NOTE: In March 2018 my surgeon was switched to Drs Kleinberger and Shih after Dr Gill became unavailable.As a result of a
grievance I had filed with Kaiser, I received a referral for an evaluation by
Dr. Roop Gill with the Kaiser Sacramento office.
The appointment took a little over an hour. Dr. Gill updated her notes on my history and discussed my goals (gender dysphoria relief and safety) in wanting FFS. She took a complete set of photos, and then we sat at her computer terminal and went over the images. We discussed details of changes, difficulty, recovery and risks, all sorts of things. This was a more thorough evaluation than I had previously had.
We looked at my CT scans, both slices and volume renderings, and decided on the bone & cartilage work needed:
Brow reduction by opening and reconstructing the frontal sinus (Osterhouts type 3 procedure).
Orbit reduction by burring
Slight nose reduction, with a 'break' before the tip, a more feminine trait. No change in the bone structure setting the width, but removal of some soft tissue near the tip. No rotation needed.
Lip lift via an incision below the nose.
Shaving of bone to narrow the chin, soften the angle at the mandibular joint
Tracheal shave
Soft tissue work:
Eyebrow raise as part of bone work.
Suggested facelift, fat padding at deficit under the eyes, neck tissue, blepharoplast to open eyes further
Since we don't want to remove tracheal cartilage close to the vocal folds attachment point, a needle is inserted and position checked with a camera in the throat to verify the safe margin for tissue removal. The cartilage is shaved, or burred if calcified.
The forehead work will be done with a hairline incision. She suggested I bring by favorite hairpiece in so they could properly mark the incision on the surgery date! The frontal sinus bone will be removed and reset inward. My sinus bulge is unusually low so this may impact how much reduction can be done.
A blepharopasty would currently be covered for the right eye. (Pretty droopy; eyelashes touch the drooping tissue). This may change with the forehead work and brow lift.
The mandibular reduction involves burring at the joints and chin.
Dr. Gill would be performing the surgery with the department head observing. The procedures would be scheduled for mid-April or later, as soon as the OR schedule opens up for surgery planning.
Dr. Gill is new to Kaiser, but has been doing maxillofacial surgery for some time, including pediatric patients, who have relatively little bone to work with. She seems to have a good aesthetic sense as well as the right skills. As this surgery would be a full year sooner than what I had previously been waitlisted for, and I do like this doctors suggestions, sense, and skill set, I'm inclined to go with her for my FFS work. This may also be the only way I can get FFS done with insurance coverage. (See my link to the grievance post at the top of this post.)
I'll follow up with additional FFS activity with Dr. Gill in this thread.
