Background: I had only ever considered Dr Spiegel and Dr Harrison Lee (I had been wanting this for years. I had decided on these two before CJ ever even went to Lee) but I had a friend go to Dr S and I liked her results so I chose to go to him also. I didn't feel passable prior to surgery although people told me I was and I had been living full time for 2 years and people always called me ma'am or miss, etc but I would say for the sake of this I was mostly passable. I was concerned with my nose, cheeks, chin and forehead/hairline. I ended up getting the forehead/hairline stuff done as well as cheek implants and rhinoplasty (at a later date I got filler injected into my chin to augment which I was pleased with) I think the total at that time for FH/closed rhinoplasty/cheeks was 25-27k.
Office Staff: (Fall 2015) I did have an issue with one staff worker at his office. I signed up to meet with him at a conference and I spoke with her that everything was confirmed except the time of the appt and she said yes. 3 days later she called and said sorry we have to change your consult from Saturday to Thursday and i'm like, I'm not going to be there Thursday, I already booked my flight because you told me only the time would change, if anything. I don't think she did it maliciously, I think she made a mistake and refused to own up to it. I was so upset though because we had a conference call and she flat out lied but eventually I spoke with the office manager and they agreed to take the cost of my new flight out of my surgery cost due to the miscommunication which I appreciated. I don't think that any of the staff are still there now though. Katie the financial person is there and she's super sweet but I think the manager and everyone else are different. Stand up for yourselves ladies! Also I hate his office. The rooms are extremely cramped and the chairs are positioned so awkwardly. He has to sit beside you so to talk to him you have to turn your head 90 degrees. Also at this time I had had a trach shave done in Beverly Hills and BA done at a new center near my home so I was used to fancy, luxe places and that's just not what you get there. It is clean but not fancy by any means.
Actual Surgery: I was lucky enough to have a friend who lived an hour and a half or less from Boston and she stayed with me in a hotel near the hospital the night before the surgery and went to surgery with me. I had to be there super early 6am for registration and all of that. Went back to see the nurse, get undressed, her ask me 100 questions, etc. It got so chaotic. I'm a nurse, I told her exactly where to put my IV and she couldn't get it although I have good veins. So then she left, and another nurse came in to try to start one while the original nurse was asking questions, Dr S came in to talk to me about what we were going to do, then The anesthesiology resident came in to talk to me about stuff there were times when I felt like my head was going to spin because they were all asking so many questions. This was my first surgery at an actual hospital and perhaps that's what it's like? I don't know- I don't work in a surgery type of area but I know that the 2 prior surgeries I had at this point were much calmer, relaxed, planned well, one person at a time, etc. So that was a little overwhelming. Next thing I knew I was waking up after the surgery. They wheeled me on the stretcher to my room and I was so nauseated. I do get nauseated fairly easily and I told the anesthesiologist that, and he said he would do everything to prevent me from getting sick but I was still sick to my stomach. I finally got to the room and I begged them to leave the stretcher because I knew if I got up I was going to puke.
I vomited blood I think 7 times from around noon til about 1AM. Dr S never came to see me after the surgery only his fellow and the resident on call. (I was upset about this because I felt like he could have at least said hi) I felt bad because the nurse had to keep paging them because I kept vomiting and my nose kept bleeding. Eventually the resident changed my meds to IV and ordered me afrin nose spray to help stop the bleeding. The next morning the fellow and resident rounded and changed my meds to PO and OK'd me to go home. After that I was really ok. I was so so so worried I was going to have out of control pain but as long as I took my medicine as scheduled I didn't really have any outlandish pain. My only issue was the bloody nose and vomiting the first night (this was a relief!)
My friend stayed with me at her house for 2 days and nights and then she had to go out of town, I stayed at her house alone for a few more days and I think at post op day 7 or 10 I can't remember I had a followup appt with Dr S, he took off my nose cast and took out my forehead staples and sutures. I also could feel I had pockets of drainage like under my scalp and he drained those as well (it was not much but I could hear it squishing and it was annoying me)
(Note) I did have to go back and have a little growth that I had form in my nose cut out (this was 2 months later) I couldn't find anyone near me that was willing to cut it out because who knows why, so I did have to spend about another 1k flying back and going to his office for a 15 min visit but he was nice and didn't charge me to remove it or anything, plus it wasn't his fault it was just a complication. He said it may go away on it's own but I was tired of waiting after years of waiting for surgery I didn't want to be pretty but look like I had a booger in my nose lol
Results:

Am I happy? I would say I'm mostly happy 8/10. I think i will have my nose done again. He did a closed rhinoplasty and I think I would be happier had it been open and he had made the sides of my nose smaller and it is still curved like 1-2mm to the left which bothers me. No one else sees it unless I show them specifically in a pic (I didn't even notice it until he pointed it out to me at the consult now its all I see!). I also sometimes wish that my cheeks were bigger on the side (like where you highlight with makeup) They are full on the apples but I wish the other part was a little more prominent. And I did have a patch of hair about the size of a nickel fall out at the corner of my hairline which sucks so bad but again that was not his fault. I will most likely get some hair transplants there anyway.
I would say I am definitely passable - I am not out as TS thus why I don't have any photos to share. I have had people in medical settings and not medical settings think I am cisgender (asking if i've had any pregnancies or lactating, asking for a tampon, etc) which is of course something that makes me happy (and I'm the type of extra that does carry one tampon LOL)

Sorry this was so long, I didn't expect for it to be. Please PM me if you have any specific questions or reply here if you have something you would like to know.