Kaiser surgeon refusing parts of FFS (pics)

[Selene858]

What are my options now ? I saw both a head and neck surgeon for a tracheal shave consult and a plastic surgeon for FFS/BA  consult

The H&N guy said a tracheal shave isn't necessary because it's not "prominent" enough and the FFS surgeon rejected the idea of doing anything other than my upper 3rd of my face

I definitely need both my jaw and chin done (v line) as well as my nose and lip length shortened 

I definitely have a visible Adam's apple as well

It may not always be super visible but I'm most pics and lighting situations it really is

I feel like these surgeons are recommending the bare minimum and trying to gaslight me to save Kaiser money when it's obvious I don't pass and look like a man

I've attached some photos to give you a good idea of what I'm working with

Anyone have any suggestions on what to do next ? Will Kaiser approve more if I get a second opinion

My face is really masculine and my Adam's apple quite large so they're both a huge source of dysphoria for me

Thanks

[Lori Dee]

The H&N guy said a tracheal shave isn't necessary because it's not "prominent" enough and the FFS surgeon rejected the idea of doing anything other than my upper 3rd of my face

Very often a plastic surgeon will decline a surgery because the risk of a bad outcome is greater than a good outcome. I had a similar consult for my eyelids. The surgeon said he CAN do surgery, but there would be no guarantee the results would be better, and there is the risk of it turning out worse.

With a tracheal shave, they are shaving off the cartilage "prominence" (the part that sticks out). If it doesn't stick out far enough, surgery runs the risk of damaging the cartilage or making it too thin to be structurally sound.

You can always keep trying different surgeons until you find one who will do what you want. I have heard good things about plastic surgeons in Turkey. That might be an option.

I think you should be talking to your therapist about your self-image issues. Since you first arrived here, you keep asking for honest opinions, the members give you their opinions, and you disagree. I know that it is very difficult for us to see what others see. We are our own worst critic. But I think your money would be better put to use in therapy than surgery. Many of us would kill to have your looks.

But it's your money to spend as you see fit. Good luck.

[Selene858]

Very often a plastic surgeon will decline a surgery because the risk of a bad outcome is greater than a good outcome. I had a similar consult for my eyelids. The surgeon said he CAN do surgery, but there would be no guarantee the results would be better, and there is the risk of it turning out worse.

With a tracheal shave, they are shaving off the cartilage "prominence" (the part that sticks out). If it doesn't stick out far enough, surgery runs the risk of damaging the cartilage or making it too thin to be structurally sound.

You can always keep trying different surgeons until you find one who will do what you want. I have heard good things about plastic surgeons in Turkey. That might be an option.

I think you should be talking to your therapist about your self-image issues. Since you first arrived here, you keep asking for honest opinions, the members give you their opinions, and you disagree. I know that it is very difficult for us to see what others see. We are our own worst critic. But I think your money would be better put to use in therapy than surgery. Many of us would kill to have your looks.

But it's your money to spend as you see fit. Good luck.

You mean bad result like aesthetically or clinically ? V line/chin and jaw is a pretty low risk operation from what I remember seeing in the presentation that Kaiser sent me

The recovery just sucks because you can't eat anything solid for a few weeks

The FFS surgeon is in SoCal and extremely well regarded locally so I think the risks of complications are pretty non existent though his expertise is more forehead type 3 , browbone and hairline

I think he just doesn't want to do it like my nose and lips

My nose sticks out way too much and he even tried telling me I don't need a lip lift lol I can pay out of pocket to have the forehead tissue used for a permanent lip aug though

I can't believe Kaiser is this much of a PITA to get surgery with

I thought they were supposed to be the best for GAC ? Either way if I have to live with both a man face and man body then I'm gonna  consider roping because that just puts my dysphoria in overdrive

[Sarah B]

Hi Everyone

"What are my options now? I saw both a head and neck surgeon for a tracheal shave consult and a plastic surgeon for FFS/BA consult."

It sounds like you have already taken proactive steps by consulting with specialists, which is great.  If you are not satisfied with their feedback, seeking additional opinions might help you feel more confident in your decisions.

"The H&N guy said a tracheal shave isn't necessary because it's not 'prominent' enough and the FFS surgeon rejected the idea of doing anything other than my upper 3rd of my face."

Surgeons are often cautious when recommending procedures.  If they believe a tracheal shave is not necessary or feel certain areas do not need changes, it is likely because they are balancing potential risks against benefits.  However, if you strongly disagree, exploring other surgeons is always an option.

"I definitely need both my jaw and chin done (v line) as well as my nose and lip length shortened."

It might help to discuss these feelings with a therapist to explore why these features cause you so much distress.  Others might see your face as beautiful, and it is important to understand how much of this concern comes from self-perception versus reality.  If you are certain about pursuing changes, finding a surgeon who aligns with your goals could be the next step.

"I definitely have a visible Adam's apple as well.  It may not always be super visible but in most pics and lighting situations it really is."

If the Adam's apple is a significant source of dysphoria, you might consider seeking a second opinion.  Surgeons may decline a tracheal shave if they feel it is unnecessary or risky, but a different specialist might see it differently.  Keep in mind, though, that in many cases, others may not notice it as much as you do.

"I feel like these surgeons are recommending the bare minimum and trying to gaslight me to save Kaiser money when it's obvious I don't pass and look like a man."

It is understandable to feel frustrated, but surgeons are trained to assess what they believe is medically and aesthetically necessary.  If you feel like your needs are not being fully addressed, consider consulting outside Kaiser's network or even looking into specialists abroad, such as those in Turkey as Lori suggested or Thailand, who have been recommended by others.

"I've attached some photos to give you a good idea of what I'm working with."

Photos can help convey your concerns, but it is also worth remembering that we are often our own worst critics.  Many people may see your face as more feminine and attractive than you perceive it to be.  Talking to a therapist about self-image could provide a new perspective and reduce the stress you feel.

"Anyone have any suggestions on what to do next? Will Kaiser approve more if I get a second opinion?"

Seeking a second opinion is always a good idea if you are unhappy with the feedback you have received.  If Kaiser remains restrictive, exploring options with a different insurance provider or paying out of pocket for consultations could open up new possibilities.

"My face is really masculine and my Adam's apple quite large so they're both a huge source of dysphoria for me."

To me and others your face s not masculine and your Adam's apple, well I cannot see it.  It might feel that your face is masculine, but your face is more feminine than you think.  Many others would likely see no issue with your Adam's apple or features.  That said, if these concerns are causing significant dysphoria, therapy can help alongside pursuing the surgical changes you feel are necessary.

Your surgeons may have declined procedures due to medical risks or their belief that changes are not necessary, but you always have the option to consult others. Therapy could also help address the intense dysphoria you feel, as it is common to struggle with self-perception.

Many people would love to have your looks, and it is important to acknowledge that. Ultimately, this is your journey, and pursuing a combination of emotional support and medical opinions can help you feel more at peace with your decisions.

Take care and all the best for the future.

Best Wishes Always
Sarah B
Global Moderator
@Selene858 @Lori Dee

[Lilis]

Either way if I have to live with both a man face and man body then I'm gonna  consider roping because that just puts my dysphoria in overdrive

What will roping fix? And, Why are you feeling this way?

Lori and Sarah have both told you that you are beautiful and have encouraged you to explore other options if you're not comfortable with your current medical and psychological team.

I know the current political climate has sent shockwaves through the community, leaving many struggling with intense dysphoria. Please don't let it win.

I also read your post to the new member, where you mentioned feeling brain-wormed. I'm not too familiar with this online culture, but from what I understand, it means you're struggling with self-doubt, self-hatred, and dysphoria as a trans person.

Is that right? If so, would you be open to sharing more about this? Maybe someone who understands it better can offer support and guidance.

What ever you do please don't harm yourself.

[Jessica_Rose]

Selene, you're beautiful. Many women are critical of their reflection. When they look in the mirror, all they can see are flaws. It took me years, and several surgeries, to stop seeing the guy in the mirror, even though I was the only one seeing him. Please remember, mirrors are evil. They only show you what you want to see. Instead of looking for perceived flaws, look for the beauty that everyone else sees.

My honest opinion? Only because I've been there, I can see where brow contouring may help with your facial concerns. I don't see an Adam's Apple. Your nose, jawline, and lips are perfect. Like me, you are being haunted by the ghost of your past.

Love always -- Jessica Rose

[Tig58072]

How about a mock neck top?

[ChrissyRyan]

Selene,

You have a nice appearance.  I do not see any harm in getting another medical opinion; however, I would just be content with your natural facial appearance.  But I am not you!  This is your decision. 

Chrissy

[Lori Dee]

You mean bad result like aesthetically or clinically ? V line/chin and jaw is a pretty low risk operation from what I remember seeing in the presentation that Kaiser sent me

The recovery just sucks because you can't eat anything solid for a few weeks

The FFS surgeon is in SoCal and extremely well regarded locally so I think the risks of complications are pretty non existent though his expertise is more forehead type 3 , browbone and hairline

I think he just doesn't want to do it like my nose and lips

My nose sticks out way too much and he even tried telling me I don't need a lip lift lol I can pay out of pocket to have the forehead tissue used for a permanent lip aug though

I can't believe Kaiser is this much of a PITA to get surgery with

I thought they were supposed to be the best for GAC ? Either way if I have to live with both a man face and man body then I'm gonna  consider roping because that just puts my dysphoria in overdrive

The risks are mostly aesthetic. I had FFS and part of that was to do a brow lift and cheek lift and remove my droopy eyelids. I now have scars below my eyelids, as well as bulging veins in the thin skin below the eyes.

I went to a different surgeon to get an evaluation to remove the scar tissue and the bulging veins. He said that he could do it, but there was no guarantee that new scar tissue from the surgery would develop. If he pinched off the bulging veins, the body could react and develop spider veins to keep blood circulation going to those areas. That would be even more difficult to treat because they are so close to the eyes.

I have spoken to several people who asked what surgery I wanted to get done, and when I told them about the scars under my eyes, they said they hadn't noticed. To me, they are very prominent. But the reality is that people don't notice. So I make myself feel better by dabbing with coverup makeup and all is well.

Don't be so hard on yourself. Yes, there will always be things we would like to improve. But I agree with Jessica that I think you are being haunted by the ghost of your past. It took me a long time to stop seeing that and to start seeing the woman that I am. It just takes time so try not to hurry.

[Brynn]

Hi Selene!

I see that other sisters have positively commented on your natural feminine beauty already but thought that I would add my own compliments as I am very envious of your beauty. As a new transgender female I still have the luxury of my learned male traits in addition to my newly uncovered latent feminine and bisexual ones, and can say that from both perspectives I would definitely have been drawn to you as a beautiful woman if I saw you at Home Depot or anywhere else. Please love yourself because you deserve to be loved for who you are and as your are, and know that all of us want to support you in finding a positive way forward!

With love! Brynn

[MaryT]

I must say that in the photos I see a strikingly and enviably beautiful woman.

[Gina P]

Selene,
My first thought after looking at your pictures was that you were a cis girl transitioning to a man. Then I read what you wrote and was surprised. You look beautiful girl! I would love to have that cute nose. I had to look back at the photos to even see the slight Adam's apple.
 We are our worst critics. Mannerisms and, voice will make you pass more than surgery. Stand back at least 6 feet from the mirror and see what everyone else see's. I hope this helps. We are here for you whatever you decide.