What FFS procedures are usually unnecessary?

[scrambledeggs]

I recently had a quote for FFS. I don't have it in writing yet but the approximate cost will be $40k USD. I can already pass as a woman (if I wear a wig -- my hair is still growing out) so I honestly didn't think it would be so much money to make me look prettier. Oh how wrong I was!

I know surgeons want to get the most money as they can and I want to avoid unnecessary procedures. So I'm wondering what procedures are usually considered unnecessary in terms of feminization? Here are the procedures we discussed:

• Scalp advancement: I'm actually at a Norwood Type II. The surgeon said he can guarantee 1/2 inch of central advancement and 3/4 inch lateral advancement but I still might need up to 2000 hair grafts to feminize my hairline. This is one of the procedures I was interested in when I went in.
• Fat injections: I didn't think I'd need fat injections but the surgeon wants to round out my face a little more and fill in around my cheeks and temples and frown lines. I've only been on hormones a week so I want to wait to see how much of my face fills in on it's own before deciding to do this.
• Rhinoplasty: This is something else I wanted done because I want a cuter nose. I have a mole on my nose and the surgeon isn't sure it can be removed which is very disappointing.
• Lip lift: My lip-to-nose distance is a little too long. This is another procedure I knew I wanted
• Forehead contouring, Type I: Another procedure I knew I wanted/needed. I don't have a bad brow ridge so I think type I is good enough
• Masseter muscle shave:I do have a little bit of a squarish jaw but didn't think it was a huge deal. I haven't read too many accounts of people being happy with this procedure and I think HRT alone might reduce my masster enough
• Chin contouring: I have a somewhat square chin so this involves grinding down the bone and evening it out
• Tracheal shave: This is another procedure I didn't think I'd need. You can't even really see my Adam's apple as it's so small but the surgeon said doing the chin contouring involves tightening the skin which will make it more prominent. It adds <$1000 USD to the cost of the procedure so I might get it done anyway.

I think if I could get the total cost down to around 30k plus 8k for the hair transplants if I need them later I'd be a lot happier with moving forward. I'm curious as to what everyone's consensus is on what is necessary and isn't when it comes to FFS.

[AnonyMs]

Regarding the mole, it may be that it can't be removed during the ffs rather than it can't be removed at all.

There's a paid service that might be able to help you with this. I've been thinking about doing it myself.

http://virtualffs.co.uk

Quite an interesting site as well.

[scrambledeggs]

Regarding the mole, it may be that it can't be removed during the ffs rather than it can't be removed at all.

There's a paid service that might be able to help you with this. I've been thinking about doing it myself.

http://virtualffs.co.uk

Quite an interesting site as well.

Thanks! I actually paid Alexandra for her services a few weeks ago and I'm still waiting for her photos and assessment. In the meantime I figured it would be worthwhile to poll the community and see what procedures ladies were generally happy with and which they weren't.

[AnonyMs]

Could you let us know how that goes?

I've heard its not necessarily accurate, but it is helpful.

[scrambledeggs]

Could you let us know how that goes?

I've heard its not necessarily accurate, but it is helpful.

Definitely!

[josie76]

I think often fat transfers, cheek implants, masseter muscle cutting are all kind of extra and can be over the top. I know I have had cheek implants suggested to me by 3 of 4 doctors so far. My cheekbones are not large but I think if my chin is shortened and V shaved that will change the appearance of my existing cheek bones plenty.

Tracheal shave is another one that not everyone actually needs. Some definitely can benefit while some its just extra.

Of course everyone's skull is different and everyone has different wants so -\ /-

[Sonja]

Tracheal shave is another one that not everyone actually needs. Some definitely can benefit while some its just extra.

Of course everyone's skull is different and everyone has different wants so -\ /-

I agree - I'm not sure its worth the scar let alone the money - some have had to have a revise as well....I personally would only do this if you have a pronounced adams apple...

Sonja.

[warlockmaker]

Each person has a look they want and deem its necessary. Many are restricted because of finance as to what they can do. Some need extensive work to look feminine, others very little. I had a facial rejunivation facelift, brow shave, neck skin tightening, eyebrow lift, minor rhino and my teeth completely redone by a cosmetic dentist ( the most expensive costing usd 50,000). I have botox every 4 months on the upper portion of my face and some filler in smile line and lips every 18 months. But then again I'm 70 years old.

[Sonja]

Each person has a look they want and deem its necessary. Many are restricted because of finance as to what they can do. Some need extensive work to look feminine, others very little. I had a facial rejunivation facelift, brow shave, neck skin tightening, eyebrow lift, minor rhino and my teeth completely redone by a cosmetic dentist ( the most expensive costing usd 50,000). I have botox every 4 months on the upper portion of my face and some filler in smile line and lips every 18 months. But then again I'm 70 years old.

@warlockmaker
70!?!  Wow - Your avatar pic looks great.

Sonja.

[Linde]

But then again I'm 70 years old.

If that avatar picture is your current picture, I can only say wow!  That would mean that there might be the chance that I do not need to look like an old hag!

[Dani]

Getting back to the original question, "How much FFS is needed?", it really depends on how old you are. Younger transitioners usually do not need any FFS, while the middle age and older transitioners need quite a lot.

Surgeons often will quote you every procedure that they do. It is not a matter of money, but they feel that they need to make you aware of everything that they can do for your face. You must decide what you want done.

[Ethelind]

I probably wouldn't touch muscle or fat only one week after HRT. I would wait see the impact the hormones end up having on those areas first.

The scalp advancement is probably unnecessary as well if your hair has only receded in the corners and not in the front but you may want to fill in the corners instead. It's hard to be sure though without seeing your hairline but Alexandra will be able to tell you. I also made an assessment with her and it definitely helped a lot in clarifying what I need and what I don't.

[scrambledeggs]

I probably wouldn't touch muscle or fat only one week after HRT. I would wait see the impact the hormones end up having on those areas first.

The scalp advancement is probably unnecessary as well if your hair has only receded in the corners and not in the front but you may want to fill in the corners instead. It's hard to be sure though without seeing your hairline but Alexandra will be able to tell you. I also made an assessment with her and it definitely helped a lot in clarifying what I need and what I don't.

Oops! I should have said that I'm just getting quotes and researching now and that I don't plan to have surgery for 9 to 12 months.

I'm anxiously waiting Alexandra's reply. I think it's receded a bit in the front, too, but I've always had a high hairline.  Scalp advancement was actually one of the procedures I'm looking to get.

I can save 6k by not doing the jaw/masseter muscle work since I don't think I really need it.

[scrambledeggs]

Getting back to the original question, "How much FFS is needed?", it really depends on how old you are. Younger transitioners usually do not need any FFS, while the middle age and older transitioners need quite a lot.

Surgeons often will quote you every procedure that they do. It is not a matter of money, but they feel that they need to make you aware of everything that they can do for your face. You must decide what you want done.

I'm in my mid 30s and passable now so it's debatable if I 'need' it at all. However, in order to pass I have to wear a wig since my hair is still growing out. My hairline is a major source of dysphoria for me so it's the main thing I was hoping to correct. I figured if I'm doing forehead/hairline then I might as well do rhinoplasty and have a cuter nose, and the lip lift to shorten that distance up. My chin is a little broad so there's chin contouring but he said a whole lower facelift is needed otherwise I'd have loose skin. He said the lower neck facelift requires trachea shaving even though I barely have an Adams apple. That's because the tighter skin will make it obvious .

So the main things I'm hesitant about are the jaw work, fat injections and trachea shave.

[Linde]

He said the lower neck facelift requires trachea shaving even though I barely have an Adams apple. That's because the tighter skin will make it obvious .

So the main things I'm hesitant about are the jaw work, fat injections and trachea shave.

I know quite a few cis women that have some kind of Adams Apple, and they are still pretty attractive females.  I would be weary to have a trachea shave done if there is nothing really to shave.  The voice box is very close there!

I think one can overdo it, and looks more female than most women, and results in an artificial look!

[AnonyMs]

Each person has a look they want and deem its necessary. Many are restricted because of finance as to what they can do. Some need extensive work to look feminine, others very little. I had a facial rejunivation facelift, brow shave, neck skin tightening, eyebrow lift, minor rhino and my teeth completely redone by a cosmetic dentist ( the most expensive costing usd 50,000). I have botox every 4 months on the upper portion of my face and some filler in smile line and lips every 18 months. But then again I'm 70 years old.

Would you mind elaborating a bit more on this. Does it include the FFS by PAI? What does a cosmetic dentist do? Which part was $50k?

[warlockmaker]

Hi AnonyMs, The teeth costs USD 50,000. All the other procedures cost around USD 36,000 then the GRS another USD 8,000. I live in Bangkok thus no accomodation costs. I have a private nurses and now an assistant, she was an indispensible help . Other than the teeth, PAI performed the surgeries.

Dietlind, yes that me. I also had professional make up classes, weekly facials, both very important. Constant hair care and living a healthy life The key is daily beauty regime, and diet.  Im 5ft 7ins, 130lbs.

[Linde]

Dietlind, yes that me. I also had professional make up classes, weekly facials, both very important. Constant hair care and living a healthy life The key is daily beauty regime, and diet.  Im 5ft 7ins, 130lbs.

I can only say wow!  If I ever get close to your looks, I  will be pretty happy.  My hair is OK, my skin is pretty OK because of my Klinefelter Syndrome, but I have more wrinkles than one can wish to have.  I never wear sunglasses and live in a very sunny are.  That makes me squint ll the times and that causes wrinkles!  Weight is not a big problem with me either, I am 6' and have about 190 lb, but plan to loose about 15 lb.  I am Type II diabetic, and that forces me to eat very healthy.  It is the skin of yours that makes me say WOW

[warlockmaker]

Dietlind, Sun damage to the skin is very difficult to correct. The skin become non elastic with deep wrinkles. Surgeons doing FFS have refused surgery on badly sun damagef skin until treated I belueve there are a umber of treatments to soften the skin like acid peelsI, laser Hifu, etc.  I loved the sun but I am Eurasian and our skin handles the sun much better. I have ceased going out in the sun too much.

[Linde]

Dietlind, Sun damage to the skin is very difficult to correct. The skin become non elastic with deep wrinkles. Surgeons doing FFS have refused surgery on badly sun damagef skin until treated I belueve there are a umber of treatments to soften the skin like acid peelsI, laser Hifu, etc.  I loved the sun but I am Eurasian and our skin handles the sun much better. I have ceased going out in the sun too much.

I don't think that I have any sun damage, my skin is very soft (people with intersex conditions mostly do not get any of the hard male skin), My problems are just the wrinkles around my eyes from squinting.  I also avoid the sun as most people in very sunny areas do, only tourists are really suntanned around here.

Even tough my skin is very soft, i can not measure up to you at all.  Those computer programs that do face recognition and age guestimation always make me about 20 years younger than I am, but I look ancient compared to you!

I still have to say WOW, what a top looking face!