Community Conversation => Transitioning => Facial feminization surgery => Topic started by: Blush on January 12, 2015, 08:22:24 AM Return to Full Version
Title: Which FFS procedure helps with passing the most?
Post by: Blush on January 12, 2015, 08:22:24 AM
Post by: Blush on January 12, 2015, 08:22:24 AM
I imagine every person is different and it's all on a case by case basis, but on an average or general basis, which procedure do you all think is the most feminizing?
I was quoted for a few procedures, forehead contouring, a slight rhinoplasty, mandible contouring (I've already have my trachea shave done).
However, all of these procedures together would cost around $35k, and I only have 1/3 of that amount to spend at the moment. I'd prefer not to wait to get all of them done at once, both from a financial perspective and so I can see how each procedure goes (I'm scared to get everything done at once.
So since they cost give or take around the same amount, I'm trying to decide which procedure I should get done first, and specifically which one is the most feminizing.
Neither my brow area, nose, or jaw are "that bad", but of course all together they're clearly masculine. I'm thinking the brow might be the most feminizing - if I got my nose done it'd probably just look like I got my nose done. If I got my jaw done it'd probably just look like I have a feminine jaw. But if I got my brow/forehead done I think it might help me pass more, and then perhaps be like I have a slightly masculine jaw and nose, albeit me looking female?
I'd love to know everyone's thoughts on this! :)
I was quoted for a few procedures, forehead contouring, a slight rhinoplasty, mandible contouring (I've already have my trachea shave done).
However, all of these procedures together would cost around $35k, and I only have 1/3 of that amount to spend at the moment. I'd prefer not to wait to get all of them done at once, both from a financial perspective and so I can see how each procedure goes (I'm scared to get everything done at once.
So since they cost give or take around the same amount, I'm trying to decide which procedure I should get done first, and specifically which one is the most feminizing.
Neither my brow area, nose, or jaw are "that bad", but of course all together they're clearly masculine. I'm thinking the brow might be the most feminizing - if I got my nose done it'd probably just look like I got my nose done. If I got my jaw done it'd probably just look like I have a feminine jaw. But if I got my brow/forehead done I think it might help me pass more, and then perhaps be like I have a slightly masculine jaw and nose, albeit me looking female?
I'd love to know everyone's thoughts on this! :)
Title: Re: Which FFS procedure helps with passing the most?
Post by: missymay on January 12, 2015, 08:40:03 AM
Post by: missymay on January 12, 2015, 08:40:03 AM
IMO forehead reconstruction done with rhinoplasty is the most feminizing (I know you said that you only want one procedure recommendation, but this combination is magical)
Title: Re: Which FFS procedure helps with passing the most?
Post by: Blush on January 12, 2015, 08:57:47 AM
Post by: Blush on January 12, 2015, 08:57:47 AM
Quote from: missymay on January 12, 2015, 08:40:03 AMYou have a good point about including rhinoplasty with forehead reconstruction, they probably flow pretty well together.
IMO forehead reconstruction done with rhinoplasty is the most feminizing (I know you said that you only want one procedure recommendation, but this combination is magical)
My only concern with that is my FFS surgeon charges almost $8k for a rhinoplasty. Considering I don't need much work done, I thought about getting it done locally, but of course with the anesthesia and operating room fees it might amount to near that price. ???
But yeah thank you!
Title: Re: Which FFS procedure helps with passing the most?
Post by: Paula1 on January 12, 2015, 09:39:09 AM
Post by: Paula1 on January 12, 2015, 09:39:09 AM
I just don't know where some of these FFS surgeons get their prices from ... :o
Yes I do, because they know we girls are limited with choice.
But since my FFS in 2004, there are more surgeons entering the FFS market place with prices dropping which can only be a good thing.
Yes I do, because they know we girls are limited with choice.
But since my FFS in 2004, there are more surgeons entering the FFS market place with prices dropping which can only be a good thing.
Title: Re: Which FFS procedure helps with passing the most?
Post by: Blush on January 12, 2015, 09:48:26 AM
Post by: Blush on January 12, 2015, 09:48:26 AM
Quote from: Paula1 on January 12, 2015, 09:39:09 AMIt's a good point. I think it's tricky, where FFS probably does require a bit of special knowledge in terms of performing the procedures on patients who are transitioning from one gender to the next, not your average cis patient - but still I'd think the theory behind the procedures is pretty straight forward.
I just don't know where some of these FFS surgeons get their prices from ... :o
Yes I do, because they know we girls are limited with choice.
But since my FFS in 2004, there are more surgeons entering the FFS market place with prices dropping which can only be a good thing.
Title: Re: Which FFS procedure helps with passing the most?
Post by: misty2 on January 12, 2015, 01:54:19 PM
Post by: misty2 on January 12, 2015, 01:54:19 PM
Hi Blush,
I posted this response to Brenda at this link: https://www.susans.org/forums/index.php/topic,180708.msg1603704.html#msg1603704
I am re-posting it here because much of it addresses your question.
I was born January of 1964. I started my public transition, going full-time, January 1, 2013. My beard had been fully removed, using laser, by 2008. HRT had begun November of 2012. My first stage of FFS surgery, forehead contouring and tracheal shave, took place on June 19, 2013. I had my first Rhinoplasty September of 2013. I had revision rhinoplasty August 19, 2014. I had chin and Jaw surgery and lip-lift October 29, 2014.
The only thing that kept me going for the six months from the beginning of January 2013 to end of June 2013, that stretch of interacting with the general public without any facial corrective surgery, was the knowledge that eventually I would have FFSurgery.
During my first six months in public nobody thought I was a woman or treated me as a woman. I was treated as if I was a man dressing as a woman. Negative reactions ranged from fear, to disdain, to disgust, to pity. Positive reactions were entertained politeness or occasionally, I would be congratulated for my bravery. None of those reactions was affirming. But those six months did reinforce my resolve to pursue FFS. I do acknowledge that negative reactions are a spiral. When people frowned at me I often frowned back. When I would get a lot of frowns I would start to expect frowns... which, I am sure would lead to more frown... it is tough. I would try to break the cycle. I would try to "be in the moment." It simply was not enough.
During my FFS research I decided that I was going to have my facial surgery in steps. This is because it was my observation that I was not able to find any single surgeon that (I thought) could handle my three critical areas with equal skill. Also, I held out hope that (just maybe) I would not need all of the surgery that I initially dreaded I would need. Finally, I was scared, the idea of being on the operating table for 8 to 12 hours frightened me.
Now that I've completed my lower face surgery I basically have one surgery left (which is to correct my hairline.) At this point I think I can provide anecdotal comments on having my FFS into the three phases:
1. Forehead and trachea
2. Rhinoplasty
3. Chin/jaw and lip lift.
The positives:
Each surgery, separately, was easier to handle. However, no surgery was easy. My forehead surgery was incredibly difficult and I sometimes wonder if I would have lived had I also had rhinoplasty and jaw surgery at the same time. In retrospect, I think the doctors would have had to stop my first surgery prematurely if it would have been scheduled to last longer. This was due to my allergic reaction to my intravenous antibiotic on the operating table. I literally was vomiting while I was unconscious on the operating table.
My first 24 hours post forehead surgery felt like I was on the edge of death. I know that seems melodramatic. Nevertheless, that is how I felt. It took my body about 24 hours to get the antibiotic out of my system. Once that resolved, the rest of my forehead contouring recovery went very well. Less than 72 hours after my forehead surgery I actually went clubbing for a few hours. I begin to enjoy my time in Buenos Aires very much. I remember it fondly.
The forehead result was better than I had imagined. In 48 hours I went from never passing to being able to pass all the time while walking down the street. And I was passing maybe half the time in face to face interactions. I still was not passing all of the time. However, even when I was clocked, people were still nicer to me post forehead surgery. I have found that even if people figured out I lived much my life as a male, the more feminine I looked the more accepting people behaved.
My rhinoplasty surgery was the easiest surgery compared to the forehead surgery and the lower face surgery.
As I have written recently the jaw/chin/lip surgery has been very challenging for me psychologically. The over month long recovery from swelling had left me in a very deep funk. Lower face surgery was one step backward to take two steps forward.
The biggest positive of my multi-step process is that I think the aesthetic outcome has been maximized. (I'm not writing that I think my result is spectacular. What I am contending is that given my start with extremely masculine features, I think my result is better than what could have been expected in one single surgery.)
When I began my research, I felt that Doctor Ousterhout and Doctor DiMaggio were doing the best foreheads. I chose Doctor DiMaggio because I thought that his procedure built and improved upon Doctor Ousterhout's technique.
I chose a separate (non FFS specific) surgeon for my rhinoplasty because I didn't think any of the FFS surgeons did an adequate job addressing a nose as large, humped and droopy as mine. I had never seen a good example.
I selected Facial Team for my chin, jaw and lip lift because I liked their CT scan approach to my very bony and asymmetrical chin. Also, the limited amount of information I could locate regarding long term sensation change (for all surgeons) in the lower lip was favorable to Facial Team. Finally, that they had three full surgeons, not residents, in the operation room at the same time was remarkable.
People ask why I did not choose Facial Team for my forehead. The reason is that when I was deep in my forehead selection process, there simply were not enough Facial Team forehead examples for me to be confident on predictable outcome. From 2010 to 2012 there were many, many example of Dr. DiMaggio's work coming online and every example was excellent. I also considered most of the U.S. based surgeons but I could not find (except for Dr. O) the consistently predictable or volume of examples attributed to Dr. DiMaggio. This also goes for Dr. Suporn (not enough examples.) I choose to not use Dr. O because when I visited him, in person, and compared him to my interactions with Dr. DiMaggio I preferred the demeanor of Dr. DiMaggio. I liked Dr. DiMaggio's technique and personality better than Dr. O. Dr. O was so against splitting my nose surgery from my forehead surgery that I was not confident that he would do it separately. Every time I brought it up he said no. But I did not get to the point of putting him on the spot. Maybe if I would have forcefully insisted he would have relented.
This was my ranking of forehead surgeons two years ago:
1. DiMaggio
2. Facial Team
3. Ousterhout
4. Suporn
5. Bart
6. Spiegel
If I were redoing that ranking today, it would be different of course. I am going to pass on re-ranking that list today. But I will write, that I think the top two spots are still occupied by Facial Team and Dr. DiMaggio. If hair transplants are going to be part of the process I think it's important to note that Facial Team can offer that during the forehead surgery. As far as I'm aware, that is new.
If a favorite surgeon of others is not on that list it is because I thought they did poor work or there simply was not enough examples of their work, available to me, to be able to reliably project an outcome.
I believe another benefit of breaking up my surgeries into stages was that each surgeon was able to start with a healed image from each previous procedure. I know some argue that one surgeon being able to modify all the parts during one long surgery creates better synergy and balance. I don't agree. I found that being able to plan the next phase while considering the healed phase is better.
Reducing the amount of procedures in each surgery allowed both me and my surgeons to focus on less variables during pre-surgery planning. I believe this increased our ability to communicate with each other, reduced misunderstanding and allowed for a maximum cooperative, predictable, outcome.
The interval between surgeries also allowed me the luxury of time to consider my next step with a healed and progressively more feminine face. This should not be underestimated. I was able to get evolving feedback from some very close friends and doctors such as my dentist and dermatologist about the next best step. This time and evolution also made engaging in virtual Photoshop sessions easier and more predictable as I could model (with actual resolved outcomes) and focus on altering only the parts remaining to be altered.
The negatives:
Cost: breaking the surgery into components probably tripled (maybe more) my costs. This is a huge negative, but an effect for which I had planned. I realize cost makes the idea of breaking up the surgeries unmanageable in many cases.
Time: I have spent a lot more time: swollen, bruised, debilitated and traveling. I am tired of it. It would've been nice to have one surgery (if it had only been one surgery) and just be done with it. It would be nice to be able to get onto the next phase of my life. If people ask me what I've been doing with my life recently: the answer I tell them is working on my stand-up comedy. But, in reality the biggest part of my life is been working on transition, my divorce, (which my wife blames on me having surgery) and healing.
Another huge negative is that having multiple independent surgeries (and being open about it) leads many friends, family and acquaintances to conclude that I am nuts. I had been very open about my surgery and my plans for surgery. I now regret this. People think I've had a lot of surgery. And, of course, the perception is that it's all based on vanity. If I hear one more warning about not turning into Michael Jackson I think I will throw up. I have also received one too many emails about how I just need to find Jesus or, its spiritual alternative... spend more time meditating. Sorry, does that last sentence literally offend everybody?
My perception, of course, is that my surgeries are corrective surgery. But it's hard for me to convey this to a non-transgender audience. If I would have had one FFS surgery, the works, it would be perceived by others as "one" surgery and it would be over. I wouldn't be judged as harshly. It's frustrating when people treated me with disdain because I didn't look like their vision of a woman and later also treated me with derision because I am taking steps to bring my appearance more in line with a stereotype.
It also did not help that I was over 50 years old. In addition to slowing recovery. This led people to conclude that was going through a mid-life crisis. What they do not realize is this crisis began in January 1964 when the doctor mis-categorized me. Those five or 10 seconds of visual inspection, set me on a path, threw me into a canyon, from which it has literally taken half a lifetime to climb free. I was consciously aware I was in a bad predicament when I very young. If there is a crisis, it began much earlier than mid-life. It is only now, in mid-life, that I have the resources of time and money to correct this error. My lifetime of work, to earn the money, to plan the path and follow the plan, has taken me decades.
What I've learned:
I would have worked harder to have each procedure with less time between each. In an ideal world I would not have had other commitments. But, that simply was not my case.
I should have revealed that I was transgender about five years, maybe ten years, earlier. Even if I would not have been living as women full time.
I should not have waited for my wife to "come around" and give me permission to have FFS. For twenty years she was on the edge of saying "yes" she even booked our trip to see Dr. O back in 2006. But when she saw what magic he could do' (there were many, many more photographs in his office than online) she left the appointment in tears. That set me back another 5 years as I tried to work through a compromise with her. This is also where the idea of having FFS in stages germinated.
Additionally, if I were starting over, I would have been much less open (to non-transgender acquaintances) about the surgeries. I would have been much more secretive. (Only about surgery, not about being transgender.)
I need to write that I would still be very open to members of this forum. I will continue to be an open book on this forum. This resource, has been precious.
Finally, if I was only able to afford one procedure the decision is easy, it would have been the forehead.
Thank you so very much to all who have contributed to helped to make this forum.
Kind regards,
Danielle
I posted this response to Brenda at this link: https://www.susans.org/forums/index.php/topic,180708.msg1603704.html#msg1603704
I am re-posting it here because much of it addresses your question.
I was born January of 1964. I started my public transition, going full-time, January 1, 2013. My beard had been fully removed, using laser, by 2008. HRT had begun November of 2012. My first stage of FFS surgery, forehead contouring and tracheal shave, took place on June 19, 2013. I had my first Rhinoplasty September of 2013. I had revision rhinoplasty August 19, 2014. I had chin and Jaw surgery and lip-lift October 29, 2014.
The only thing that kept me going for the six months from the beginning of January 2013 to end of June 2013, that stretch of interacting with the general public without any facial corrective surgery, was the knowledge that eventually I would have FFSurgery.
During my first six months in public nobody thought I was a woman or treated me as a woman. I was treated as if I was a man dressing as a woman. Negative reactions ranged from fear, to disdain, to disgust, to pity. Positive reactions were entertained politeness or occasionally, I would be congratulated for my bravery. None of those reactions was affirming. But those six months did reinforce my resolve to pursue FFS. I do acknowledge that negative reactions are a spiral. When people frowned at me I often frowned back. When I would get a lot of frowns I would start to expect frowns... which, I am sure would lead to more frown... it is tough. I would try to break the cycle. I would try to "be in the moment." It simply was not enough.
During my FFS research I decided that I was going to have my facial surgery in steps. This is because it was my observation that I was not able to find any single surgeon that (I thought) could handle my three critical areas with equal skill. Also, I held out hope that (just maybe) I would not need all of the surgery that I initially dreaded I would need. Finally, I was scared, the idea of being on the operating table for 8 to 12 hours frightened me.
Now that I've completed my lower face surgery I basically have one surgery left (which is to correct my hairline.) At this point I think I can provide anecdotal comments on having my FFS into the three phases:
1. Forehead and trachea
2. Rhinoplasty
3. Chin/jaw and lip lift.
The positives:
Each surgery, separately, was easier to handle. However, no surgery was easy. My forehead surgery was incredibly difficult and I sometimes wonder if I would have lived had I also had rhinoplasty and jaw surgery at the same time. In retrospect, I think the doctors would have had to stop my first surgery prematurely if it would have been scheduled to last longer. This was due to my allergic reaction to my intravenous antibiotic on the operating table. I literally was vomiting while I was unconscious on the operating table.
My first 24 hours post forehead surgery felt like I was on the edge of death. I know that seems melodramatic. Nevertheless, that is how I felt. It took my body about 24 hours to get the antibiotic out of my system. Once that resolved, the rest of my forehead contouring recovery went very well. Less than 72 hours after my forehead surgery I actually went clubbing for a few hours. I begin to enjoy my time in Buenos Aires very much. I remember it fondly.
The forehead result was better than I had imagined. In 48 hours I went from never passing to being able to pass all the time while walking down the street. And I was passing maybe half the time in face to face interactions. I still was not passing all of the time. However, even when I was clocked, people were still nicer to me post forehead surgery. I have found that even if people figured out I lived much my life as a male, the more feminine I looked the more accepting people behaved.
My rhinoplasty surgery was the easiest surgery compared to the forehead surgery and the lower face surgery.
As I have written recently the jaw/chin/lip surgery has been very challenging for me psychologically. The over month long recovery from swelling had left me in a very deep funk. Lower face surgery was one step backward to take two steps forward.
The biggest positive of my multi-step process is that I think the aesthetic outcome has been maximized. (I'm not writing that I think my result is spectacular. What I am contending is that given my start with extremely masculine features, I think my result is better than what could have been expected in one single surgery.)
When I began my research, I felt that Doctor Ousterhout and Doctor DiMaggio were doing the best foreheads. I chose Doctor DiMaggio because I thought that his procedure built and improved upon Doctor Ousterhout's technique.
I chose a separate (non FFS specific) surgeon for my rhinoplasty because I didn't think any of the FFS surgeons did an adequate job addressing a nose as large, humped and droopy as mine. I had never seen a good example.
I selected Facial Team for my chin, jaw and lip lift because I liked their CT scan approach to my very bony and asymmetrical chin. Also, the limited amount of information I could locate regarding long term sensation change (for all surgeons) in the lower lip was favorable to Facial Team. Finally, that they had three full surgeons, not residents, in the operation room at the same time was remarkable.
People ask why I did not choose Facial Team for my forehead. The reason is that when I was deep in my forehead selection process, there simply were not enough Facial Team forehead examples for me to be confident on predictable outcome. From 2010 to 2012 there were many, many example of Dr. DiMaggio's work coming online and every example was excellent. I also considered most of the U.S. based surgeons but I could not find (except for Dr. O) the consistently predictable or volume of examples attributed to Dr. DiMaggio. This also goes for Dr. Suporn (not enough examples.) I choose to not use Dr. O because when I visited him, in person, and compared him to my interactions with Dr. DiMaggio I preferred the demeanor of Dr. DiMaggio. I liked Dr. DiMaggio's technique and personality better than Dr. O. Dr. O was so against splitting my nose surgery from my forehead surgery that I was not confident that he would do it separately. Every time I brought it up he said no. But I did not get to the point of putting him on the spot. Maybe if I would have forcefully insisted he would have relented.
This was my ranking of forehead surgeons two years ago:
1. DiMaggio
2. Facial Team
3. Ousterhout
4. Suporn
5. Bart
6. Spiegel
If I were redoing that ranking today, it would be different of course. I am going to pass on re-ranking that list today. But I will write, that I think the top two spots are still occupied by Facial Team and Dr. DiMaggio. If hair transplants are going to be part of the process I think it's important to note that Facial Team can offer that during the forehead surgery. As far as I'm aware, that is new.
If a favorite surgeon of others is not on that list it is because I thought they did poor work or there simply was not enough examples of their work, available to me, to be able to reliably project an outcome.
I believe another benefit of breaking up my surgeries into stages was that each surgeon was able to start with a healed image from each previous procedure. I know some argue that one surgeon being able to modify all the parts during one long surgery creates better synergy and balance. I don't agree. I found that being able to plan the next phase while considering the healed phase is better.
Reducing the amount of procedures in each surgery allowed both me and my surgeons to focus on less variables during pre-surgery planning. I believe this increased our ability to communicate with each other, reduced misunderstanding and allowed for a maximum cooperative, predictable, outcome.
The interval between surgeries also allowed me the luxury of time to consider my next step with a healed and progressively more feminine face. This should not be underestimated. I was able to get evolving feedback from some very close friends and doctors such as my dentist and dermatologist about the next best step. This time and evolution also made engaging in virtual Photoshop sessions easier and more predictable as I could model (with actual resolved outcomes) and focus on altering only the parts remaining to be altered.
The negatives:
Cost: breaking the surgery into components probably tripled (maybe more) my costs. This is a huge negative, but an effect for which I had planned. I realize cost makes the idea of breaking up the surgeries unmanageable in many cases.
Time: I have spent a lot more time: swollen, bruised, debilitated and traveling. I am tired of it. It would've been nice to have one surgery (if it had only been one surgery) and just be done with it. It would be nice to be able to get onto the next phase of my life. If people ask me what I've been doing with my life recently: the answer I tell them is working on my stand-up comedy. But, in reality the biggest part of my life is been working on transition, my divorce, (which my wife blames on me having surgery) and healing.
Another huge negative is that having multiple independent surgeries (and being open about it) leads many friends, family and acquaintances to conclude that I am nuts. I had been very open about my surgery and my plans for surgery. I now regret this. People think I've had a lot of surgery. And, of course, the perception is that it's all based on vanity. If I hear one more warning about not turning into Michael Jackson I think I will throw up. I have also received one too many emails about how I just need to find Jesus or, its spiritual alternative... spend more time meditating. Sorry, does that last sentence literally offend everybody?
My perception, of course, is that my surgeries are corrective surgery. But it's hard for me to convey this to a non-transgender audience. If I would have had one FFS surgery, the works, it would be perceived by others as "one" surgery and it would be over. I wouldn't be judged as harshly. It's frustrating when people treated me with disdain because I didn't look like their vision of a woman and later also treated me with derision because I am taking steps to bring my appearance more in line with a stereotype.
It also did not help that I was over 50 years old. In addition to slowing recovery. This led people to conclude that was going through a mid-life crisis. What they do not realize is this crisis began in January 1964 when the doctor mis-categorized me. Those five or 10 seconds of visual inspection, set me on a path, threw me into a canyon, from which it has literally taken half a lifetime to climb free. I was consciously aware I was in a bad predicament when I very young. If there is a crisis, it began much earlier than mid-life. It is only now, in mid-life, that I have the resources of time and money to correct this error. My lifetime of work, to earn the money, to plan the path and follow the plan, has taken me decades.
What I've learned:
I would have worked harder to have each procedure with less time between each. In an ideal world I would not have had other commitments. But, that simply was not my case.
I should have revealed that I was transgender about five years, maybe ten years, earlier. Even if I would not have been living as women full time.
I should not have waited for my wife to "come around" and give me permission to have FFS. For twenty years she was on the edge of saying "yes" she even booked our trip to see Dr. O back in 2006. But when she saw what magic he could do' (there were many, many more photographs in his office than online) she left the appointment in tears. That set me back another 5 years as I tried to work through a compromise with her. This is also where the idea of having FFS in stages germinated.
Additionally, if I were starting over, I would have been much less open (to non-transgender acquaintances) about the surgeries. I would have been much more secretive. (Only about surgery, not about being transgender.)
I need to write that I would still be very open to members of this forum. I will continue to be an open book on this forum. This resource, has been precious.
Finally, if I was only able to afford one procedure the decision is easy, it would have been the forehead.
Thank you so very much to all who have contributed to helped to make this forum.
Kind regards,
Danielle
Title: Re: Which FFS procedure helps with passing the most?
Post by: Leila on January 12, 2015, 02:17:13 PM
Post by: Leila on January 12, 2015, 02:17:13 PM
Thank you Danielle.
Your write up about your FFS experience has been very useful to me.
I've been pondering FFS but I do want to give HRT a chance do whatever it can to develop my face before I go to surgeons for a consultation.
It is interesting to note that if you could only do one procedure it would be the forehead contouring. For me I think the forehead contouring would be my first priority too; with perhaps a rhinoplasty as well if I were able to get a good deal to do the two together.
Your write up about your FFS experience has been very useful to me.
I've been pondering FFS but I do want to give HRT a chance do whatever it can to develop my face before I go to surgeons for a consultation.
It is interesting to note that if you could only do one procedure it would be the forehead contouring. For me I think the forehead contouring would be my first priority too; with perhaps a rhinoplasty as well if I were able to get a good deal to do the two together.
Title: Re: Which FFS procedure helps with passing the most?
Post by: Melissa_fox on January 12, 2015, 08:42:32 PM
Post by: Melissa_fox on January 12, 2015, 08:42:32 PM
Thanks for the great write up Misty! :)
Title: Re: Which FFS procedure helps with passing the most?
Post by: Melissa_fox on January 12, 2015, 08:49:12 PM
Post by: Melissa_fox on January 12, 2015, 08:49:12 PM
I agree as forehead is what I would get first. It's also the thing I notice on so many girls looking to transition.
Title: Re: Which FFS procedure helps with passing the most?
Post by: warlockmaker on January 12, 2015, 09:34:09 PM
Post by: warlockmaker on January 12, 2015, 09:34:09 PM
I have also looked into FFS, and have researched all the top surgeons. Honestly many of them while they have great bedside manners (we are paying them) are really not the best facial cosmetic surgeons. We seem to believe that we need a FFS surgeon to accomplish our goals but there are so many cis women that have cosmetic surgery and they pay more , in most cases than TG, and they have the best surgeons. I have started my process and just to give you an idea of pre FFS surgery work that are equally important:
1. Most don't consider teeth and even if you have great teeth there is a difference in the shape. Also a specific shape may make you more feminine and also the way you smile and how your teeth show and need to fill out the dark spaces at the side. I am having my whole mouth change and I had good teeth for a male, but not for a female. The cost USD 50,000. WOW I could not believe this quote and it was about the same with cosmetic dentists.
2. Face peel - acidic or laser. USD 3,000
3. Electrolysis for 24 months, around 200 sessions at $130 per. Totalling USD 25,0000
Then comes the facial surgery which has been covered above and a good cosmetic surgeon in LA or NYC can double the price of our FFS surgeon. Its such a long journey
1. Most don't consider teeth and even if you have great teeth there is a difference in the shape. Also a specific shape may make you more feminine and also the way you smile and how your teeth show and need to fill out the dark spaces at the side. I am having my whole mouth change and I had good teeth for a male, but not for a female. The cost USD 50,000. WOW I could not believe this quote and it was about the same with cosmetic dentists.
2. Face peel - acidic or laser. USD 3,000
3. Electrolysis for 24 months, around 200 sessions at $130 per. Totalling USD 25,0000
Then comes the facial surgery which has been covered above and a good cosmetic surgeon in LA or NYC can double the price of our FFS surgeon. Its such a long journey
Title: Re: Which FFS procedure helps with passing the most?
Post by: Charlotte2 on January 13, 2015, 12:56:45 PM
Post by: Charlotte2 on January 13, 2015, 12:56:45 PM
Quote from: warlockmaker on January 12, 2015, 09:34:09 PM+1
1. Most don't consider teeth and even if you have great teeth there is a difference in the shape. Also a specific shape may make you more feminine and also the way you smile and how your teeth show and need to fill out the dark spaces at the side. I am having my whole mouth change and I had good teeth for a male, but not for a female. The cost USD 50,000. WOW I could not believe this quote and it was about the same with cosmetic dentists.
I've searched the internet lots of times for feminizing dentistry but there's almost nothing out there. I'd really like to do something about my teeth, which IMHO look very masculine. What sort of procedures is your dentist doing? And did you go to a top cosmetic dentist or a general dentist?
Like you say $50,000 wow! :D
Title: Re: Which FFS procedure helps with passing the most?
Post by: Zumbagirl on January 13, 2015, 09:34:05 PM
Post by: Zumbagirl on January 13, 2015, 09:34:05 PM
Quote from: missymay on January 12, 2015, 08:40:03 AM
IMO forehead reconstruction done with rhinoplasty is the most feminizing (I know you said that you only want one procedure recommendation, but this combination is magical)
I agree with Missy. The nose is the center of the face and the forehead is the largest piece of real estate on your head that people will see :) I did my forehead nose and trachea shave all at the same time. Later I did jaw reshaping (about 4-5 years later to be honest)
Title: Re: Which FFS procedure helps with passing the most?
Post by: Zumbagirl on January 13, 2015, 09:45:50 PM
Post by: Zumbagirl on January 13, 2015, 09:45:50 PM
Quote from: warlockmaker on January 12, 2015, 09:34:09 PM
2. Face peel - acidic or laser. USD 3,000
3. Electrolysis for 24 months, around 200 sessions at $130 per. Totalling USD 25,0000
Then comes the facial surgery which has been covered above and a good cosmetic surgeon in LA or NYC can double the price of our FFS surgeon. Its such a long journey
I did dermabrasion with a cosmetic surgeon which was done in 6 sessions over the span of about 4 months. It cost me about $1,500 for the treatments in I am thinking 2004 or so. It was about the same cost as a chemical peek or laser resurfacing at the time. I talked to some cosmetologists and came to the conclusion that dermabrasion was better (sort of like sandblasting except on the face). Each treatment was about an hour or so. After about the 3rd session is when I could really tell it was making a difference. The only thing I knew is that they wouldn't work on me until my electrolysis was completely finished and done. This way they could not just resurface the skin but also treat areas of the skin that may have been damaged by the electrolysis. With the pores closed up from the electrolysis treatments and the skin resurfacing I actually looked even younger and had incredibly soft skin. I am probably over due to get another round of treatments but it's not high on my radar anymore.
Getting to the point of the electrolysis being finished and done was quite an ordeal. I thought it would never end. Hairs just kept turning up here and there even if they were light and easy to see. My last electrolysis appointment ended up being a week before the first dermabrasion session. I just wanted my technician to go over my face carefully and make sure that there were no hairs. There was practically nothing to zap. That's when I knew I was finally done :)
Title: Re: Which FFS procedure helps with passing the most?
Post by: Blush on January 14, 2015, 10:27:54 AM
Post by: Blush on January 14, 2015, 10:27:54 AM
Quote from: Zumbagirl on January 13, 2015, 09:45:50 PMHow long was it from start to finish?
Getting to the point of the electrolysis being finished and done was quite an ordeal. I thought it would never end. Hairs just kept turning up here and there even if they were light and easy to see. My last electrolysis appointment ended up being a week before the first dermabrasion session. I just wanted my technician to go over my face carefully and make sure that there were no hairs. There was practically nothing to zap. That's when I knew I was finally done :)
Title: Re: Which FFS procedure helps with passing the most?
Post by: Violet Bloom on January 14, 2015, 11:18:53 AM
Post by: Violet Bloom on January 14, 2015, 11:18:53 AM
Although only judging by my personal needs, the procedures of choice for my upcoming FFS will be brow/orbital rims and nose. The scope of work on me is relatively minor (and deemed by some to be unnecessary :-*) but these areas are what always bugged me. My surgeon agreed with my personal assessment and feels that the changes, however minor, will make a difference to how others view me. For reference, I am deemed to be a Type 2 for forehead and will also be having the overall size of the nose reduced along with other small refinements to the shape.
These physical features don't just affect feminization - in cis females they are also generally considered a factor in feminine attractiveness. It appears from what a number of the members have experienced first-hand, and what I remember from studies and documentaries on the geometry and mathematics of human attractiveness, that the more attractive you are considered to be, the nicer you'll be treated. Upon reflection I must admit that feeling attractive is something I've never experienced in my life (despite what others may have said) and it is as much a goal for my FFS as feminization is. When I went for my consultation, there was a constant stream of perfectly normal cis women coming through the office for various cosmetic procedures and botox. If they are all entitled to seek a beauty ideal without being questioned about it than I think I have every right to do the same as an MTF. I'm not trying to make anyone else look 'lesser' by comparison - I'm simply driven by the opportunity to be the best I can be in my own eyes.
Interesting question - If we were to present our desire for feminizing surgery as one of "wanting to look more beautiful as a woman" rather than "wanting to look more like a woman than a man", would society view us as more 'normal' or purely vain?
These physical features don't just affect feminization - in cis females they are also generally considered a factor in feminine attractiveness. It appears from what a number of the members have experienced first-hand, and what I remember from studies and documentaries on the geometry and mathematics of human attractiveness, that the more attractive you are considered to be, the nicer you'll be treated. Upon reflection I must admit that feeling attractive is something I've never experienced in my life (despite what others may have said) and it is as much a goal for my FFS as feminization is. When I went for my consultation, there was a constant stream of perfectly normal cis women coming through the office for various cosmetic procedures and botox. If they are all entitled to seek a beauty ideal without being questioned about it than I think I have every right to do the same as an MTF. I'm not trying to make anyone else look 'lesser' by comparison - I'm simply driven by the opportunity to be the best I can be in my own eyes.
Interesting question - If we were to present our desire for feminizing surgery as one of "wanting to look more beautiful as a woman" rather than "wanting to look more like a woman than a man", would society view us as more 'normal' or purely vain?
Title: Re: Which FFS procedure helps with passing the most?
Post by: warlockmaker on January 14, 2015, 08:20:53 PM
Post by: warlockmaker on January 14, 2015, 08:20:53 PM
For teeth, you need to see a cosmetic dental surgeon. Yes, the difference between male and female teeth are slightly different which goes with the facial structure. They take pictures from all angles, many impressions and align your face etc. - quite a scene. Generally, male teeth are more square blocks especially the front ones. Then you need teeth that fill your smile. I just had my first session and there will be 9 in total. I will have 28 new veneer caps and a root canal. I had good teeth but I remember saying to the dentist that " i wanted movie star teeth".
Title: Re: Which FFS procedure helps with passing the most?
Post by: Zumbagirl on January 15, 2015, 06:18:30 AM
Post by: Zumbagirl on January 15, 2015, 06:18:30 AM
Quote from: Blush on January 14, 2015, 10:27:54 AM
How long was it from start to finish?
I'm not 100% sure, but I am going to say from start to finish with my electrolysis it was about 3 years. Most of that was used by 4 hour sessions of electrolysis. Towards the start it was almost exclusively just my face, near the end it would be maybe 30 minutes to keep my face clear and using the electrolysis on other areas (arms, legs, underarms, eyebrow shaping, etc). The thing I noticed with electrolysis is once the giant hair bulb is finally removed from under the skin the pore closes up nicely.
If I wanted to do just my face and only that it probably would have been done sooner, but once I got going I found that electrolysis was addicting. Every hair that I couldn't stand became a reminder of where it was I came from and wanted to kill it with extreme prejudice :)
Title: Re: Which FFS procedure helps with passing the most?
Post by: misty2 on January 15, 2015, 10:58:56 AM
Post by: misty2 on January 15, 2015, 10:58:56 AM
Whenever I see the topic of hair removal, I feel compelled to put my 2 cents in about laser. I was contacted by my endocrinologist, last year, because he was surprised with my hair removal results. The hospital, that is his employer, does perform hair removal for transgender patients but he had not seen similar results. He wanted to be able to give some advice to his other transgender patients since reduction of facial hair is one of the side effects of hormone therapy that patients usually desire.
Additionally, I have been contacted separately by a few other friends and aquantiances requesting more information about my laser journey. A very brief history is that I started with electrolysis in 1998 and switched to laser hair removal in 2000. I completed my facial laser hair removal in 2006 (I did also go on to have other areas of my body treated.) I was not on hormone therapy at the time of my facial hair removal.
My thesis is that excellent permanent laser hair removal results, on both the face and body, are achieved due to the combination of a skilled operator and the right laser.
In order to get a more detailed answer to the question about why I think I had good results, I reconnected with Susan Lossing at Permanent Choice (the owner and founder of the chain of laser clinics) to talk about her techniques and my treatment with her.
I learned that she does use a different laser than most other laser clinics. The laser she uses is no longer manufactured. The machine she used on me is the Lumenis LightSheer Diode Laser XC with a 12 mm tip. This is the machine that works to get the finest hairs in the most difficult situations. The LightSheer Diode Laser XC is no longer manufactured. It has been replaced by the Lumenis LightSheer Duet. Susan seems to feel that the Duet is a good machine for course hair. But it does not have the tip necessary for fine work. Nor does it have the higher levels of power like the XC. When her favorite laser was being discontinued, (LightSheer Diode Laser XC) she purchased all of the obsolete XC lasers that she could find. She now has 20 of these lasers located in her 10 Minnesota clinics.
(I want to also emphasize that she does use other lasers for other hair removal applications, I am writing specifically about the LightSheer Diode Laser XC laser she used on me, a transgender person with abundant, masculine, facial hair at the start of treatment.)
My observation of treatment is that a skilled laser operator works to push the Joule output of the machine as high as possible while not burning the patient, many operators are too wimpy or fear causing the patient pain. For me, the procedure tested my highest tolerance to pain. Sometimes I could not stifle screams. But I thanked her because I knew it was working. Simultaneously to pushing my pain tolerance, my operator was vigilant to avoiding burning. One way this is accomplished is by involving the patient intimately, me, in the selection of the output levels of the laser. This was done by literally allowing me to see the settings on the machine while being treated. And changing Joule levels frequently, during each treatment, as different areas of the face are treated. More power on the chin and sideburns... a little less on the upper lip and parts of the neck. Levels are determined by patient pain tolerance, thickness of hair and by monitoring the hair follicle response to the energy levels administered. Seeing some hairs literally be "blown" out of their follicles was a proper response during my treatment to an appropriate energy intensity of the laser. Also the distinctive smell of hair burning was expected and was a positive sign.
Regarding Susan and her clinics specifically – I'm very happy to give my recommendation. Particularly when I can recommend something, without hesitation, because of the quality. There is a tremendous amount of frustration about hair removal within the transgender community. Susan cares. (Disclosure: I am NOT being compensated in any way for this recommendation.)
The clinic I used was: Permanent Choice
The owner is: Susan Lossing
Susan was also the only operator who always treated me. I started with her when her clinic was only two locations – over 14 years ago. From my many hours, and years, on the table being treated by Susan, I have come to know her well. She is excellent. However I'm confident that she also trains her staff thoroughly. My point being, that it might not be necessary to deal directly with Susan. Nevertheless, despite the growth of her business over the years, you can still ask for Susan to do your treatment.
Here is a link to her website:
http://www.permanentchoice.com/
Here is a link to the manufacturer (Lumenis) of the laser:
http://www.lumenis.com/
An even more anecdotal note is that I think getting the laser treatments improved my skin quality. I realize there's more than one variable going on (I started HRT.) Additionally, as I aged the oiliness of my skin declined. Nevertheless, in the weeks following my laser treatments I felt like I had substantially fewer blemishes. I've read that laser can kill certain types of bacteria that cause acne – I think I believe it. Less anecdotally, removing the hair from the follicle helps reduce pore size. I believe that also reduced oiliness. More out there, I think there is an effect on superficial capillaries. And that they are cauterized by the laser and that reduces redness to the face – making the skin more even colored. This is only my theory – I have absolutely nothing to back this up except my personal experience.
Additionally, I have been contacted separately by a few other friends and aquantiances requesting more information about my laser journey. A very brief history is that I started with electrolysis in 1998 and switched to laser hair removal in 2000. I completed my facial laser hair removal in 2006 (I did also go on to have other areas of my body treated.) I was not on hormone therapy at the time of my facial hair removal.
My thesis is that excellent permanent laser hair removal results, on both the face and body, are achieved due to the combination of a skilled operator and the right laser.
In order to get a more detailed answer to the question about why I think I had good results, I reconnected with Susan Lossing at Permanent Choice (the owner and founder of the chain of laser clinics) to talk about her techniques and my treatment with her.
I learned that she does use a different laser than most other laser clinics. The laser she uses is no longer manufactured. The machine she used on me is the Lumenis LightSheer Diode Laser XC with a 12 mm tip. This is the machine that works to get the finest hairs in the most difficult situations. The LightSheer Diode Laser XC is no longer manufactured. It has been replaced by the Lumenis LightSheer Duet. Susan seems to feel that the Duet is a good machine for course hair. But it does not have the tip necessary for fine work. Nor does it have the higher levels of power like the XC. When her favorite laser was being discontinued, (LightSheer Diode Laser XC) she purchased all of the obsolete XC lasers that she could find. She now has 20 of these lasers located in her 10 Minnesota clinics.
(I want to also emphasize that she does use other lasers for other hair removal applications, I am writing specifically about the LightSheer Diode Laser XC laser she used on me, a transgender person with abundant, masculine, facial hair at the start of treatment.)
My observation of treatment is that a skilled laser operator works to push the Joule output of the machine as high as possible while not burning the patient, many operators are too wimpy or fear causing the patient pain. For me, the procedure tested my highest tolerance to pain. Sometimes I could not stifle screams. But I thanked her because I knew it was working. Simultaneously to pushing my pain tolerance, my operator was vigilant to avoiding burning. One way this is accomplished is by involving the patient intimately, me, in the selection of the output levels of the laser. This was done by literally allowing me to see the settings on the machine while being treated. And changing Joule levels frequently, during each treatment, as different areas of the face are treated. More power on the chin and sideburns... a little less on the upper lip and parts of the neck. Levels are determined by patient pain tolerance, thickness of hair and by monitoring the hair follicle response to the energy levels administered. Seeing some hairs literally be "blown" out of their follicles was a proper response during my treatment to an appropriate energy intensity of the laser. Also the distinctive smell of hair burning was expected and was a positive sign.
Regarding Susan and her clinics specifically – I'm very happy to give my recommendation. Particularly when I can recommend something, without hesitation, because of the quality. There is a tremendous amount of frustration about hair removal within the transgender community. Susan cares. (Disclosure: I am NOT being compensated in any way for this recommendation.)
The clinic I used was: Permanent Choice
The owner is: Susan Lossing
Susan was also the only operator who always treated me. I started with her when her clinic was only two locations – over 14 years ago. From my many hours, and years, on the table being treated by Susan, I have come to know her well. She is excellent. However I'm confident that she also trains her staff thoroughly. My point being, that it might not be necessary to deal directly with Susan. Nevertheless, despite the growth of her business over the years, you can still ask for Susan to do your treatment.
Here is a link to her website:
http://www.permanentchoice.com/
Here is a link to the manufacturer (Lumenis) of the laser:
http://www.lumenis.com/
An even more anecdotal note is that I think getting the laser treatments improved my skin quality. I realize there's more than one variable going on (I started HRT.) Additionally, as I aged the oiliness of my skin declined. Nevertheless, in the weeks following my laser treatments I felt like I had substantially fewer blemishes. I've read that laser can kill certain types of bacteria that cause acne – I think I believe it. Less anecdotally, removing the hair from the follicle helps reduce pore size. I believe that also reduced oiliness. More out there, I think there is an effect on superficial capillaries. And that they are cauterized by the laser and that reduces redness to the face – making the skin more even colored. This is only my theory – I have absolutely nothing to back this up except my personal experience.
Title: Re: Which FFS procedure helps with passing the most?
Post by: Paula1 on January 15, 2015, 07:47:44 PM
Post by: Paula1 on January 15, 2015, 07:47:44 PM
Hi Danielle,
Your posts giving advice and your experiences to girls on here are wonderful ... :)
I really enjoy reading them.
Next month I am seeing the Facial Team here in London about more surgery.
In 2004, we were limited to choice betwen the big four, namely Suporn, Ousterhaut, van der Dussen and Zukowski.
My threads ' Thank God for the UK's NHS ' on here and FFS Support says it all really but we all indeed fortunate to have a wider choice these days.
Take care
Paula 1
Your posts giving advice and your experiences to girls on here are wonderful ... :)
I really enjoy reading them.
Next month I am seeing the Facial Team here in London about more surgery.
In 2004, we were limited to choice betwen the big four, namely Suporn, Ousterhaut, van der Dussen and Zukowski.
My threads ' Thank God for the UK's NHS ' on here and FFS Support says it all really but we all indeed fortunate to have a wider choice these days.
Take care
Paula 1
Title: Re: Which FFS procedure helps with passing the most?
Post by: misty2 on January 16, 2015, 05:16:10 AM
Post by: misty2 on January 16, 2015, 05:16:10 AM
Quote from: Paula1 on January 15, 2015, 07:47:44 PM
Hi Danielle,
Your posts giving advice and your experiences to girls on here are wonderful ... :)
I really enjoy reading them.
Next month I am seeing the Facial Team here in London about more surgery.
In 2004, we were limited to choice betwen the big four, namely Suporn, Ousterhaut, van der Dussen and Zukowski.
My threads ' Thank God for the UK's NHS ' on here and FFS Support says it all really but we all indeed fortunate to have a wider choice these days.
Take care
Paula 1
Thank you Paula, you have certainly added a wealth of experience as well. Thank you. I do not know when you started your transition, but it is like a mountain sometimes, particularly for us who grew up before the internet. From a distance it looked like a mountain. But, a mountain that I could climb. Then, as I got closer the mountain kept getting bigger. When I got to its base it turned scary. But, I started climbing anyhow. After climbing for a few months, steadily, exhausted, I turned to look down. It was so extraordinary how far below the ground seemed. Then I looked up. I realized that I had only climbed a 1/10 of the way. And I was already exhausted! I didn't realize that I literally still had years to climb!
As I look up, now, I can finally see the summit. But, I'm still not there! I think I still have at least 2 more years of climbing.
Kind Regards, Danielle
Title: Re: Which FFS procedure helps with passing the most?
Post by: antonia on January 16, 2015, 07:49:36 AM
Post by: antonia on January 16, 2015, 07:49:36 AM
Exactly, I feel like many operators just don't get it, passing over an area at half strength twice is not the same as full strength once, you have to boil the hair root and totally kill all the follicle cells and heating a follicle up twice is not the same as boiling it once.
Quote from: misty2 on January 15, 2015, 10:58:56 AM
Whenever I see the topic of hair removal, I feel compelled to put my 2 cents in about laser. I was contacted by my endocrinologist, last year, because he was surprised with my hair removal results. The hospital, that is his employer, does perform hair removal for transgender patients but he had not seen similar results. He wanted to be able to give some advice to his other transgender patients since reduction of facial hair is one of the side effects of hormone therapy that patients usually desire.
Title: Re: Which FFS procedure helps with passing the most?
Post by: misty2 on January 16, 2015, 08:35:17 AM
Post by: misty2 on January 16, 2015, 08:35:17 AM
Quote from: antonia on January 16, 2015, 07:49:36 AM
Exactly, I feel like many operators just don't get it, passing over an area at half strength twice is not the same as full strength once, you have to boil the hair root and totally kill all the follicle cells and heating a follicle up twice is not the same as boiling it once.
Antonia, Great analogy! - Danielle
Title: Re: Which FFS procedure helps with passing the most?
Post by: Paula1 on January 17, 2015, 12:23:02 PM
Post by: Paula1 on January 17, 2015, 12:23:02 PM
Quote from: misty2 on January 16, 2015, 05:16:10 AM
Thank you Paula, you have certainly added a wealth of experience as well. Thank you.
You are welcome Danielle ... :)
I do not know when you started your transition, but it is like a mountain sometimes, particularly for us who grew up before the internet.
I started in 1988 - a long time ago but also seems like yesterday
From a distance it looked like a mountain. But, a mountain that I could climb. Then, as I got closer the mountain kept getting bigger. When I got to its base it turned scary. But, I started climbing anyhow. After climbing for a few months, steadily, exhausted, I turned to look down. It was so extraordinary how far below the ground seemed. Then I looked up. I realized that I had only climbed a 1/10 of the way. And I was already exhausted! I didn't realize that I literally still had years to climb!
It is a long journey indeed. But what a trip eh? If I had to start again I would, despite all the problems with transition which in my case were virtually all caused by poor surgery.
As I look up, now, I can finally see the summit. But, I'm still not there! I think I still have at least 2 more years of climbing.
Me too
Kind Regards, Danielle
My very best wishes to you and I am sure both of us will keep strong despite any problems that we have had. We girls sure need to be as tough as cookies.
Hugs
Paula
Title: Re: Which FFS procedure helps with passing the most?
Post by: Jannicke on January 18, 2015, 08:28:10 AM
Post by: Jannicke on January 18, 2015, 08:28:10 AM
Hello Danielle,
It was very interesting to read your story. Thanks a lot for sharing.
Having reaped what benefits I can from HRT I've finally decided to embark upon a journey through FFS that hopefully will result in a facial apperance more to my liking.
I decided intially that moving forward in steps, like you did, would suit my needs best.
Most important to me was beeing able to assess the progress and adjust the next step according to that, and-like you did too-hoping to have reaced a satisfactory result before all the planned steps is completed.
First step is the forehead and I have shortlisted Di Maggio, Dr Ousterhout and Bart vd Veen. I addition I will have to take a closer look on Facial Team.
At first I wanted to include Rhinoplasty in the first step, but your approach makes me want to reconsider. Who did you shortlist here, and where did you carry out the surgery?
Second(or third) step is lower part of the face and I haven't really started my ressearch here as I still haven't decided what I need to do.
Also interesting to read about your experiences with hair-removal by laser as I made use of the same approach. I had 4 treatments on the body and and a bit over 10 on the face-leaving me happy with the results. They were all carried out some 12-13 years ago.
Take care.
It was very interesting to read your story. Thanks a lot for sharing.
Having reaped what benefits I can from HRT I've finally decided to embark upon a journey through FFS that hopefully will result in a facial apperance more to my liking.
I decided intially that moving forward in steps, like you did, would suit my needs best.
Most important to me was beeing able to assess the progress and adjust the next step according to that, and-like you did too-hoping to have reaced a satisfactory result before all the planned steps is completed.
First step is the forehead and I have shortlisted Di Maggio, Dr Ousterhout and Bart vd Veen. I addition I will have to take a closer look on Facial Team.
At first I wanted to include Rhinoplasty in the first step, but your approach makes me want to reconsider. Who did you shortlist here, and where did you carry out the surgery?
Second(or third) step is lower part of the face and I haven't really started my ressearch here as I still haven't decided what I need to do.
Also interesting to read about your experiences with hair-removal by laser as I made use of the same approach. I had 4 treatments on the body and and a bit over 10 on the face-leaving me happy with the results. They were all carried out some 12-13 years ago.
Take care.
Title: Re: Which FFS procedure helps with passing the most?
Post by: Sybil on January 18, 2015, 11:41:17 AM
Post by: Sybil on January 18, 2015, 11:41:17 AM
I posted this in another thread, but I thought it would be useful here as well:
I also want to add to my list that the philtrum can be a very strong indicator if it is exceptionally long and has prominent anterior projection (i.e. lack of lip curl).
I hope this helps you. Best of luck on your FFS journey.
Quote from: Sybil on January 11, 2015, 04:26:03 PMI also want to add that getting forehead work done without a rhinoplasty can be tricky business. These two parts of the face are very closely integrated with one another. However, I suppose it would be possible to get a forehead reconstruction done and adjust the bridge of the nose accordingly, leaving the rest of the features alone for a future surgeon. I think the result could potentially be very odd in the interim, though.
If passing to the general public is the concern, the human face is replete with signatures of sexual dimorphism. Their importance, in my opinion, is as follows:
Very strong indicators:
- brow bone prominence
- lower chin projection, chin length, square vs. rounded chin shape (viewed from the front)
- angle and depth of the nose
- vertical ratio of facial thirds; from the hairline to the eyebrows, from the eyes to the lower nose, lower nose to chin
- upper eyelid exposure (covered / not covered by brow bone and its soft tissues)
Strong indicators:
- anterior cheek bone projection
- upper and lower lip ratio, upper lip curl
- hairline shape
- overall nose size
- jaw width
Mild indicators:
- cheek fullness
- angle of jaw line
- lip fullness
- length of the philtrum (the area between the upper lip and bottom of nose)
- lateral cheekbone projection
Very mild indicators:
- canthal tilt (the angle between the fleshy inner and outer bits of the eye)
- cheekbone height
There are indeed women who carry a lot of masculine facial traits and men who, likewise, carry many feminine traits. The reason that humans maintain a strong ability to tell one another apart is because these differences are often measured in millimeters and depend on how they relate to the rest of the face. For example, a woman with a strong brow bone is often either older or has considerable upper eyelid show. She is also likely to inhabit many other female-range features (like a sweeping nose angle and shallow upper nasal depth). A man with a petite, dainty nose likely still has strong nasal depth, modest upper eyelid show, and a facial ratio that favors the middle and lower thirds. He could also have masculine lower chin projection. The list goes on.
Whether or not a trans woman "needs" FFS to pass depends on how all of her facial features relate to one another. Even one well-established masculine feature can throw off the rest, especially if it is a feature that is strongly associated with sexual dimorphism.
As an aside, facial thirds cannot be manipulated by medicine that is practiced by the vast majority of surgeons (and certainly not any FFS surgeons, that I'm aware of). The techniques currently available to move these bits are fairly risky, often produce ample scarring, and are almost entirely reserved for people disfigured by genetic abnormalities. However, someone with masculine thirds (especially a very long midface) can still easily pass as long as their remaining features are feminine, hence there are few people that skilled FFS cannot help.
I also want to add to my list that the philtrum can be a very strong indicator if it is exceptionally long and has prominent anterior projection (i.e. lack of lip curl).
I hope this helps you. Best of luck on your FFS journey.
Title: Re: Which FFS procedure helps with passing the most?
Post by: misty2 on January 18, 2015, 10:30:54 PM
Post by: misty2 on January 18, 2015, 10:30:54 PM
Quote from: Jannicke on January 18, 2015, 08:28:10 AM
Hello Danielle,
It was very interesting to read your story. Thanks a lot for sharing.
Having reaped what benefits I can from HRT I've finally decided to embark upon a journey through FFS that hopefully will result in a facial apperance more to my liking.
I decided intially that moving forward in steps, like you did, would suit my needs best.
Most important to me was beeing able to assess the progress and adjust the next step according to that, and-like you did too-hoping to have reaced a satisfactory result before all the planned steps is completed.
First step is the forehead and I have shortlisted Di Maggio, Dr Ousterhout and Bart vd Veen. I addition I will have to take a closer look on Facial Team.
At first I wanted to include Rhinoplasty in the first step, but your approach makes me want to reconsider. Who did you shortlist here, and where did you carry out the surgery?
Second(or third) step is lower part of the face and I haven't really started my ressearch here as I still haven't decided what I need to do.
Also interesting to read about your experiences with hair-removal by laser as I made use of the same approach. I had 4 treatments on the body and and a bit over 10 on the face-leaving me happy with the results. They were all carried out some 12-13 years ago.
Take care.
Hi Jannicke,
Thank you so much for writing. Do you have any photos... particularly profile, posted anywhere? - Danielle
Title: Re: Which FFS procedure helps with passing the most?
Post by: misty2 on January 18, 2015, 10:34:53 PM
Post by: misty2 on January 18, 2015, 10:34:53 PM
Quote from: Sybil on January 18, 2015, 11:41:17 AM
I posted this in another thread, but I thought it would be useful here as well:I also want to add that getting forehead work done without a rhinoplasty can be tricky business. These two parts of the face are very closely integrated with one another. However, I suppose it would be possible to get a forehead reconstruction done and adjust the bridge of the nose accordingly, leaving the rest of the features alone for a future surgeon. I think the result could potentially be very odd in the interim, though.
I also want to add to my list that the philtrum can be a very strong indicator if it is exceptionally long and has prominent anterior projection (i.e. lack of lip curl).
I hope this helps you. Best of luck on your FFS journey.
What a great post, thank you. One think I might add to the "strong" category is upper tooth show. Almost all women have upper tooth show when the mouth is in repose, but open. Kind Regards, Danielle
Title: Re: Which FFS procedure helps with passing the most?
Post by: Paula1 on January 19, 2015, 04:02:51 AM
Post by: Paula1 on January 19, 2015, 04:02:51 AM
Hi Danielle,
Could not agree with you more about the teeth.
After my Zukowski upper lip lift, he then put fat in the top lip that negated the effect of the lift so that I really need another one. This I will be discussing with the Facial Team when they are in London next month.
A friend of mine in the USA who hated her fat filled top lip had him try to remove the fat by cutting it out in April 2013 but she is still very unhappy with it's appearance. She is currently looking elsewhere to get more removed.
In fact another friend of mine who was having revisions done by him insisted that he did not top up the fat in her top lip but he went ahead anyway and she was furious.
All this fat does is make the top lip longer (also fatter) and is another marker ( like the similar short nose and over raised eyebrows ) that you are a 'Z' girl which I really dislike and as a result don't often like mixing with some of my 'Z' friends in public because we look like relatives.
When I look at my Pre FFS fotos. I used to have a longer nose without the slight piggy look it has now and my top lip also looked shorter than it does now because of my natural born aesthetics !!!! An Upper Lip Lift with no fat and a far better rhinoplasty would have been desirable.
I am so upset that I am going to have to spend more money to improve my appearance. Whether my nose can be improved is going to be a real challenge and maybe I will just have to live with it. It's sad that I wake up each morning regretting my Zukowski FFS and having to go thru that major forehead revision last October here in the UK was indeed quite hard to say the very least.
If my nose can't be altered, then another upper lip lift and, if possible, fat removal will make the whole area look better.
But at least my forehead has been sorted so I am getting there which is awesome ... :) so I must remain positive.
Could not agree with you more about the teeth.
After my Zukowski upper lip lift, he then put fat in the top lip that negated the effect of the lift so that I really need another one. This I will be discussing with the Facial Team when they are in London next month.
A friend of mine in the USA who hated her fat filled top lip had him try to remove the fat by cutting it out in April 2013 but she is still very unhappy with it's appearance. She is currently looking elsewhere to get more removed.
In fact another friend of mine who was having revisions done by him insisted that he did not top up the fat in her top lip but he went ahead anyway and she was furious.
All this fat does is make the top lip longer (also fatter) and is another marker ( like the similar short nose and over raised eyebrows ) that you are a 'Z' girl which I really dislike and as a result don't often like mixing with some of my 'Z' friends in public because we look like relatives.
When I look at my Pre FFS fotos. I used to have a longer nose without the slight piggy look it has now and my top lip also looked shorter than it does now because of my natural born aesthetics !!!! An Upper Lip Lift with no fat and a far better rhinoplasty would have been desirable.
I am so upset that I am going to have to spend more money to improve my appearance. Whether my nose can be improved is going to be a real challenge and maybe I will just have to live with it. It's sad that I wake up each morning regretting my Zukowski FFS and having to go thru that major forehead revision last October here in the UK was indeed quite hard to say the very least.
If my nose can't be altered, then another upper lip lift and, if possible, fat removal will make the whole area look better.
But at least my forehead has been sorted so I am getting there which is awesome ... :) so I must remain positive.
Quote from: misty2 on January 18, 2015, 10:34:53 PM
What a great post, thank you. One think I might add to the "strong" category is upper tooth show. Almost all women have upper tooth show when the mouth is in repose, but open. Kind Regards, Danielle
Title: Re: Which FFS procedure helps with passing the most?
Post by: Jannicke on January 19, 2015, 01:07:08 PM
Post by: Jannicke on January 19, 2015, 01:07:08 PM
Hello again Danielle,
I don't seem to be allowed yet to include photos in my profile.
Weather you wish to answer my questions or not it's entirely up to you. I',m here just looking for information and, occassionally, to give some information to whoever might be interested.
I don't seem to be allowed yet to include photos in my profile.
Weather you wish to answer my questions or not it's entirely up to you. I',m here just looking for information and, occassionally, to give some information to whoever might be interested.
Title: Re: Which FFS procedure helps with passing the most?
Post by: Sybil on January 20, 2015, 06:56:23 PM
Post by: Sybil on January 20, 2015, 06:56:23 PM
Quote from: misty2 on January 18, 2015, 10:34:53 PMThank you, I appreciate that. I do agree that upper tooth show could be added to the "strong" category, though it is age dependent. Upper tooth show is a very strong indicator of age (in men, too), and older women begin to lose their tooth exposure as life continues on. I really should add this to any future iterations of the list.
What a great post, thank you. One think I might add to the "strong" category is upper tooth show. Almost all women have upper tooth show when the mouth is in repose, but open. Kind Regards, Danielle
It is also considered a masculine trait to have considerable lower tooth show -- mind you, unlike with women, this is not exclusive to also having upper tooth show. I think this is important to keep in mind when smiling (and possibly even speaking), as either gender seems a bit conditioned to use different facial muscles to express a smile and exaggerate this effect. That is to say, men use mid/lower facial muscles for an even-toothed exposure, while women use upper facial muscles for greater upper tooth exposure and lower tooth concealment.
For anyone wondering how FFS would expose your upper teeth, it is a side effect of a lip lift. A lip lift removes a section of the philtrum in order to shorten the philtrum's length, create a lip curl, and roll out the upper lip so that it is more prominent. The shorter philtrum length and heightened, centrally angled vermillion border (http://en.wikipedia.org/wiki/Vermilion_border) create more tooth exposure.
Title: Re: Which FFS procedure helps with passing the most?
Post by: Obfuskatie on January 21, 2015, 03:13:59 AM
Post by: Obfuskatie on January 21, 2015, 03:13:59 AM
Quote from: misty2 on January 12, 2015, 01:54:19 PM
This was my ranking of forehead surgeons two years ago:
1. DiMaggio
2. Facial Team
3. Ousterhout
4. Suporn
5. Bart
6. Spiegel
...
Time: I have spent a lot more time: swollen, bruised, debilitated and traveling. I am tired of it. It would've been nice to have one surgery (if it had only been one surgery) and just be done with it. It would be nice to be able to get onto the next phase of my life. If people ask me what I've been doing with my life recently: the answer I tell them is working on my stand-up comedy. But, in reality the biggest part of my life is been working on transition, my divorce, (which my wife blames on me having surgery) and healing.
...
Before I did my FFS, I made sure to read Dr. Ousterhout's book, which is available on ebook-form on Amazon. Unfortunately, Dr. O doesn't perform surgeries anymore, he is now consulting with and assisting Dr. Jordan Deschamps-Braly in San Francisco in a joint practice for their FFS patients. I ended up choosing them for my FFS, and am quite happy with the results so far, although I'm barely a month and a half into my recovery. Also, doing all my procedures at once really kicked my butt, and it has been a really hard recovery so far. Price-wise, I spent nearly 50k total, including hospital fees, anesthesiologist, and a room for a week at a hotel near my doctor's office. The procedures i had done were; trache shave, a small amount of fat removal from my neck, chin, nose, forehead contouring, and a scalp advancement.
I'd say the most important procedure to do first is the one you feel most insecure about. Forehead/Nose, Scalp Advancement, Lips, Chin, Jaw Contouring, whatever you like least about your face, do that procedure first.
Just know that paying for the anesthesiologist and hospital visit each procedure, will cost a lot.
Title: Re: Which FFS procedure helps with passing the most?
Post by: misty2 on January 21, 2015, 08:05:13 PM
Post by: misty2 on January 21, 2015, 08:05:13 PM
Quote from: Obfuskatie on January 21, 2015, 03:13:59 AM
Before I did my FFS, I made sure to read Dr. Ousterhout's book, which is available on ebook-form on Amazon. Unfortunately, Dr. O doesn't perform surgeries anymore, he is now consulting with and assisting Dr. Jordan Deschamps-Braly in San Francisco in a joint practice for their FFS patients. I ended up choosing them for my FFS, and am quite happy with the results so far, although I'm barely a month and a half into my recovery. Also, doing all my procedures at once really kicked my butt, and it has been a really hard recovery so far. Price-wise, I spent nearly 50k total, including hospital fees, anesthesiologist, and a room for a week at a hotel near my doctor's office. The procedures i had done were; trache shave, a small amount of fat removal from my neck, chin, nose, forehead contouring, and a scalp advancement.
I'd say the most important procedure to do first is the one you feel most insecure about. Forehead/Nose, Scalp Advancement, Lips, Chin, Jaw Contouring, whatever you like least about your face, do that procedure first.
Just know that paying for the anesthesiologist and hospital visit each procedure, will cost a lot.
I think you are correct about everything you have written here. And, post op or not, your avatar is beautiful. - Kind Regards, Danielle
Title: Re: Which FFS procedure helps with passing the most?
Post by: misty2 on January 21, 2015, 08:15:19 PM
Post by: misty2 on January 21, 2015, 08:15:19 PM
Quote from: Jannicke on January 19, 2015, 01:07:08 PM
Hello again Danielle,
I don't seem to be allowed yet to include photos in my profile.
Weather you wish to answer my questions or not it's entirely up to you. I',m here just looking for information and, occassionally, to give some information to whoever might be interested.
Hi Jannicke,
I only wanted to see a photo to see if a FFS surgeon could do your nose. I trust FFS surgeons more with less complicated noses. For my nose I went to a surgeon in Minnesota. I do not mind sharing his name, if you really want it, just ask again. However, I think the surgeon you chose depends a great deal on your "before" nose. Look at many before and after photos and look for your nose (if possible) in the "before"... then do you like the "after" versions? Hopefully there are some surgeon comments along with the before and after of your nose. Those will give a great idea what the patient requested... such as, "I do not want much change, keep it similar to my existing nose. just take out the hump" or simply, "make me beautiful!" the patient requests are an important factor. Finally, visit a lot of rhinoplasty surgeons. I am sure there are at least 10 within 100 miles of you. Visit all ten! You will learn something every time. This seemed like your only question, if not please follow up with more details.
Kind Regards, Danielle
Title: Re: Which FFS procedure helps with passing the most?
Post by: Obfuskatie on January 21, 2015, 10:12:06 PM
Post by: Obfuskatie on January 21, 2015, 10:12:06 PM
Quote from: misty2 on January 21, 2015, 08:05:13 PMAww, thank you Danielle!
I think you are correct about everything you have written here. And, post op or not, your avatar is beautiful. - Kind Regards, Danielle
And to the OP: be careful about getting your nose done by a doctor unfamiliar with FFS. Make sure you clearly inform them you want to make your face look more feminine and bring examples of what you'd like, then listen to their input to see what they think would be the best course of action. They are the expert opinion you need most of all. And if you feel like they are merely trying to sell you any new nose, get out of there and find a Rhinoplasty surgeon who cares more about patient satisfaction than money.
Sent from my iPad using Tapatalk
Title: Re: Which FFS procedure helps with passing the most?
Post by: misty2 on January 22, 2015, 07:31:09 AM
Post by: misty2 on January 22, 2015, 07:31:09 AM
Quote from: Obfuskatie on January 21, 2015, 10:12:06 PM
Aww, thank you Danielle!
And to the OP: be careful about getting your nose done by a doctor unfamiliar with FFS. Make sure you clearly inform them you want to make your face look more feminine and bring examples of what you'd like, then listen to their input to see what they think would be the best course of action. They are the expert opinion you need most of all. And if you feel like they are merely trying to sell you any new nose, get out of there and find a Rhinoplasty surgeon who cares more about patient satisfaction than money.
Sent from my iPad using Tapatalk
Absolutely, make it clear you want a feminine nose. It is important to know about "Nasolabial Angle" & "angle of rotation" (106 degrees is a good target, but results are individual.) Supra-tip break. (I like it, but also an individual choice.) Alar show... and so many other terms. Visiting a good rhino website, (this is a good basic site... but there are many: http://www.drhilinski.com/rhinoplasty-tutorial/nasal-analysis-in-rhinoplasty/)
Visiting a surgeon, then back to an instructional website, then back to a surgeon. Then visit a different surgeon... Learning the terms and how to describe in Doctor terms what you want is critical. Communication is difficult and important.
The first few times visiting I was nervous and hardly remembered anything. Another reason to visit many doctors and be patient before being a patient. (sorry, had to make that corny joke.)
Kind Regards, Danielle