Round 2 forehead feminization: About to make the decision in choosing the surgeon

[Celia0428]

I find it odd that a surgeon who was trained by Dr. O doesn't value the importance of shaving the orbital rims. In my research I found out that even surgeons who don't claim to be FFS specialists the first thing they recommend is to shave the orbital rims. When I talked to them about feminizing my face they said sure, yes, let's start with a rhinoplasty, cheek implants and shave the orbital rims. Even if they never heard about setting back the frontal sinus or don't dare to do it shaving the orbital rims is still within their scope.

[jasmine891]

Yes, during my consultations, both Dr. O and Dr. D were present and also during my surgery, so I'm not sure if it was an oversight or maybe a little bad compromising between the doctors during the procedure. My right orbital rim is set back more than the left side, which seems untouched, but even the right has room for more improvement. During a consultation with Dr. Spiegel after my first forehead reconstruction the prominent outer rims were the first thing one of his students shadowing him noticed. Which proved to me I wasn't being over critical.

Like I said originally Dr. D didn't even want to set back my sinus area, even after I said I wanted a flat transition from forehead to the top of my nasal bridge,he was just very concerned with giving me a "round" forehead, which I didn't realized meant adding volume. Thankfully either he changed his mind or Dr. O during the procedure felt my suggestion was best, because when I woke up, I had the flatter appearance I wanted in the sinus area, and it looked great, but with the prominent orbital rims, still appeared not completely or feminine enough!

[Hanana90]

I don't really have anything else of value to add to this topic, other than to chime in and say that I too went to the same doctor and have the same problem.  The setback of my sinus has been fantastic but the orbital rims on either side of my eyes are still prominent and masculine looking.  I have a consultation with another surgeon soon to further burr down the orbital rims, because it's not sufficient.  I don't regret going to this surgeon, though.  I still believe he's the best in the business with aggressive setback of the forehead.  It's just that the transition from the forehead into the eyes (aka the orbital rims) is not properly addressed, in my opinion.

[jasmine891]

Yes, I don't regret going to him either, the first time! The second time however, I wish I would have done more research, but I felt since he did the first procedure and knew his work, to go back to him, but I was wrong.

Perhaps he feels working on the orbital rims is risky, otherwise I don't see why he wouldn't. I would describe his technique and attitude has conservative and by the book, compared to say someone like Dr. Z who is rogue ( in a good way), and has a go hard or go home attitude and is more aggressive with their work.

[Ypsf09]

Jasmine and Hanana,

Thanks a lot for sharing your experience. I struggled myself a lot with respect to why my orbital rims are still Sharp but glabella so feminine as even regular non ffs specialists do that. Initially I thought it maybe some special secret sauce to give an exotic/sexy feminine look. After being declined by Dr Deschamps for a revision as I started consulting other surgeons(7) they all mentioned your forehead needs more work and that it's still prominent.

After struggling almost an year after surgery in trying to figure out whats still wrong with my forehead (aka why don't I totally look feminine with all hair pulled back), I realized that the orbital rims prominence as well as the sides of the forehead and it's transition to the cheekbone is the reason.

I choose Dr Deschamps without meeting him in person based on Dr O's reputation. However now I realize it's not the same as going to Dr O. He seems a conservative version of Dr O.

[jasmine891]

Yes, totally agree. I wish he had declined my revision, and yes, the two surgeons I met with also said it needed to be taken down more for me also.

Im not sure how much of that paste was added, but looking at old pics, before even my first forehead work, I feel knowing more now, that I could have gotten away with just brow bossing being  shaved down and setting the sinsus area back. Now I have so much added volume due the "round" appearance that was trying to be achieved.

On the bright side, Ive spoken with one surgeon who said it can be shaved down.

[Celia0428]

I choose Dr Deschamps without meeting him in person based on Dr O's reputation. However now I realize it's not the same as going to Dr O. He seems a conservative version of Dr O.

You can take driving classes with Michael Schumacher for years. It does not guarantee that you will ever drive like him

[oneoftwo]

I just think you are stunning as is and very feminine. I wouldn't want to chant anything if I were you. I'm having a consult with Dr Deschamps. I like your results from him!

Your  pictures are no longer posted - - but as TigerLily and others on Susan's observed at the time a few months ago, when your pictures were still linked, you ended up with a rather outstanding feminine result from your facial feminization surgery.   Pretty easily an 8 or maybe a 9 out of 10 from the perspective of most people.  Also, a modest amount of orbital rim presence is normal and well within the range of the majority of everyday observations of female faces seen in public. The complete absence of any evidence of "orbital rims" is really rare. 

In addition,  it is relatively easy for a surgeon to remove bone from the orbital rims.  But it is really hard to go back and replace that bone with grafts or fillers and try to build it back up when you do not like the result.  Your surgeon may have done you a big favor by stopping where he stopped, given your results.   

Also, in many or most instances, some modest remaining orbital rim structure appears very attractive.  It draws peoples attention to the eyes.  Currently, there is one example with multiple pictures from a timeline posted on another forum where the lady has some visible remaining orbital rim bone structure.  Her results look so good three months after surgery that she ended up getting a photo shoot as a model.

Keep in mind the wisdom that says "... the enemy of good is an attempt at better."  That is really important with facial surgery!

And also remember the further thought that the enemy of a "stunning" result (as TigerLily described it) is even thinking about an "attempt at better."    That is really not likely to turn out to have been a good decision.

[Ypsf09]

Yes, totally agree. I wish he had declined my revision, and yes, the two surgeons I met with also said it needed to be taken down more for me also.

Im not sure how much of that paste was added, but looking at old pics, before even my first forehead work, I feel knowing more now, that I could have gotten away with just brow bossing being  shaved down and setting the sinsus area back. Now I have so much added volume due the "round" appearance that was trying to be achieved.

On the bright side, Ive spoken with one surgeon who said it can be shaved down.

Jasmine,

I called his office couple of times to reconsider the revision. But now I am grateful that they declined. Looking back now I think they realized that maybe what I was looking for was out of their comfort zone. I feel that my unhappiness with my face is due to its width. What I was asking for is the sides of the forehead decreased(so the forehead looks more convex and fuller without adding any material), browbone completely removed along with cheekbone reduction and jaw reduction. A wider forehead, relatively wide cheekbone and jaw makes my face look a bit boxy which is not very feminine. From the profile view, my eyes could be more open and orbital rims/browbone less pronounced if not completely gone. For what I was looking for I definitely would have been again disappointed after the second surgery, had he agreed. 

Also I was/am seeking a round/convex forehead appearance only by aggressive reduction of browbone and sides of the forehead without adding any foreign material with the exception of fat.

Anyways, Can I pm you to find out more about who you are considering for the revision?

[jasmine891]

Hey,

Im not considering anyone in particular to be honest. I have Dr. Z in mind but I want another open forehead reconstruction to hopefully return my hairline to its natural round appearance and he hates that technique. Dr. Spiegel is in mind, but he was suppose to do some jaw work while adding a chin implant, that I eventually had removed, and guess what...my jaw bone was never touched, so Im not sure Im willing to spend the money for his mediocre results.

Im thinking I need to go outside the top names for what will be my last FFS surgeries. Im so over surgeries and just want to live and not have a to-do list when it comes to this thing we call transitioning.

I do agree some what with the persons messages above yours, but at the same time, if someone in our position still doesn't see the image they have in their head, then its hard to say, be content, especially if your still getting "clocked" after spending tens of thousands on surgeries.


Like I said, if you are considering a revision, do research, have a clear explanation of your desired results, and make sure the surgeon understands them, and gives you their plan of execution on how they will go about fixing your problem.

[Ypsf09]

Your  pictures are no longer posted - - but as TigerLily and others on Susan's observed at the time a few months ago, when your pictures were still linked, you ended up with a rather outstanding feminine result from your facial feminization surgery.   Pretty easily an 8 or maybe a 9 out of 10 from the perspective of most people.  Also, a modest amount of orbital rim presence is normal and well within the range of the majority of everyday observations of female faces seen in public. The complete absence of any evidence of "orbital rims" is really rare. 

In addition,  it is relatively easy for a surgeon to remove bone from the orbital rims.  But it is really hard to go back and replace that bone with grafts or fillers and try to build it back up when you do not like the result.  Your surgeon may have done you a big favor by stopping where he stopped, given your results.   

Also, in many or most instances, some modest remaining orbital rim structure appears very attractive.  It draws peoples attention to the eyes.  Currently, there is one example with multiple pictures from a timeline posted on another forum where the lady has some visible remaining orbital rim bone structure.  Her results look so good three months after surgery that she ended up getting a photo shoot as a model.

Keep in mind the wisdom that says "... the enemy of good is an attempt at better."  That is really important with facial surgery!

And also remember the further thought that the enemy of a "stunning" result (as TigerLily described it) is even thinking about an "attempt at better."    That is really not likely to turn out to have been a good decision.

Thanks Oneoftwo. If I am not mistaken, TigerLily ended up going to the same surgeon later on for her forehead and felt it wasn't done enough.

Personally I feel like the female model robust facial bone structure is not so favorable for transwomen. While a sharp orbital rims, prominent forehead, cheekbones and defined jawline can make a cis women look very exotic and attractive, the same very rarely applies for a tranwomen with similar features. While it may help getting a photoshoot, it may not be very advantageous if one desires maximum passibilty/absolute stealth.

We are better off making things as smooth, soft and feminine as possible while also looking natural.

I am not seeking perfection, just trying to erase features that deem masculine or are signs of my previous past as much as possible. For Example, this morning I had a video consult with surgeon about a body procedure. He is not very popular for FFS however he does have a craniofacial background and routinely operates on cis as well as some trans folks for improving their forehead appearance. While my consult was only for a body specific procedure, when I asked his opinion about my face without telling him anything about my facial surgical history, this is what he said.

" Right off the bat, the first screaming thing I noticed was your forehead. Its very wide, square and flat with orbital rims prominence.

And I had my hair covering my side forehead. After that comment, I pulled my hair back and told him that I already had forehead feminization. He then said

"That makes sense because I noticed both feminine and masculine characteristics in your forehead. The center is in the feminine range but what sticks out it how the edges don't curve making it look very rectangular and wide from the front view. Also the eyes look hooded on the sides because of the heavy orbital rims"

He was very sure that only the central part of my forehead was worked on while the sides and edges were untouched, thus giving that look. And I didn't tell him anything about my previous surgery or about what I was happy or unhappy about. That was his frank opinion without knowing anything.

Not wanting to settle for a mediocre result is not the same as seeking perfection. Anyone with a decent background in male vs female forehead can figure out about me when my forehead is fully exposed.

[jasmine891]

Yes,
I agree...one thing I think is not talked about much on here, that I've noticed is making sure not to place your opinion onto someone else.

I agree about the cis-women being able to get away with semi-masculine features, because so many do. For Trans women, we have the voice, height (in most cases), body structure, etc to deal with, so keeping things semi-masculine because some cis-women get away with it, is B.S.

It just leaves a Trans women open for being clocked after having spent time/money to look as fem. as possible.

I don't want to be perfect, or look perfect, but its odd to have just worked on the center portion of the forehead and left the orbital rims untouched. Like the doctor stated to you today, its the hooding that it creates over the eyes, that also makes it look masculine. For me, it doesn't fit my face, my jaw was slimmed, nose was slimmed, and now I have a forehead thats wide and prominent, because paste was added to it, when just like everything else it should have been reduced in size. My advice to myself and others, just make sure you know exactly what your surgeon is going to do once you are asleep. If they don't feel your outcome is appropriate or a fit for you, don't give them a dime, because ultimately (in my case) once your asleep, they will do/or not do, what THEY feel is best!

[Devlyn]

You can take driving classes with Michael Schumacher for years. It does not guarantee that you will ever drive like him

The flip side of that is that a good master teaches the apprentice everything they know, and the apprentice adds to that, advancing the art. 

Hugs, Devlyn