Overwhelmed by FFS and feel at a loss

[Sophia Sentiment]

I've been researching FFS for over a year now, mostly lurking and compiling information on surgeons. I know what I would like done and have enough money and can loan a small amount. But I'm so lost as to who to go to and it's left me feeling depressed and stagnant. I don't want to wait any longer, I want to make a choice.
How do you decide on a surgeon?

Particularly people who have had surgery or have made their deposit/booked surgery; what made you feel you knew enough to decide?

I was going to go with Facial Team because their results on their website look pleasing and they have a legion of fangirls. Then I kept hearing bad things about their lack of craniofacial specialty and how their results are too subtle to make a difference (which often looks the case).

I was considering Dr Bart van de Ven because I like the approach of the clinic but haven't found a great deal of information out there as to whether he's worth travelling abroad or is simply popular to Europeans.

I was considering Dr. Marcelo Di Maggio because he is so affordable and has a reputation for amazing forehead work (my primary concern). But I keep hearing about how his work is "too smoothed out" and cannot find enough photos of his patients to feel safe.

So I'm lost and exhausted. I don't know who to choose and I feel desperate and tired of waiting.

[julia-madrid]

Hello Sophia

You say you've been researching for over a year, but have you engaged with any surgeon to get their specific proposal for your case?  If not, you need to do this.

All surgeons you have mentioned are good, and results will obviously vary depending on what you need done and the practicalities of implementing the changes.  Too subtle or not subtle enough are very subjective statements, and you should state your requiements and trust that the surgeon knows how to achieve a harmonious result. 

You need to be realistic about the results - very few of us transform into a supermodel, and we use our clothes, hair and makeup judiciously to compose the entire physical woman.

Good luck.  Take action!

Regards
Julia

[Sophia Sentiment]

have you engaged with any surgeon to get their specific proposal for your case?  If not, you need to do this.

Hey Julia. Yes I have had a consultation with both Facial Team and Di Maggio as both are free. Dr. Bart not yet because he costs to see and I only pay for a consultation if I am impressed enough by the work. Both FT and MDM said similar things but FT did not suggest jaw/chin which I'm beginning to consider as very important. But I can still negotiate this with FT.

You need to be realistic about the results - very few of us transform into a supermodel, and we use our clothes, hair and makeup judiciously to compose the entire physical woman.

I hope I am realistic. I'm not looking for a surgeon to make me a supermodel, I just want to pass. What I want is to not have to stress about hair and makeup and still look female. Attractiveness is another thing to me. But even so, it's hard to know who could feminise my face the best.

[Fresas con Nata]

How do you decide on a surgeon?

My take on this is that it's good to research a bit but it makes no sense to go too far about it (not saying you are) (but then you say you are overwhelmed so maybe...) An average surgeon may make an awesome work on you while the "best" (TM) one may make an error and leave you with eg. asymmetric cheeks.

I'm planning on FFS+SRS+BA to save on travel/theatre costs, to go under anaesthesia only once, and to go through post-op only once, so I'll probably end up in Thailand.

[deeiche]

It took me 10 years to save up for FFS, in the meantime I was a member of a once very active Yahoo FFS group, then found this place.  In late spring 2015 I realized I needed to move forward, as I wasn't getting any younger ( 56 in 2015).  So I had to make a decision.

I've been researching FFS for over a year now, mostly lurking and compiling information on surgeons. I know what I would like done and have enough money and can loan a small amount. But I'm so lost as to who to go to and it's left me feeling depressed and stagnant. I don't want to wait any longer, I want to make a choice.
How do you decide on a surgeon?

I contacted 3 FFS entities, FT, T-Change (Dr Rossi) and Dr Mardirossian.  I had consults and quotes from Dr Mardirossian and T-Change.  Both suggested similar procedures, except Dr Mardirossian suggested cheek implants, whereas T-Change recommended fat transfers.  Along with Type III FFS and sliding genioplasty I had a lot of age related soft tissue work.  Both suggested for best results I have bone work first, then return in 12 months or so to have soft tissue work done.  I couldn't see putting myself through two surgical recoveries so I asked if everything could be done together.  I was told yes by both, but not with the same level of results.  T-change suggested 80% results by doing everything together, I can't recall what Dr Mardirossian said.  Dr Mardirossian came across as a genuine person in my Skype conversations with him.  However I ended up deciding on Dr Rossi.

FT never responded to my query, well they did 3 months after I had surgery.

Particularly people who have had surgery or have made their deposit/booked surgery; what made you feel you knew enough to decide?

The decision to go with Dr Rossi was based upon the fact he was represented by T-Change, T-change is run by Amanda R.  I've followed Amanda from when she first posted to Yahoo FFS group regarding her search for a surgeon in her native Buenos Aires.  To make a long story short she is the one who first posted about Dr DiMaggio to the rest of the FFS community.  After a number of years of T-Change representing MdM they had some differences and severed their relationship.  A year or so after this T-Change was representing Dr Rossi.  Because I had followed Amanda R for years I believed the person who brought MdM to the trans community was a good judge of a surgeons capability.  Also at that time there were several other positive posts regarding Dr Rossi on this forum.

I was going to go with Facial Team because their results on their website look pleasing and they have a legion of fangirls. Then I kept hearing bad things about their lack of craniofacial specialty and how their results are too subtle to make a difference (which often looks the case).

I was considering Dr Bart van de Ven because I like the approach of the clinic but haven't found a great deal of information out there as to whether he's worth travelling abroad or is simply popular to Europeans.

I was considering Dr. Marcelo Di Maggio because he is so affordable and has a reputation for amazing forehead work (my primary concern). But I keep hearing about how his work is "too smoothed out" and cannot find enough photos of his patients to feel safe.

So I'm lost and exhausted. I don't know who to choose and I feel desperate and tired of waiting.

Ultimately you just have to make the decision.

I believe all the surgeons mentioned in this thread would be good surgeons to go to.  I know you stated about FT "I kept hearing bad things about their lack of craniofacial specialty" however by now they probably have more experience doing Type III surgeries than a lot of FFS surgeons who are board certified craniofacial surgeons.

In another comment you wrote something about "passing".  "Passing" is an interesting word, I've read enough over the years about people getting FFS who still don't "pass".  When they post their pictures they look female.  While having FFS helps, it's not the only thing that clue other people to your gender.  Your demeanor, the way you carry yourself is also very important.  I transitioned in 1980's, before all the facial bone work was available to us.  I "passed" for years before getting FFS.

I wish you the best.

[Maybebaby56]

I hope I am realistic. I'm not looking for a surgeon to make me a supermodel, I just want to pass. What I want is to not have to stress about hair and makeup and still look female. Attractiveness is another thing to me. But even so, it's hard to know who could feminise my face the best.

Hi Sophia,

First of all, you already look damn attractive.  You already pass.  That said, I can relate to some of what you feel.  I was never as pretty as you, but when I was presenting as female in public part-time before FFS, I seemed to pass well enough.  I didn't ever see anybody staring at me; I didn't get any rude comments, and I even stood inline in the ladies room without problem. But I didn't feel comfortable. I didn't have confidence in who I was. I think that it really what you are looking for.

As far as picking a surgeon, it comes down to a matter of faith.  You will find positive and negative comments about every FFS surgeon there is.  I had personal conversations with three FFS surgeons.  I first saw Dr. Harrison Lee in Beverly Hills.  Surgeon to the Stars (he did Caitlyn Jenner). Triple board-certified in maxilofacial surgery, plastic surgery, and head and neck surgery.  Very nice guy.  Very expensive. He quoted me about $58K USD for a variety of procedures. I just could not afford that.

I next went to Dr. Eric Bensimon in Montreal. Very nice guy. Great reputation. He suggested a much more conservative approach for much less money (about $20K USD). 

I then went to Dr. Mark Zukowski in Chicago, who suggested a very aggressive approach, everything from my scalp to my trachea, for about $35K USD. I went with Dr. Z. Why? Little things.  For one, he noticed that one of my orbital rims was slightly higher than the other, and that I had a deviated septum.  He saw that on the first 60 seconds he looked at me.  Neither of the other surgeons noticed, or commented on that.  Secondly, he explained exactly what each procedure would accomplish and why.  Thirdly, he backed up his work 100%.  If anything didn't turn out right, he would fix it free of charge.  He also has tremendous follow-up care.  His office is very responsive, and he even gives you his personal cell phone number.

Bottom line is go with someone with a solid track record, who you feel you can trust, and is reasonable for your schedule and bank account.  There is no "best" surgeon.  There is only the surgeon that you feel is best for you at the time. It is always a roll of the dice.

With kindness,

Terri

[IglooAustralia]

I've been researching FFS for over a year now, mostly lurking and compiling information on surgeons. I know what I would like done and have enough money and can loan a small amount. But I'm so lost as to who to go to and it's left me feeling depressed and stagnant.

Girl i'm exactly at the same point as you right now. No surgeon seems good enough for me anymore. I been researching FFS for around 3 years, but the last year is when i started looking more deeply into it. At the beggining of my transition i said to myself that i'm gonna wait 2-3 years to see what hormones can do and after that get all my problem areas fixed. But now that i'm getting closer and closer to that point + after looking more into FFS i'm starting to think that there is nothing that can help me "fix" my problems anymore. I'm starting to realize that i probably had the wrong impression of what FFS really can do for you, because i kept seing those big changes in girls (mostly girls who had FFS with dr. O), but now when it's time for me to get FFS i'm stuck and don't know if it's really worth it to get FFS at all if i'm gonna end up looking the same. It's seems to me like there is no aggressive surgeon out there anymore who does forehead 3 reconstruction + GOOD work on the nose. Like i see girls going to Facial Team or dr. Spiegel, getting forehead 3 reconstruction and end up looking the same from the front after FFS (but have a better profile i guess), but then i see girls going to dr. Zukowski or dr. Mayer (two surgeons who don't do forehead 3 reconstruction) and end up looking way better and feminine than girls who had forehead 3 reconstructiuon, just with an more un-natural profile, i guess. I been considering dr. Dimaggio for a while as well but he seems to not be able to setback the glabella region, so he's out of the question as well. Dr. Deschamps Braley seems to be really good with foreheads but from few of the results i seen from him, he seems to have a problem with lifting up the tip of the nose and makes it look really weird and unnatural ( i don't know how to explain correctly but if u don't have a good starting point on your nose he will most likely give you that look). And for dr. Bart he seems to do an ok job with setting back the sinus area and i seen in some cases that he can be really aggressive on the orbital rims but his nose results really aren't that great.. so yeah...
And sorry for my bad english lol, after re-reading what i just wrote i realized that the structure of my sentences is really repetitive and hard to read.

[Ypsf09]

Girl i'm exactly at the same point as you right now. No surgeon seems good enough for me anymore. I been researching FFS for around 3 years, but the last year is when i started looking more deeply into it. At the beggining of my transition i said to myself that i'm gonna wait 2-3 years to see what hormones can do and after that get all my problem areas fixed. But now that i'm getting closer and closer to that point + after looking more into FFS i'm starting to think that there is nothing that can help me "fix" my problems anymore. I'm starting to realize that i probably had the wrong impression of what FFS really can do for you, because i kept seing those big changes in girls (mostly girls who had FFS with dr. O), but now when it's time for me to get FFS i'm stuck and don't know if it's really worth it to get FFS at all if i'm gonna end up looking the same. It's seems to me like there is no aggressive surgeon out there anymore who does forehead 3 reconstruction + GOOD work on the nose. Like i see girls going to Facial Team or dr. Spiegel, getting forehead 3 reconstruction and end looking the same from the front after FFS (but have a better profile i guess), but then i see girls going to dr. Zukowski or dr. Mayer (two surgeons who don't do forehead 3 reconstruction) and end up looking way better and feminine than girls who had forehead 3 reconstructiuon, just with an more un-natural profile, i guess. I been considering dr. Dimaggio for a while as well but he seems to not be able to setback of the glabella region, so he's out of the question as well. Dr. Deschamps Braley seems to be really good with foreheads but from few of the results i seen from him, he seems to have a problem with lifting up the tip of the nose and makes it look really weird and unnatural ( i don't know how to explain correctly but if u don't have a good starting point on your nose he will most likely give you that look). And for dr. Bart he seems to do an ok job with setting back the sinus area and i seen in some cases that he can be really aggressive on the orbital rims but his nose results really aren't that great.. so yeah...
And sorry for my bad english lol, after re-reading what i just wrote i realized that the structure of my sentences is really repetitive and hard to read.

It's pretty sad that some of us feel this way(though it's not just a feeling but a fact too). One would think FFS should have become more advanced since its invent from Dr O times, but judging just based on results, I think it's the other way. Too bad there aren't many(if any) equivalents of Dr O now, because so far he was the only guy that could transform a very male looking face into a undeniably female one(Dr Christine McGinn is one of the many spectacular results of his).

I was not as well informed as you guys when I signed up for my ffs(one year ago), but I did know one thing that despite of the starting base, most of us need/could use a aggressive approach which is what is often required in delivering an undeniably female face. Hence I choose Dr Deschamps who still is a lot more aggressive than other surgeons. And even though I will get more surgeries, I like his work on me a whole lot more than results from other surgeons.

[Debra]

For all my surgeries I've always interviewed and researched a few surgeons before deciding.

Factors included seeming expertise/results as well as how comfortable they made me feel. It can be different for everyone though.

[IglooAustralia]

It's pretty sad that some of us feel this way(though it's not just a feeling but a fact too). One would think FFS should have become more advanced since its invent from Dr O times, but judging just based on results, I think it's the other way. Too bad there aren't many(if any) equivalents of Dr O now, because so far he was the only guy that could transform a very male looking face into a undeniably female one(Dr Christine McGinn is one of the many spectacular results of his).

I was not as well informed as you guys when I signed up for my ffs(one year ago), but I did know one thing that despite of the starting base, most of us need/could use a aggressive approach which is what is often required in delivering an undeniably female face. Hence I choose Dr Deschamps who still is a lot more aggressive than other surgeons. And even though I will get more surgeries, I like his work on me a whole lot more than results from other surgeons.

To be honest, you're the only girl i seen so far, who went to dr. Deschamps and had great results with the rhinoplasty, but if i remember correctly you posted your before photos at some point and your nose didn't seem that bad at the beginning. Honestly i was considering going to dr. Deschamps but knowing that just the forehead work + rhinoplasty cost around 32k + i still need work done on my jaw and chin so even if i go to anothe doctor or to Korea it's going to cost me around 10-15k + i would probably have to get revision rhinoplasty which is around +10k with a good doctor = not something i can afford, lol. I know it might seem like i'm being a bit too harsh on dr. Deschamps, especially because i only seen 4 FFS results of him so far, so maybe i'm drawing conclusions way to early, but if i'm going to pay 20k just for the forehead and nose (without scalp advancment which is extra +4k) + 12k on medical fees i would expect the results to be A+.
And ps girl, thanks for sharing your transition process here on susans. I'm not posting on here too often but i check this forum all the time and you are one of the girls on here, who i learned the most from.

[Ypsf09]

To be honest, you're the only girl i seen so far, who went to dr. Deschamps and had great results with the rhinoplasty, but if i remember correctly you posted your before photos at some point and your nose didn't seem that bad at the beginning. Honestly i was considering going to dr. Deschamps but knowing that just the forehead work + rhinoplasty cost around 32k + i still need work done on my jaw and chin so even if i go to anothe doctor or to Korea it's going to cost me around 10-15k + i would probably have to get revision rhinoplasty which is around +10k with a good doctor = not something i can afford, lol. I know it might seem like i'm being a bit too harsh on dr. Deschamps, especially because i only seen 4 FFS results of him so far, so maybe i'm drawing conclusions way to early, but if i'm going to pay 20k just for the forehead and nose (without scalp advancment which is extra +4k) + 12k on medical fees i would expect the results to be A+.
And ps girl, thanks for sharing your transition process here on susans. I'm not posting on here too often but i check this forum all the time and you are one of the girls on here, who i learned the most from.

You are so welcome. I hope I don't come across being too forward/aggressive or critical about the ffs field. But I feel we deserve much better outcomes overall regardless of the surgeon especially in the western world where ffs is so expensive.

Agree my nose was in pretty good shape to begin with, so that needs to be considered when judging my results. Also if one doesn't have unlimited funds to get revision work(which one may require and important to factor that in), I would avoid the expensive ones. Dr MDM does good forehead work too, especially for his price I would categorize his work as excellent. I would rather get forehead+ Basic nose done with him. And later get a revision rhinoplasty, jaw, chin work elasewhere(probably Asia,Korea). That way you still are going to the best in the respective areas and paying much less.

Did you have a consult with Dr MDM? If not maybe you should and ask him personally what are the limitations in setting back the glabella+ nasion and how far back he could go in your case.

Thanks.

[Sophia Sentiment]

Your demeanor, the way you carry yourself is also very important.  I transitioned in 1980's, before all the facial bone work was available to us.  I "passed" for years before getting FFS.

Hi deeiche, thank you so much, your information was great. As for passing, you are right, a lot of other things can help with passing. However, my voice, mannerisms, movements are all pretty good. I get clocked in photographs on dating websites by my face alone. I also have people who might say "Excuse me, miss" and when I turn around they gasp "Oh I'm so sorry! I meant sir!". I have a feeling my face is something specific that does betray me.

First of all, you already look damn attractive.  You already pass.

Hi Terri/Maybebaby56, unfortunately my profile photo is not me. I wish it were! It's a favourite singer of mine, Florence Welsh from "Florence and the Machine". I'm also a read-head, so I guess it's just wishful thinking! But hearing you write about your experience is truly encouraging. I think we do have this in common, this need to feel comfortable. I pass very rarely but I still need that feeling of confidence to stand in public with other women. I think FFS will help.

But now that i'm getting closer and closer to that point + after looking more into FFS i'm starting to think that there is nothing that can help me "fix" my problems anymore. I'm starting to realize that i probably had the wrong impression of what FFS really can do for you

IglooAustralia, I too worry that nothing can fix my problems. It's a scary thought but I think I've also gotten to a stage where I realise there are no other options for me but to pick the best available. I may simply have an ugly face and I could end up passing and still be unsatisfied. Perhaps this is the curse of losing the genetic lottery?

(Dr Christine McGinn is one of the many spectacular results of his)

Ypsf09, I totally agree Dr Christine is absolutely gorgeous. Even though she looked "male" beforehand, she did have a short face and soft eyes which can help immensely. My face is very long so I do worry even with softened features I may still be too proportionally wrong. I sincerely hope not. I think the thing I try to remind myself is that often, even with Dr. O, the most successful FFS patients had beautiful canvases to work with to start with.

[jamjam]

Hi Sophie, surgery is always a leap of faith it seems with large quantities of expectation management required, balancing our desired outcomes with a realistic outcome is always hard. Will it be enough .........

What might help is looking at females in your family that share similar features as you. A surgeon will most likely get you to a female family version of yourself if you know what I mean. It gives you an idea of what could be possible and what you might end up with.

All the best with your decision,

jj

[Meshi]

What FFS procedures were you looking to have done? 

[audreytn]

Dr. Terrance Murphy is in Denver, CO and has gotten a lot of positive feedback amongst the trans community here in Denver.

http://murphyplasticsurgery.com/

[Sarah leah]

I am in the process of looking too. I hope to get FFS in the latter half of 2017 as I have only started on hrt in the last 8 weeks.

The person I am considering is Dr. Lazaro Cardenas, as he is going to do my liposuction fat transfer when I get my forehead and nose done.


He is in Guadalajara, Mexico which means a 35 hour flight if I do go there.

http://transop.com/index.php

[audreytn]

disregard my recomendation

[tarabel]

Choosing an FFS surgeon is a big decision.  There are a lot of pros and cons for each surgeon.  Don't let travel be something which dissuades you from picking a particular surgeon - travel only adds a day or two to your itinerary and a great result lasts forever.

[alejandratx]

Im a bit a ways from this but the thought of surgery well any surgery rather is just theres no guarantee of results. you pay anywhere from a few thousand to who knows how much. and if its not how you wanted it, not how the doctor said it would be well thank you for your money. pay us again to fix it. ill have enough savings to do it right once but not twice or go back and have to fix errors.

[Doreen]

I went to Dr. Cardenas in Mexico, and personally would recommend him.  It helps if you speak some spanish, but by no means required (Saw another gal there who didn't speak a bit of it).  I had type 1 forehead brow reduction, orbital rim, hairline lowered, upper lip, jaw recontouring, and some fat injections too, along with a facelift.

I get hit on now by guys.. gals tell me I look gorgeous.  They didn't before.   That alone is enough to convince me it worked.  That and the b4/after kinda makes it obvious too.

Hope this helps someone.