would be significant improvements to be made. The one most conservative was PAI, who only wanted to shave a bit of the chin and orbitals. Facialteam and Dr Bart were in the middle - saying I can benefit from the "big five" but it is more subtle because not much has to be changed. Biggest change would be forehead and hairline. None of them took a 3D scan of the bones though, Facialteam and Dr Bart had the advantage of "touching" and thus at least feeling where the bones are.

So far, I liked Facialtema the best, but the VFFS they did with Alexandra did not give me a satisfying chin - so I am not sure if what I want is possible for them (or at all). I was also told they are not so great at rhinoplasty. Maybe I should reconsider di Maggio, although I know he does usually a hairline incision and hairline lowering, which I do not favour so much, because of the visible scare and the frequent complication of loss of sensitivity in the hairline region and behind that line. I am also not sure if he really would do more visible , but still natural looking modifications than Facialteam. I jusge Facialteam to be a bit more conservative, maybe rather doing too little than too much in an effort to always give natural results. I have seen some photos where I do literelly see no change in some parts of the face that they have worked on, which puzzles me a bit - usually this is with patients who already were feminine before. So I wonder if that was worth it then for those patients - very very subtle changes . But with other surgeons I sometimes see that drastic changes are possible but can look "odd" or "done", so that is the opposite fear I would have.

I guess it's good that most of the surgeons you saw came to a broad agreement about what might help you.
I'd be wary about anyone who was suggesting a lot of surgery, if you already pass well, and think your face is generally feminine already.
Facial Team used the 'touching' technique on me as well. I found it strangely reassuring. I am definitely after very subtle changes only, I don't want to draw attention to myself, or make it obvious that something significant has changed. I went into the whole FFS thing, thinking that I only wanted forehead, hairline and tracheal shave, and that's exactly what FT suggested. Just to 'test' them, I suggested some jaw work, and they were quite adamant I didn't need it, which I thought reflected well on them.
I guess the 'big five' are forehead, orbitals, nose, chin and jaw?
I am sure that there are some very subtle changes that could be made to my nose, chin and jaw, but I also know that they would be so subtle as to raise the question is it worth it? To me, the cost, discomfort and risk of extra (possibly 'unnecessary') surgeries are not worth the slight improvement they may bring. As long as there aren't enough 'big pointers' in my face towards masculine traits, I can live with the small subtle ones that may be present, because the overall impression of the whole package will be feminine enough.

I am very lucky that I don't 'need' any rhinoplasty, because of all the plastic surgery 'changes' that I see women doing (both cis and trans) it's the nose, and lips, that can look the most unnatural, to me. Out of all the changes I could make to my face, I'd be the most afraid to change the nose and lips.
I too, do not want any hairline scar, as the results I've seen seem to take a long time to heal, and it's really very difficult to hide, at least initially, that you've had that kind of surgery. For someone living 'in stealth', it's way to much of a risk. And I worry that the scar may never be fully hidden, and I'd go from trying to hide a male-pattern hairline, to trying to hide a hairline scar instead. Just exchanging one problem for another, and that's not appealing to me.

As I said, I am after subtle changes only, nothing drastic, because apart from drawing attention to yourself and saying "look! I've had surgery on my face", there is always the risk that too many large changes are made which can take upwards of 2 years to fully heal, and can result in an 'over done' look, as you say. In my mind, "too subtle" is a better bad result than "too drastic". But we are all different, and have different ideas, and the above are just my own views.
What I got back from Alex looks good, and is just the subtle changes that FT suggested in the first place. If anything, the virtual FFS possibly shows too large a change, and I think the actual result, especially in the hairline area, will be more subtle, and that isn't a bad thing in my eyes.

Spotting subtle changes in 'before and after' photos can be difficult if the two sets of photos are not taken in very similar lighting and positions.

[anjaq]

I was lucky in that I used a budget airline (Monarch) to fly to Malaga. It cost me £100 total.
...
But as I said earlier, you need to do whatever you have to, to make the best decision you can for yourself. Even if you eventually decide to not have FFS, that too is a valid decision.

That sounds like a reasonable expense.

Well, I really wanted to consider not getting anything done, but I cannot get it out of my head for good and I know it will keep popping up until I do something

You might have bigger measurements, but they are still in a decent proportion to each other to give you a feminine figure. Especially your hips.
I am borderline underweight, so I daren't lose any more weight. But regardless of that, I can't do much about the shape of my skeleton. My ribcage doesn't help me either, as it isn't tapered downwards, but is quite 'straight'. So it ends abruptly and then my waist goes in abruptly too. It doesn't look great as there are no flowing curves from torso to waist to hips, rather 'jumps' from one to the next. Naked I don't look great, but with the right clothes it looks acceptable and not very masculine. I didn't know there was such a thing as rib removal surgery? Does that give you a better waist?

Yes, I like my hips, actually. The liposuction surgeon even wanted to remove some fat there because she thought they are big enough already. - in early transition when I was not even out to everyone I was told I have hips that would make it good to have children - lol. I was blushing about this.
Yes sadly my ribcage is quite flaring, too. There is a break between ribs and waist. I would love to have a tapered shape but its not really possible, maybe with a corset or something like that. Or rib surgery, which however is very invasive - there are some myths and stories about this going around in the trans community. apparently no doctors in the US or Europe will usually do this without a medical reason, but Mexico and other places have it. Leaves scars though and is very painful....

I guess it's good that most of the surgeons you saw came to a broad agreement about what might help you.
I'd be wary about anyone who was suggesting a lot of surgery, if you already pass well, and think your face is generally feminine already.

Well - so and so.
The downside is, the "consensus" was that my face is quite female already, but can be made more feminine with surgeries, but sind I have no one big thing that sticks out, these surgeries would have to be  several. A bit change on the forehead, some change to the nose, some modification of the chin, some hairline tranplants,... nothing big in each case but overall there should be change. So in a way it is "a lot of surgeries" (number of surgery sites) but not "a lot of surgery" (amount of change that has to be done) ... which means it is painful, expensive , but only gives subtle changes

I went into the whole FFS thing, thinking that I only wanted forehead, hairline and tracheal shave, and that's exactly what FT suggested. Just to 'test' them, I suggested some jaw work, and they were quite adamant I didn't need it, which I thought reflected well on them.
I guess the 'big five' are forehead, orbitals, nose, chin and jaw?

Yes, I call them big five because almost everyone can profit from them to some degree

I think the surgeons so far all downplayed my issue with the chin or jaw. Maybe it is because there cannot be changed much to it or maybe the changes needed are not their expertise - I do think my chin sticks out - I have a wide jaw and cheeks - slightly asian influence apparently, my grandfather had "slit eyes" - but a narrow real tooth distance. I think especially if I wear shoals or hav emy hair open and hanging to the sides of the face, the chin/lower jaw looks too big. But FFS surgeons so far only said to shave off a little, Facialteam suggested it is optional and not really worth it, probably. So in that sense I am a bit unsure.

I am very lucky that I don't 'need' any rhinoplasty, because of all the plastic surgery 'changes' that I see women doing (both cis and trans) it's the nose, and lips, that can look the most unnatural, to me. Out of all the changes I could make to my face, I'd be the most afraid to change the nose and lips.

I guess my wishes would be to straighten the nose a bit and remove the little bumb on top and maybe do a lip lift. But no bigger changes like reducing the size of the nose massivley or injecting the lips with a lot of stuff. But without removing the bump on the nose, a new forehead would look only half as good, according to the VFFS simulation.

And I worry that the scar may never be fully hidden, and I'd go from trying to hide a male-pattern hairline, to trying to hide a hairline scar instead. Just exchanging one problem for another, and that's not appealing to me.

Yes, I have heard this from some who had FFS - the scar is no problem because they wear bangs or hairstyles that cover them anyways - d'uh that is not the point for me getting FFS - The goal would be to also be able to pull the hair back in a ponytail for sports or work and still not get problems. I can wear bangs now and have no problem, if I want that, I can just leave it as it is.

What I got back from Alex looks good, and is just the subtle changes that FT suggested in the first place. If anything, the virtual FFS possibly shows too large a change, and I think the actual result, especially in the hairline area, will be more subtle, and that isn't a bad thing in my eyes.

Oh - you thoink so? Some said the real changes of FFS were actually more visible to them and more beautiful than the simulation. The simulation was a bit of a letdown for me because the changes are so subtle that in the case of chin and jaw I do not even see them without switching back and forth. The forehead change and most noteable the hairline change are more pronounced, but if I show the before and after simulation photos to someone else, they will always say "but that is the same photo!"... So it is subtle alright - if in reality it is more subtle, then its bordering on "not worth the effort". Maybe I should consider di Maggio as a second choice again, he was rather positive to be able to make my face clearly more feminine and 100% female looking and was not so much emphasizing the subtlety of the changes... I would not want to get this surgery and then only get 50% improvement and still have a remaining percentage of my face looking masculine.

[V]

That sounds like a reasonable expense.

Well, I really wanted to consider not getting anything done, but I cannot get it out of my head for good and I know it will keep popping up until I do something
Yes, I like my hips, actually. The liposuction surgeon even wanted to remove some fat there because she thought they are big enough already. - in early transition when I was not even out to everyone I was told I have hips that would make it good to have children - lol. I was blushing about this.
Yes sadly my ribcage is quite flaring, too. There is a break between ribs and waist. I would love to have a tapered shape but its not really possible, maybe with a corset or something like that. Or rib surgery, which however is very invasive - there are some myths and stories about this going around in the trans community. apparently no doctors in the US or Europe will usually do this without a medical reason, but Mexico and other places have it. Leaves scars though and is very painful....
Well - so and so.
The downside is, the "consensus" was that my face is quite female already, but can be made more feminine with surgeries, but sind I have no one big thing that sticks out, these surgeries would have to be  several. A bit change on the forehead, some change to the nose, some modification of the chin, some hairline tranplants,... nothing big in each case but overall there should be change. So in a way it is "a lot of surgeries" (number of surgery sites) but not "a lot of surgery" (amount of change that has to be done) ... which means it is painful, expensive , but only gives subtle changes

Yes, I call them big five because almost everyone can profit from them to some degree

I think the surgeons so far all downplayed my issue with the chin or jaw. Maybe it is because there cannot be changed much to it or maybe the changes needed are not their expertise - I do think my chin sticks out - I have a wide jaw and cheeks - slightly asian influence apparently, my grandfather had "slit eyes" - but a narrow real tooth distance. I think especially if I wear shoals or hav emy hair open and hanging to the sides of the face, the chin/lower jaw looks too big. But FFS surgeons so far only said to shave off a little, Facialteam suggested it is optional and not really worth it, probably. So in that sense I am a bit unsure.
I guess my wishes would be to straighten the nose a bit and remove the little bumb on top and maybe do a lip lift. But no bigger changes like reducing the size of the nose massivley or injecting the lips with a lot of stuff. But without removing the bump on the nose, a new forehead would look only half as good, according to the VFFS simulation.
Yes, I have heard this from some who had FFS - the scar is no problem because they wear bangs or hairstyles that cover them anyways - d'uh that is not the point for me getting FFS - The goal would be to also be able to pull the hair back in a ponytail for sports or work and still not get problems. I can wear bangs now and have no problem, if I want that, I can just leave it as it is.
Oh - you thoink so? Some said the real changes of FFS were actually more visible to them and more beautiful than the simulation. The simulation was a bit of a letdown for me because the changes are so subtle that in the case of chin and jaw I do not even see them without switching back and forth. The forehead change and most noteable the hairline change are more pronounced, but if I show the before and after simulation photos to someone else, they will always say "but that is the same photo!"... So it is subtle alright - if in reality it is more subtle, then its bordering on "not worth the effort". Maybe I should consider di Maggio as a second choice again, he was rather positive to be able to make my face clearly more feminine and 100% female looking and was not so much emphasizing the subtlety of the changes... I would not want to get this surgery and then only get 50% improvement and still have a remaining percentage of my face looking masculine.

Y'know, I wonder if we should take this convo to private messaging? I'm worried about clogging up this thread with our chatting, even though I'm quite enjoying it.

I know what you mean about a nagging thought that just won't go away, I've had a few of those in my time 
I think that FFS is one such thought, even though I really do feel I'd benefit from it, and even if that benefit is mostly psychological.

I'm jealous of your hips, mine are certainly not my best asset, and I know I could get hip/thigh implants, but I don't want to have any kind of implants at all. Just something I'm not keen on personally.
I'm quite lucky to have small hands/wrists and relatively small feet. My frame and height are on the tall/broad side for women, but not outside of the normal range I see when out and about. Most of my facial features are androgynous enough to have responded well to 16 years of HRT, and I'm very lucky in that respect.
I did used to wear a corset (actually it was a waist cincher) because I have spinal problems, and it helped my posture a lot, and the side effect was a more feminine figure. But one day I just had enough of doing that, and now I rely on exercise to control my waist as best I can.
I can imagine that rib removal surgery might be very painful, I think I'll leave that alone 

The way you describe your FFS recommendations, as being lots of small subtle changes, I fully understand your trepidation and hesitation in going forward. That must be quite a difficult decision.
For me, the changes recommended are less subtle, but only in a couple of areas, hence the overall effect is still subtle, but the surgery is less invasive because it isn't over most of my face. In fact looking at my VFFS, it's really quite obvious where things need to be changed, and what effect they will have. In fact if I discount the tracheal shave because that is more neck than face, it's only my forehead/orbitals/eyebrows that would be subtly changed, so one area. Of course that doesn't include my hairline, but that's not exactly on my face either. If you add nose/chin/jaw work to that, then it really does start to become more invasive.

My chin is a bit broad, but as it is a family trait on my mother's side, and she has the same look to her chin, I'm fine with leaving it as it is. I really don't want to erase the character or family likeness from my face, and I have seen that happen to some people who have had quite invasive facial plastic surgery. They end up with what I term "generic good looks", but lose some facial character and personality at the same time. I don't want to smooth everything out, I'm in my mid-40's, and my face has developed along certain family character lines, and I'm fine with keeping that, even if it doesn't give the the ultimate feminine face.

I have heard of people talking about the side effects of changing certain facial features having a knock-on effect on other features, which by themselves, were perfectly fine before. If your face has a certain broadness to it, but is overall feminine, then narrowing just the chin (for instance) might make other aspects of the face suddenly seem out of place. I guess this is where the VFFS comes into it's own.

My hair is just about the worst part of my face/head/appearance. It's very thin and very difficult to create any feminine style without the 'gaps' becoming too obvious. Out of everything, my crappy crappy hair is what knocks my everyday confidence the most. I can't wear bangs, there just isn't enough hair at the front of my head to do it. It's centre parting with a hairband, or wear a hat or a wig. And I've done wigs for a few years and I don't want to go back to that. I'm half expecting that I might have to have some further FUE hair transplants the following year to fill out the hairline more, if necessary. But at least I can get these done in the UK, probably at DHI.
My goal too is to be able to wear my hair tied up/back, who knows if that will ever be possible...

What I meant by the results of my VFFS being less subtle than the actual surgery results is entirely surrounding my hairline. Alex gave me quite a strong (well populated) hairline in the areas where the transplants are meant to go, and I actually think that the results won't give me such a dense hairline as that, especially as the hairline at the centre of my forehead is thin, so I fully expect the sides (where the transplants would go) to be equally as thin, so as to blend in. My whole hairline is thin, and I don't expect that there would be enough hair follicles available from the strip that FT remove from the scalp, to give me a really dense hairline. It's one area I'm quite anxious about, and I don't think I'd get a complete idea of what I ended up with until 1 year after surgery, when all the hairs had had a chance to grow. I have had a hair transplant before, and that took a year until the effects were really visible.
But as for the bone modifications, I reckon the VFFS should be pretty accurate. But until it's all done and healed, who really knows?

As I've always said, you need to decide what's best for you. I'm after subtle changes, so what's best for me might not be the same for you. If you want, we could exchange VFFS images with each other via private messaging, and give each other a critique of what we thought?

[staciM]

^ i wouldn't say a resume that includes performing additional surgeries on Pixie Fox is particularly comforting.  She's gone to another level which is probably waaaaay past "not dangerous".

[anjaq]

V, I think going to private Messages is a good idea indeed

[TigerLilyNYC]

Hi V, I'm curious to know your hesitation with wigs. I have alopecia so I have to wear them. And I love them. People say they can't tell I'm wearing one but then I do get long stares and I wonder is It my exceptionally manly forehead (which I'm fixing) or is it the wig.Is that what you were experiencing with your wig...stares from people trying to figure out if you're wearing a wig or not? Thanks! Lily

[V]

V, I think going to private Messages is a good idea indeed

Hi V, I'm curious to know your hesitation with wigs. I have alopecia so I have to wear them. And I love them. People say they can't tell I'm wearing one but then I do get long stares and I wonder is It my exceptionally manly forehead (which I'm fixing) or is it the wig.Is that what you were experiencing with your wig...stares from people trying to figure out if you're wearing a wig or not? Thanks! Lily

Ah, I'm not knocking them, or anyone who wears them. It's purely a personal preference.
I've had some success with wigs, and at the beginning of my transition, I didn't have enough hair of my own, so I wore them all the time. Luckily with medication/HRT, a lot of my hair grew back, enough for me to not have to wear wigs any longer.
I did struggle with them sometimes, they were very hot in the summer, sometimes they would come adrift while I was out, and occasionally I didn't notice until it was too late. Some people thought it was my own hair, while others could immediately spot I was wearing a wig, and some were less than pleasant to me because of that. What can I say, some people just suck, like massively.
Also, wigs wear out, and I had to have a few of the same style so I could wear one while one was being washed, and as they began to wear out, I'd have to 'break in' a new one, in a way that wasn't obvious to others. Plus some jobs and activities just don't lend themselves readily to wig wearing. I found it nigh-on impossibly to wear a hat as well as a wig, and some jobs require you to do so.
I'm lucky that I don't have too severe alopecia, so I can mostly 'get away' with my own hair, but I do still have a couple of my wigs stored away, just in case I ever have to go back to wearing them. My boyfriend states quite frankly that I looked ridiculous in a wig, so much so that he can't bear to see old photos of me when I was wearing them.
So, as you can see, I've had mixed success with wigs.
Glad to hear you love yours
As for 'the stares', well I do get them, and I guess I'll never know exactly why, because I generally don't go up to folks and ask them why they were staring, except for the times when they make it pretty obvious why. I bet quite a few trans women have had that kind of experience