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Should I look into getting FFS?

Started by Allie24, February 05, 2017, 05:43:11 PM

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KayXo

Quote from: Sophia Sage on February 06, 2017, 10:25:07 AMI am personally most impressed with the work of Facial Team in Marbella, Spain, but there are many good options to choose from in the US, Europe, Asia, and even South America now.

Also Canada, Dr. Eric Bensimon apparently does some good work.

QuoteThe risks for surgery are the same for most surgeries -- the biggest risks being post-op infection and adverse reaction to anesthesia.  But these are the same risks for SRS, and they're quite small; modern operating theaters are very good at managing them.

What about the risk of having breathing problems with nose or experiencing permanent numbness in forehead?
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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Sophia Sage

Quote from: KayXo on February 06, 2017, 12:51:54 PMWhat about the risk of having breathing problems with nose or experiencing permanent numbness in forehead?

I think those risks are pretty low, too.  Rhinoplasty is a very advanced procedure these days, and usually results in some improvement in breathing problems, particularly if you've got a deviated septum.

The numbness that's most typically experienced is not on the forehead, but the crown of the head, if one goes for a superorbital incision (along the hairline), and even then that numbness is temporary, lasting on average six months, and even in cases where it's permanent it's more like a slight reduction in sensation, not 100%.  The coronal incision, on the other hand, doesn't damage those nerves at all as far as I know.

So really, and I wouldn't call it a "risk" so much as an "expectation," is that there's a quite a recovery period after facial surgery, and yes one should be aware of that.  But there's quite a recovery period for bottom surgery, too, and from what I've seen over the years there are more complications with that. 

Quote from: Allie24 on February 06, 2017, 11:13:33 AMYikes! That's pretty high. I feel I might have to end up choosing between FFS and SRS. I have some pretty serious dysphoria around both, but I think fixing my face might alleviate a lot of my bottom dysphoria.

I prioritized facial surgery -- it makes the biggest difference in day-to-day living.  I borrowed some for it, and put SRS (which I had 8 months later) entirely on my credit cards, paying that all back over the following five years.  They aren't mutually exclusive options, though. 

Facial surgery, imho, is the "real" sex-reassignment surgery, conferring an overall improvement in quality of life.  Bottom surgery will help you pass in bed.  That's a much more limited arena, most people you meet will never see it, whereas everyone sees and interacts with your face.

Quote from: Nina_Ottawa on February 06, 2017, 11:31:03 AMIn my first year, I suffered a wee bit of dysphoria and got a trachea shave. Add in the cost of 80 sessions of electrolysis, therapy...came in around 13k. I was considering vocal cord and FFS, and had the money available, but I convinced myself to wait and live through year #2. And the end of year 2, for some reason - probably the combination of RLE and the payoff from electroylsis, I ditched spending any more money.

Your facial features aren't nearly as exacerbated by testosterone as most transitioners, in my opinion. I wouldn't think you'd need FFS given your profile pic. 

But yes, it's more important to get electrolysis done (there's not much point in FFS if you have beard shadow) and especially to develop one's voice.  That and some good HRT results will definitely go far, for much less money.  And these generally take time -- the electrolysis especially can take a good couple years to complete.  So it's very difficult to sprint through transition -- it really is a marathon.

All this, of course, assuming that eliciting constant and reliable female gendering is what you actually need to alleviate dysphoria and bring out one's joy.  Some people find they don't mind occasional misgenderings. Others find they get gendered perfectly well, by themselves and others, without facial surgery; certainly before Dr O came on the scene, one pretty much went with what one had, maybe opting for a nose job or cheek implants.  Some find that just by allowing themselves the freedom to act as they choose, relying only on a name change and a trans narrative to elicit what proper gendering they can get, is enough to be happy.  So what to do really depends on what you need out of transition.  I needed impeccable female gendering, and the possibility to live with a closed narrative, and that's what guided all my choices.

So I'd be remiss to say that Allie's current bone structure won't ever get her clocked, especially given society's heightened awareness of all things trans. 
What you look forward to has already come, but you do not recognize it.
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Nina_Ottawa

#22
^^^^^^^
You're saying, and I can't believe I'm reading this, that one having made a decision to have GCS does it to pass in bed, while someone opting for facial reconstruction are the true transitions?
Pray tell me that's not what you're saying.

And the, to go on an make a comment about my facial features? Ummm, I don't recall asking for an opinion. Who are you to say? I'm comfortable enough in my transition that what's inside me makes me passable, not the outside.

Wondering if perhaps a mistake joining here.




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staciM

Quote from: Nina_Ottawa on February 06, 2017, 01:59:44 PM
^^^^^^^
You're saying, and I can't believe I'm reading this, that one having made a decision to have GCS does it to pass in bed, while someone opting for facial reconstruction are the true transitions?

Pray tell me that's not what you're saying.
If you're prioritizing looks over getting rid of "it," well, I enjoyed my month here.

I bet, and I could be wrong, many have gotten FFS didn't need it.


  I believe she's saying that she prioritized FFS because it's what allowed her to be more broadly accepted in public compared to GCS....which is a more personal necessity that the majority of others don't see/experience.  I see that side of it, even though "it" being there really bothers me as well.

If a girl is obviously damaged by years of testosterone and getting through the day is quite difficult because they are always hassled and misgendered, I can see how putting GCS as a secondary "need "makes sense.....even if "it" being there is also a very dysphoric element.  Perhaps the constant harassment, looks, and social impacts are more depressing on a day to day basis than dealing with what's between their legs.

  Nina, I think your input is valued, I would hate to see you go because of a simple difference of opinion ....and it's always good to have more canucks around :)
- Staci -
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Nina_Ottawa

Quote from: staciM on February 06, 2017, 02:38:21 PM

  I believe she's saying that she prioritized FFS because it's what allowed her to be more broadly accepted in public compared to GCS....which is a more personal necessity that the majority of others don't see/experience.  I see that side of it, even though "it" being there really bothers me as well.

If a girl is obviously damaged by years of testosterone and getting through the day is quite difficult because they are always hassled and misgendered, I can see how putting GCS as a secondary "need "makes sense.....even if "it" being there is also a very dysphoric element.  Perhaps the constant harassment, looks, and social impacts are more depressing on a day to day basis than dealing with what's between their legs.

  Nina, I think your input is valued, I would hate to see you go because of a simple difference of opinion ....and it's always good to have more canucks around :)

I like what you're saying Staci, but I often wonder if sometimes FFS is seen as the magical solution to passing. how we see ourself is often different than how others perceive. We are our worst enemy in that we find faults.
Let's says someone hasn't spent RLE, yet goes for FFS, how do they know it was their looks?
RLE should be the catalyst for change.

I take issue that GCS is for passing in bed. Bull$4!£
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Angela Drakken

Im fairly certain a cis woman could post her pic in here and someone would recommend FFS..

..more Canadians wot now?
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Nina_Ottawa

Quote from: Angela Drakken on February 06, 2017, 02:59:37 PM
Im fairly certain a cis woman could post her pic in here and someone would recommend FFS..

..more Canadians wot now?

Lol thank you.
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Mirya

Quote from: Allie24 on February 06, 2017, 11:13:33 AM
Yikes! That's pretty high. I feel I might have to end up choosing between FFS and SRS. I have some pretty serious dysphoria around both, but I think fixing my face might alleviate a lot of my bottom dysphoria.

If I were in your shoes and on a limited budget, I would choose to get SRS first, and then possibly FFS later.  I just read your introductory post on these forums, and the impression I get is that your quality of life would be vastly improved by prioritizing SRS over FFS.

Each individual has varying degrees of overall body dysphoria.  And that dysphoria can also vary for each part of the body.  So do what is best for your unique situation.

As for costs, I only needed a Type I forehead contouring, and if I separate out the costs from the other procedures I had, I'd guess that it was about $10k - $13k, including facility fees and anesthesia fees.  Based on your photos, I think you'll need to get a Type III forehead reconstruction instead (which is what most trans women need anyway).  I also agree with Sophia that you should get your nose done at the same time as a forehead reconstruction in order for everything to look balanced, so the total cost would be (I'm guess-timating again) maybe 20k at least.

SRS is also much more likely to be covered by insurance than FFS, so that may be another reason to prioritize SRS, depending on your situation.
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Mirya

Quote from: Angela Drakken on February 06, 2017, 02:59:37 PM
Im fairly certain a cis woman could post her pic in here and someone would recommend FFS..

Each surgery is a very personal decision for each woman, whether she is trans or not.  In the end, people need to do what will bring them peace.

There are some who are big proponents of FFS, and others who say it's not necessary.  It's my understanding that in Germany, for example, FFS is widely regarded by the trans community there as being completely unnecessary.  Which is fine, if that's what people want and need.

The OP asked a sincere question, and Sophia and I gave respectful responses carefully explaining our thoughts.  Although I can appreciate the remarks from those who say that Allie24 doesn't need FFS, I don't understand why you would litter this post with such a flippant remark.
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alex82

Definitely not.

I logged back in here after months just to tell you that. You really don't need it. If you did, I'd just say what I thought you needed. You really don't need to splash the cash on having things your your forehead smashed in and reconstructed. Bloody hell. All pain, no gain. For some people sure, they need it. For you, it might even be a bit of a mistake, a bit too much, tipping over into plastic.

And there are risks. Anything could go wrong - and on your face of all things. If it was awful, or even masculine, I could see the point of chancing it, but it's not.

I agree with Angela. A cis woman could post here and some people would start telling her what bones needed broken and reformed.
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Allie24

Quote from: Mirya on February 06, 2017, 03:15:30 PM
If I were in your shoes and on a limited budget, I would choose to get SRS first, and then possibly FFS later.  I just read your introductory post on these forums, and the impression I get is that your quality of life would be vastly improved by prioritizing SRS over FFS.

Each individual has varying degrees of overall body dysphoria.  And that dysphoria can also vary for each part of the body.  So do what is best for your unique situation.

As for costs, I only needed a Type I forehead contouring, and if I separate out the costs from the other procedures I had, I'd guess that it was about $10k - $13k, including facility fees and anesthesia fees.  Based on your photos, I think you'll need to get a Type III forehead reconstruction instead (which is what most trans women need anyway).  I also agree with Sophia that you should get your nose done at the same time as a forehead reconstruction in order for everything to look balanced, so the total cost would be (I'm guess-timating again) maybe 20k at least.

SRS is also much more likely to be covered by insurance than FFS, so that may be another reason to prioritize SRS, depending on your situation.

I haven't been misgendered in a very long time. My coworkers, whom I work very close to and interact with on a near daily basis (sans makeup and with my hair tied back), all assume that I'm cis. I also feel like my feminine voice and mannerisms help me a lot with passing, sometimes even moreso than my physical features. I've always beem very self-conscious about my face though, and my brow especially. Maybe you're right, maybe I should put SRS first because socially I'm a-ok. I just wish I knew how to stop fixating on this one aspect of my face.
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Dena

It tends to be difficult for us to see our faces as feminine. We still see the features that made us masculine even when they have taken a feminine twist. It may  take months or years before we can see it but one day you look in the mirror and there will be a different face staring back at you. In my case, it took a couple of years and I saw my mothers face looking at me. You need to try and believe what the others post about you because often your image is being seen for the first time so we are unbiassed. I for one post the truth. If the person isn't passing, I don't post or I will post what they need to do to fix it. In your case, you are feminine in appearance and I see no need to spend money on expensive surgery that would make little difference in your passibility.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
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KayXo

Quote from: Dena on February 06, 2017, 06:22:21 PM
It tends to be difficult for us to see our faces as feminine. We still see the features that made us masculine even when they have taken a feminine twist. It may  take months or years before we can see it

I'm post-op since 2005, started HRT in 2004. I still sometimes see "him" in the mirror. The mind is a powerful thing and distorts reality. Ignore your perceptions. Go by how the world out there says!
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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Sophia Sage

Quote from: Nina_Ottawa on February 06, 2017, 01:59:44 PMYou're saying, and I can't believe I'm reading this, that one having made a decision to have GCS does it to pass in bed, while someone opting for facial reconstruction are the true transitions?

Pray tell me that's not what you're saying.

That's not what I'm saying, and I apologize for my perhaps blithe expressions and lack of clarity. 

First, all transitions are true, regardless of what you do -- even if it's as little as a name change and a new wardrobe.  Transition is simply a process of making changes in our lives to go from one place to another, at least in terms of social identity, as far as I'm concerned. I wouldn't equate a surgical procedure with transition, though transitions typically incorporate them (for good reason).

Now, when I say that facial surgery was the "real sex-reassignment surgery," I mean just that -- with the emphasis on "reassignment."  Because in our day-to-day lives, sex (or gender) gets assigned by everyone, to everyone.  It happens automatically, subconsciously, and it's based primarily on facial features, closely followed by voice, and then overall body shape.  How we are assigned on a social basis really doesn't have much if anything to do with what's between our legs, because our privates are kept private and are generally only seen "in bed" (narrative concerns and medical situations aside).  Which is not to say that bottom surgery is done for the purpose of passing in bed, but that the passing privilege it confers is pretty much restricted to the bedroom (and perhaps some backwards state agencies). 

(In general I don't like the "GCS" terminology, for I don't think we need surgery to "confirm" gender, let alone bottom surgery; gender is, to me, primarily constructed and confirmed through a combination social interaction and self-acceptance.) 

Now, all this has to do with how other people see us.  But then there's also how we see ourselves.  It is so easy to misgender ourselves!  And it's nice to say that all it takes is changing our thinking, but there's more to how our brains work than how we think. Most of what our brains do is not actually in our control.  Brains operate mostly at the subconscious level, automatically and blindingly fast, not at the level of conscious thought.  If we could stop misgendering ourselves simply by the fiat of will or through interior work alone, a lot of people probably wouldn't go for any kind of surgery, or transition for that matter.  Why bother, if you can just rely on interiority? 

But unfortunately, emotions precede conscious thought.  Dysphoria comes unbidden, and it typically takes correcting material reality to alleviate it.  So even with "passing easily" there can still be the impetus to have surgical correction, be it down below or upon one's face; this of course will vary among individuals.  (Down below tends to end up being very important for how we gender ourselves, because it's part of our embodied material reality, and even if it's not shared it's still experienced every day.  Like when we wake up in the morning, to when we go to sleep, and all the bathroom breaks in-between.)

Why transition if not to create congruence between interiority and exteriority?

QuoteAnd then, to go on an make a comment about my facial features? Ummm, I don't recall asking for an opinion. Who are you to say? I'm comfortable enough in my transition that what's inside me makes me passable, not the outside.

Again, my apologies. 

I get it that in your personal experience, your interior work is what greatly facilitated the female gendering you receive, and I certainly agree that such interiority is essential.  It's necessary.  But I disagree that it's sufficient for most of us, because again "gender assignment" happens even before we initiate any social interactions with anyone, and that assignment is based first on physical sensory information, not from a measurement of our souls. I'm sorry, but I'm very much a materialist on this matter.  Only a few people are lucky enough thanks to their initial embodiment to not need as many exterior procedures to elicit their needed gendering.

It's the same reason I advocate for beard removal and voice training.  Because they matter when it comes to the gendering we'll elicit. 

I think of it this way -- even ciswomen with the most difficult interiorities in the world, plagued with low self esteem and doubt and insecurity, whatever you can imagine, still get gendered correctly.  At the same time, some women of transition with all the self-acceptance in the world can still get clocked, simply based on their embodiment, even those who get gendered properly 99% of the rest of the time.  I'm sorry, but when it comes to gendering, material embodiment matters a great deal, and some embodiments will get misgendered regardless of what's on the inside.

Quote from: Nina_Ottawa on February 06, 2017, 02:53:07 PMI often wonder if sometimes FFS is seen as the magical solution to passing. how we see ourself is often different than how others perceive. We are our worst enemy in that we find faults.

Let's says someone hasn't spent RLE, yet goes for FFS, how do they know it was their looks?

RLE should be the catalyst for change.

FFS is a marvelous solution, but it's certainly not magic, nor is it the only solution.  It's certainly not sufficient on its own, nor is it always necessary.  Beard removal and a decent voice are more crucial, I think, and none of this is really any good without interior acceptance and a clear idea of one's deepest truths -- because there's no point in getting female gendering if you're still miserable on the inside. 

But RLE can be problematic as a litmus test for discerning whether something like FFS will be of benefit or not.  It kind of depends on how one goes about RLE in the first place.  Like, for most people, it means going full-time pretty much all at once, which includes one's job.  But too many times I've seen transitioners get caught flat-footed and losing their jobs, before even basic things like electrolysis has been completed, and now there's no money to pay for anything, and it's much more difficult to find gainful employment when you're visibly transgendered; sorry, the rest of the world still sucks when it comes to this.

When I transitioned, I compartmentalized work -- I didn't transition there until after my surgeries were complete, because I wasn't going to compromise my finances (lol, trust issues).  In the rest of my life, though, I was full-time.  And in new social situations, I had no problems passing.  I'd like to say it was due to my own interior work, but frankly much more of it had to do with voice (primarily), electrolysis, an appropriate wardrobe, and having long hair.  I knew this because I'd still get gendered correctly in situations where there was no opportunity for my personality to shine through, or when it shined "poorly" due to distress, fatigue, what have you. 

Regardless of these positive experiences, I'd still get dysphoric in front of the mirror. 

And I tell you, how the rest of the world started responding to me after facial surgery changed.  Like, I soon realized that before there had always been a "lag time" upon meeting someone, as if their brains were doing some extra checksums or something before assigning me "female."  And there was suddenly more easiness from other people, particularly women, in my subsequent interactions.  These changes manifested within two weeks of facial surgery (after the bruising was gone), despite the fact that I still wasn't seeing it -- though I could "feel" it and I cried tears of joy the first time I took a shower, because I could feel the water pouring down my face in a different pattern than it used to.  Maybe I had so many memories of my previous image in the mirror, or maybe I was too acutely aware of some lingering swelling, I don't know what, but I wasn't seeing what other people were seeing, not until three, four months after the fact. 

Anyways, how did I know I needed facial surgery?  First, I started with my own dysphoria, but that should go without saying.  More importantly, at least for conscious decision-making, I studied the basis for the gamut of procedures that make up what's usually proposed for FFS.  In particular, I looked at the sexually dimorphic differences in male and female skulls. 

Upon understanding those differences, I realized they're pretty much as predictable as most other secondary sex characteristics.  They're just not as blatantly obvious as things like breasts and beards and the pitch of one's voice or the presence of an adam's apple.  In the vast majority of men and women, things like foreheads and jaws and chins pretty much fall into the camps of "definitely male" and "definitely female." That said, there's still quite a bit of variance, just as there is with pitch and breast size, and since we process faces as a gestalt it's the preponderance of features that ultimately matters when it comes to that automatic gender assignment.  For me, none of my bony features were in the female range, so I was always going to have the full battery of procedures done. 

Because we look into people's eyes in most social interactions, I think the forehead is the most important facial feature (at least in terms of bony structures; beards are a dead giveaway).  Strong brow-bossing is extremely rare in the female population.  In the male population, on the other hand, there's more variance -- I knew a few guys with very little brow-bossing.  It makes them look a bit femme, or at least less intimidating.

So... if Allie is dysphoric about her forehead, that's reason enough as far as I'm concerned.

I don't think she's seeing what's not there. From a physiological perspective, the projection of her forehead is in the male range, though mitigated by being relatively round and smooth so she isn't beset by the appearance of a "ridge" -- from head on, the projection is only noticeable from the shadowing across the bridge of her nose.  The angle of her jaw, on the other hand, is strongly feminine, as is the tapering of her chin.  Her nose is slightly on the feminine side. She's got great hair.  The preponderance of features is "female" despite her forehead. 

Obviously, she doesn't need it to pass, she's got enough going for her as it is. But that doesn't mean she wouldn't benefit from having the work done, at some point, from both a material perspective and a psychological one.  By the same token, though, I'd say the same about bottom surgery, too. 
What you look forward to has already come, but you do not recognize it.
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denajtuk

If it ain't broke, don't fix it. I'd kill to look that good.

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Anastasija

Quote from: Dena on February 06, 2017, 06:22:21 PM
It tends to be difficult for us to see our faces as feminine. We still see the features that made us masculine even when they have taken a feminine twist. It may  take months or years before we can see it but one day you look in the mirror and there will be a different face staring back at you. In my case, it took a couple of years and I saw my mothers face looking at me. You need to try and believe what the others post about you because often your image is being seen for the first time so we are unbiassed. I for one post the truth. If the person isn't passing, I don't post or I will post what they need to do to fix it. In your case, you are feminine in appearance and I see no need to spend money on expensive surgery that would make little difference in your passibility.

Amen. The problem that the FFS can also not accept his face, the way you see yourself now old, and after the FFS can see a completely new person. Maybe it's a stupid example, but not che me to look, just look at Kylie Jenner, before and after surgery, a completely different face
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Nina_Ottawa

Quote from: Allie24 on February 06, 2017, 03:38:06 PM
I haven't been misgendered in a very long time. My coworkers, whom I work very close to and interact with on a near daily basis (sans makeup and with my hair tied back), all assume that I'm cis. I also feel like my feminine voice and mannerisms help me a lot with passing, sometimes even moreso than my physical features. I've always beem very self-conscious about my face though, and my brow especially. Maybe you're right, maybe I should put SRS first because socially I'm a-ok. I just wish I knew how to stop fixating on this one aspect of my face.

I believe you've answered your own question.
Sit back, assess your interactions with people, and ask yourself are you fitting in better than expected? If yes, then the looking in the mirror is only how you see yourself.
I was the exact same way, but after a couple years, you'll start seeing yourself in a different way. Just keep reminding yourself daily that what you see is way, way different from what others see.
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rose

Do you need ffs : No
But if you want perfection in your look go a head do cosmetic surgeries
But you don't need them to look feminine do them if you want perfection as I said [emoji18]



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rebeccal

As others have said, FFS is completely unnecessary judging by the photos...  You look lovely.
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Summer

That's a no from me .
You have a beautiful feminine face .


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