Laura's FFS Journal

[LauraE]

May 9, 2019

It's my turn to begin a FFS thread. Given that I've rarely posted the last several months, I thought I'd provide an update.

Three years ago, when I started HRT for the first time, I lasted only about 6 weeks before freaking out, stopping HRT, and purging all my clothes. That denial lasted about eighteen months, and two relationships, when Laura popped out again, only to be rejected by my, then, girlfriend. I returned to HRT in mid-July, 2018 and over the next several months, started and stopped several times.

It was during one of these stoppages that I met a nice woman and began dating. Although I had shared my trans-status at the beginning, she was never supportive and spent a little too much time trying to convince me to be a man full-time. That relationship also started and stopped a variety of times over the course of five months, particularly when I went back on HRT in late January, stopping in late March so we could resume our love life. Still, while I really enjoyed the sex, Laura was marginalized and I knew, inside, that I'd never be accepted by my girlfriend. Now that I've broken up with her, I'm back on HRT.

So, while technically I started HRT 10 months ago, my actual time under HRT is closer to five months.

When I first started HRT three years ago, I was with Kaiser, but at the time, the only services available to trans patients was HRT. Thanks to the advocacy of many trans women, including some on Susans, a variety of services are now available for me.

I belong to Kaiser NorCal, on a Senior Advantage plan. When I met with Kaiser's MST (Multi-specialty Transitions) department in March, I was also assigned a therapist, who serves more like a case worker, checking out your progress and guiding you towards a variety of services, including voice therapy, FFS, GCS, HRT, and electrolysis. My immediate needs, though, were voice therapy and FFS, so my therapist helped arrange appointments with both. 

My first voice therapy occurred last Monday, and I must say that I've had to unlearn some things I'd learned on YouTube videos about achieving a feminine voice. I have my homework, as well as  "The Piano" and "Voice Analyst" apps to help me practice twice a day. I meet again with the voice therapist in two weeks, to check on my progress.

By the way, she told me that all of Kaiser's Voice Therapists have been trained to work with trans patients so I could have avoided the long drive to Oakland. However, given that I'm comfortable with my voice therapist, I'd rather not restart with another person.

I'm also quite pleased to have an appointment with Dr. Shih next Wednesday for a FFS consultation. I understand that the wait list is quite long, perhaps longer than a year, but a journey of a thousand miles begins with a single step. The wait will provide me more time for HRT to do its magic and for me to return to electrolysis, probably at Precision in Chicago.

I'll update after my appointment.

Laura

[LauraE]

May 15, 2019

Today, I made the 2 1/2 hour drive to Kaiser Oakland for my consultation with Dr. Shih. As written about by others, he and his PA were very helpful and respectful.

The procedures he's recommending are:
Hairline lowering
Frontal cranioplasty with orbital contouring (Type 3)
Browlift
Rhinoplasty
Lip lift
Jaw contouring
Laryngochodroplasty (tracheal shave)

In addition, he recommended cosmetic cheek injections and talked about fat injections in my lips. However, given the before/after pictures from other's lip lifts, I think the lip lift will sufficiently enhance my lips. I will opt for the cheek injections though.

As far as timeline, we're looking at a 12-14 month wait. However, they are bringing on a third surgeon later this summer, so that might speed things up just a bit.

He also recommended a face lift, but only after the initial FFS so we can see if those effects are enough. He said the cheek injections would cost around 3K and the face lift might cost 11K. Both doable....

And now the wait.

Laura

[LauraE]

November 11, 2019

Today, I received a call from Dr. Xi's office regarding scheduling my FFS. June 16th, 2020 worked best for me. The nurse told me she'd call again two or three months before the surgery for the next steps.

Spring, 2020
Then, of course, COVID struck and Kaiser halted all elective surgeries for several months, not restarting until the summer. My timeline, was busted and at the time, it was possible my FFS would have to wait perhaps six months longer than expected.

Laura

[Northern Star Girl]

@LauraE
Dear Laura:
I am so glad to see that you were able to find pieces and parts of
your FFS journal...

There is so very much good and informative sharing of your experience
as you were going through the FFS gauntlet.

Thank you for bringing it back for all of our new and old members to read.

I am sure that you will be adding more to this thread...  I am counting on it.

HUGS,
Danielle

[LauraE]

June 12, 2020

Hearing rumors that Kaiser was beginning to schedule FFS surgeries again, I called Dr. Shi's office to see if they have started rescheduling surgeries. I was told they would contact me when they have space, saying they would try to fit me in.

At this point, I'd waited 13 months since my consultation, and now I'd no idea when FFS would happen.

Laura

[LauraE]

July 27, 2020

The Squeaky Wheel
Others who were in the Kaiser pipeline shared that their being proactive helped get them a surgery date, so I called Dr. Shi's office. There was no answer, but I left a message.

Early August, 2020
It's possible my call helped, because I received a call from Dr. Shi's office that they had a cancellation for August 18th, asking if I'd like it.

Darn right I did. The race was on to prepare.

Laura

[LauraE]

August 16, 2020

Two days until FFS. In 24 hours, I'll be on my way to the Bay Area, where I'll stay overnight at a hotel two miles from the hospital. At 5am, I'll awake, take the magic potion I've been directed to drink, and at 6:45am, the hotel shuttle will take me to the hospital entrance. Around 8am, two of Kaiser's best will spend 10 hours making me look like I got run over by a truck. For the week afterwards, I'll wonder "What the hell have I done?", "Will this actually help me look more feminine?" And "Everyone's going to know that something's up".

And so it goes.

This path has been tread by many others and their stories will encourage me through the hellish first few weeks as I wait for the swelling to slowly go down, the incisions to heal, and Laura's new face to appear. I have supportive friends, a great network here, and time.

Onward.

[LauraE]

August 22, 2020

Post-Op Day Four
I am alive and because so many of you have detailed your post-op journeys, I have a wonderful perspective to judge against my current experience. This has allowed me to stay calm as my face transitions to the new Laura.

Surgery was Tuesday, August 18th, which went quickly. The worst day was the next day, Day One of my recovery where my left eye swole shut and my right eye came close to it. Beginning on Day Two the swelling around my eyes began to disappear and my bruises began to subside. Swelling, which is part of the process, wlll continue for some time but will get better.

Pain has been manageable. I've avoided taking Oxytocin, but advice from others to keep taking your other drugs, regardless of your pain or lack of pain, has been important. Both Motrin and Tylenol are taken at regular intervals to ease headaches and I'll continue this for awhile. Otherwise, I'm pleased with our pain management.

A good friend, a retired nurse, brought me home from the hospital and cared for me through this morning. I'm at the point where I feel comfortable changing the dressing, but having a nurse around has been a blessing.

Probably the hardest part for me was that my cat didn't recognize me the first two days and was quite unfriendly. Now on day four, everything is back to normal, as Cessna (my cat) sees who I am.

I'm not sure what I'll look like when this is over, but I feel calmness knowing my doctor is an expert, that the incisions are healing well, and that eventually Laura will appear. It's all good.

<coda> In reality, I looked like I'd been run over by a truck. I have pictures, but I'll spare you the pain.

Onward.

Laura

[LauraE]

September 15, 2020

Post-Op Day 28

Well, it's much better to be at the four-week mark than the day after. I've returned to all my normal activities, and I'm being a good girl about dressing my incisions to make sure they heal well.

Bruises: Not all bruises have disappeared. Small areas on both cheeks have a faded bruise that is visible and I still have one stubborn one beneath my left eye. It's a quarter-moon shape and while it's shown some sign of getting smaller, it's still prominent. I can wait until my follow-up appointment in 10 days before complaining.

The dissolvable stitches in my mouth are still present, although soft, and they often irritate my gums. Having thought these would have broken up by the three-week mark is disappointing, but I'm willing to wait for my next appointment. Numbness along my chin and jaw, as well as my forehead and head is still present.

While the doctor's instructions say I can wear my glasses normally now, I'm going to continue sleeping on my back for two more weeks as well as taping my glasses to my forehead. Given that I've read that it takes six weeks for the nose to fully heal, I don't want to do anything to mess up this new and expensive nose.

Hoping some of the swelling disappears at the two-month mark.

Onward.

Laura

[LauraE]

October 6, 2020

Post-Op Day 35
Other than the pain caused by the staples in my head the first week, the sole source of pain the last four weeks has been from the stitches in my mouth as they constantly irritated my gums. Last week, the stitches finally began falling out and the last one disappeared yesterday. It's quite amazing how quickly my gums recovered. Now, brushing my teeth is much more comfortable.

The bruising I've written about has gotten better as the small areas on each cheek have all but disappeared and the 1/2 moon bruise below my eye is fading fast. Thank goodness. I'm finding that now that I can wear my glasses normally, they don't fit the same, since my nose is shaped differently. Fortunately, I have an eye doctor appointment tomorrow so I'll have both pairs (one for tennis and one for everything else) adjusted to my new nose.

I'm certain there's still some swelling, particularly on my jaw and chin, but time will take care of that. I've been pretty loyal about applying the ScarAway roll-on during the day and the strips at night so my incisions heal with minimal scaring. The only other concern is the numbness I feel in my jaw/chin line, my forehead and my head. This, I know, takes much longer to heal so I'm being patient. I do have a follow-up appointment with my surgeon this Friday so I'll have an update with answers to some of my concerns next week.

Onward.

Laura

[LauraE]

Post-Op Day 42 (Six Weeks)

At six-weeks post-op, bruising has finally disappeared, although swelling continues and will take another 5-6 months to return to the new normal. Although I had started to wear my glasses normally, I'm finding some pinching on my nose, so I'm continuing to tape my glasses to my forehead (quite attractive) about 50% of the time.

Last Friday, I drive into the Bay Area an appointment with Dr. Shih. I had debated going as Laura, but was cautious because my nose was still sensitive, but in the end, Laura won out. After I dressed and did my make-up, I took a few pictures so I could compare Laura Now to Laura in July. When I placed the pictures side by side, I really couldn't see any difference. Now, I know FFS results in subtle changes, but as hard as I've been looking, I've not seen any difference. Most likely, this is due to the swelling,

The doctor was really nice and heard my concerns. He pulled up the pictures they had taken during my consult last year and showed me the work they had done. Given that my nose, chin and jaw are still swollen, it will take awhile for the final results. He said it could take a year for my nose swelling to go away and up to six months for my facial swelling.

So, of course, I'll wait.

Waiting is what we MTF's do.

Next appointment in six months.

Onward.

[LauraE]

November 18, 2020

FFS Post-Op, Three Months
It's a relief to reach the three-month mark for my FFS, although little has changed the past month.

First, regarding my nose, which was injured by a swift tennis ball a month ago. Swelling and numbness from that event seems to have subsided and while i've reported that i didn't think there was any damage, i am feeling little bumps along the sides and on top when i run my fingers up and down my nose. This may just be being too cautious because i see no visible effects when i look in the mirror. For now, i'm content to wait for my next follow-up appointment in 3-4 months to ask the surgeon's advice about my nose and any recommended revisions.

Because swelling is supposed to slowly lesson over the first six to 12 months, it's difficult to report on how my face looks now compared to a month ago. I do know that the top of my head still has no feeling, although i often have phantom itches that i can't scratch. Numbness along my jaw, chin and bottom lip seem to be improving, although it still feels like i've just been to the dentist and the Novocain is slow to wear off.

One effect of my FFS is that i'm now feeling more confident about being Laura in public. i can't say i pass, because i still see <deadname> when i look in the mirror, but i'm humbled when my friends here, and in RL, say that i am. i hope i can begin believing that soon. LOL.  Of course, hiding my face behind a face mask doesn't hurt.

Onward,

Laura

[LauraE]

December 18, 2020

FFS, Four Months Post-Op

It's only Four months? It feels like longer since i looked like i got run over by a truck.

Little has changed since my three month report. However, the incision inside my mouth, which had been swollen since surgery, has now returned to normal.  No one would notice, except me when i would run my tongue along the bottom insides of my mouth.

Otherwise, I can't tell if i look any different now than i did at the three month mark. Numbing, which includes complete lack of feeling on the top of my head, limited feeling in my forehead, a stiffness in my nose, and numbness along my jawline, chin and lower lip, continues.

Now,  i do realize that after surgery nerves take about a month off before beginning to regenerate, after which they may grow at 1mm/day. That surgeons say it could take a year before i regain feelings, tells me that there's lots of growing to do. i'm also away that I may never regain feeling in those parts of my face and head. If that's the cost of the process, i'll be fine. However, i'm rooting that some sensitivity returns.

For the past several months, i've sometimes felt an itch on my head that didn't respond to scratching, which may be a sign of nerve growth. OR, it could be that nerve endings are like cats; they can be jerks at times.

Onward,

Laura

[LauraE]

February 18, 2021

Six Month FFS Post-Op Report

It seems years since i got my FFS, but then so much has happened the past six months that FFS seems distant.

The hardest part of transition, apart from the fear, is the difficulty in seeing Laura when i look in the mirror. I knew beforehand that i'd be relying on FFS to make my face more feminine and, if successful, i'd have the opportunity to be Laura in public.

Well, by the six week post-op mark, Laura made her debut with a good friend as we went out to lunch and do some shopping. I'm still very fond of the picture of me that day. Over the past six months, i'm assuming much, if not all of the swelling, has gone down, but i'm hard pressed to see any differences between my two-month pictures and today's.

When i look in the mirror today, i do see some differences, but sans make-up and wig, i have trouble seeing Laura. I'm much more comfortable and confident once i'm put together for the day.

Numbness on the top of my head, chin and lower lip still seems to be the same and while it's possible i'm regain sensation, i'm not holding out hope. I'm not bothered by this either. I'll ask a few questions during the next post-op consultation with the surgeon, whenever that is. Numbness along my jaw seems to be a bit better.

In all, i'm glad i took this step. I'd never have the confidence to out myself to everyone and go full-time without it.

Laura

[LauraE]

August 18, 2021

One-Year, Post FFS Report

It's hard to believe that i received FFS one year ago. Oh, i understand the impatience we all feel during the before and after procedures. Given that transition takes four to five years, many of us, including those of us who just began in our 60s, can hardly wait to see our progression to our new selves.

i get it. Wait weeks or months for each of the gateways to talk to a surgeon, followed by a long wait (for me, 15 months) until surgery. Then, wait six to 12 months to see how things turn out. Yes, i know it drives us all a little nuts. For me, it was 27 months from my initial consultation until today. Impatience is a funny thing.  Stop paying attention and time surprisingly passes quickly.

While it's been one year since my FFS, this won't be my last report. Because of COVID, my six-month review with my surgeon was delayed by two months, as will my one-year follow up. After my last visit with Dr. Shi, i'll close out this thread with a final post.

So, where am I, what's different, and how do i feel about my FFS?

That's a complicated question.

First, FFS is not a miracle operation. I was never promised to be Barbie afterwards (darn), only that subtle changes would be made to my face, hence the title Facial Feminization.

Do i see subtle changes? Yes, but with reservations. I can see my nose is different and for once, i'm not a mouth breather any more. (I had a deviated septum, so now i can easily breath through my nose.) Others tell me my face looks more feminine, which is nice.

However, while more feminine, i still don't see Laura in the mirror, before or after make-up. I still get clocked and stared at nearly every time i'm out in public. Some of us are born with good genes and bone structure. Some of us are not. Does it matter? To some extent, yes. I long to just blend in and to not be noticed, but to go backwards is NOT be in the cards. I AM Laura, I NEED to be Laura, and these obstacles won't stop me, even though they crush me a bit inside when they happen.

How are things different from my six-month report?

Lips: For most of the year, i could not blow air through my lips to make them flap, also called a motorboat or lip-trill. My lower lip was still too numb to make this tongue-less raspberry. Recently, things have improved although blowing a motorboat still takes a bit of effort. Small steps.
Numbness: Overall, the numbness i've experienced in my lip, chin, forehead, and top of head has improved. Oh, i still feel numbness, but i'm glad things have improved somewhat. I'd say i've regained 50-70% of the sensation in these areas. Will things continue to improve in the next six to 12 months? Who knows. I'd like to not have that feeling, but i also wouldn't go back and not have FFS.
Transition is a thousand-mile journey. FFS was just one stop along the way. I'd do it again.

Onward,

Laura

[LauraE]

October 3, 2021

Do I see Laura yet?
I do at times, mostly when I'm all made up and around friends. Most of the time, though, when i look in the mirror, I still see him. I think this is partly because I WAS him for 65+ years that my mental image has been difficult to update. I've often said that transition is a thousand mile journey, taken one step at a time. While I expect my journey will take at least five years, of which i'm just starting year three, it's also possible that becoming fully Laura might take many more years.
However, my friends see her. Last night, when Yeng (my tennis partner) and her friends came over for dinner and drinks, they asked to see a picture of me and my ex-wife, who i always thought was beautiful. Now, they had never met <deadname> nor had they know my old name until recently. I trust them sufficiently that i pulled the picture off my sever to show them. Looking back and forth between the picture and me, they exclaimed that i look very different now, that <deadname> was definitely mail while i looked female. They see Laura more than i do and, for now, that has to be enough.

Regarding being clocked.
This happens almost daily and while some people "ma'am" me, i also suspect that there are many people who clock me but are too polite to make an issue of it. These are the people who are decent. The only anecdote i can recall is one i shared earlier about when i had my passport picture taken this summer.

Laura

[LauraE]

January 21, 2023

Closing Post
As a final entry to this thread, I'd like to reflect on my FFS and its impact on my life.

Those of us who transition late in life are rarely passable, with or without FFS. There are just too many decades of testosterone damage to our body. As I shared in other posts, FFS isn't a miracle surgery, but a way to reduce some of our masculine features.

When I look in the mirror today, I still don't see a woman. I still see him and I don't know whether that's because I have decades of memories about my face, or whether my self confidence is in the way.
I do know my face looks different only by one friend's response.

She never knew deadname so she had no reference point to my past self. At a party a few years ago, I shared a pre-transition picture with her. she looked back and forth between my new face and the picture and finally said, "That's not your nose."

No it wasn't and while I couldn't see it, she did. perhaps that's all the encouragement I need.

Whatever the result, I knew I needed FSS before I'd feel comfortable enough to present as Laura outside. Indeed, just six weeks after FFS, Nora and I went out to lunch and just two months after that, Laura went full-time.

I'd do it again.

Onward,

Laura