Susan's Place Transgender Resources

Hi Ladies!

I am asking for input on what I should prioritize in choosing FFS procedures.  I have had Skype consultations with Dr. Speigel and Facial team.  They each provided me with very different input on what they recommend. 

Dr. Simon from Facial Team recommended:
- Forehead with an incision on the top of the head and immediate hair transplant of the hair from the incision
- Chin shaving

That's it.  I asked about lip lift and jaw.  He said that he didn't recommend jaw work for me, and suggested that I consider a lip lift after seeing FFS results.  We discussed that if I did the lip lift later that it would be with a surgeon local to where I live (Michigan, USA).

Dr. Spiegel recommended:
- Forehead and hairline lowering, via the traditional incision on the forehead.  He said that his technique allows hair to grow through the incision, hiding the scar.
- Rhinoplasty
- Cheek implants
- Lip lift
- Jaw and Chin remodeling

He said that the cheek implants, in conjunction with the jaw work, would give me a heart-shaped face. He also said that if there procedures I didn't want, he would be happy to do only those that I chose.

So...I am looking for input from ladies that have had FFS or have been researching it on what procedures I should do, and what priority order you'd place on them.

Here's a couple of pics with no makeup (!) from today (along with a new avatar pic today with makeup).  I've been on HRT for nine months.  If I have surgery later this Summer, I'll have a year of HRT in.

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi12.photobucket.com%2Falbums%2Fa212%2Fkimsails%2FFFS%2520Planning%2FIMG_3497_zpsjugfkllb.jpg&hash=828fb2ec04391b017f0628ce6597479e88e777cb)

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi12.photobucket.com%2Falbums%2Fa212%2Fkimsails%2FFFS%2520Planning%2FIMG_3498_zps0pquucs2.jpg&hash=dab6bde24f6561c413eb49fb78a912f60de5112c)

Also, I'm adding the quotes that I received from both doctor's.  There is a second quote from Facial Team. I asked them to price out some different options after my consult with Dr. Spiegel -- something in between the two Drs. recommendations.

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi12.photobucket.com%2Falbums%2Fa212%2Fkimsails%2FFFS%2520Planning%2FFFS%2520quotes_zps3rwbhggg.jpg&hash=75d2416d6db25f08a2bfd1b2ac1f661dfb9b6f51)

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi12.photobucket.com%2Falbums%2Fa212%2Fkimsails%2FFFS%2520Planning%2FFacial%2520Team_zpslt9cykpb.jpg&hash=d36121f650641449389d7fb1218c6645caf3f7fc)


Dr. Speigel's costs are higher, but the extra travel costs for me to get to Spain would reduce that difference enough that I likely won't choose a doctor based upon cost.  I like Facial Team's hair incision, but I don't know that I have enough follicle-density to justify the 6600 Euro cost on the transplant.  And I'd hate to waste the hair if I choose to do the crown incision but don't do the transplant.

Any input from you ladies on procedures and surgeon choice would be much appreciated!

Kim :)

Hello Kim

From the pictures you posted, you look extremely good.  I would very seriously question whether FFS is necessary in your case.  Without makeup I would gender you as female, no question.

Certainly Facial Team would get rid of the small amount of brow bossing you have.  Have they given you an estimate of the number of folicular units they might be able to transplant after the coronal incision?  I'd suggest that if it's less than 1,000 (or around 5,000 hairs), it's maybe not worth the cost to get what would be a fine spray of extra hair, and on top of this have your current hairline moved 2-5 mm backwards. 

In my opinion you do not need a lip lift as your top lip is very much in a female range.

Should you go ahead with FFS, I can tell you that I was absolutely thrilled with Facial Team in Spain.  They are highly professional, and did a great job with me.  However, from the limited information from your photos, my suggestion would be to reallocate the money you'd be using on FFS for something else.

Hope this helps
Julia

I'm not sure what your goals are from what you wrote it seems you had a consultation with both doctors where you asked them what they recommended which is fine but leaves me in the dark as to what your trying to achieve. 

Honestly if I had your face my biggest priority would be moving the hair line forward because from the front you already gender as female to me (especially your avatar picture where you are smiling) and moving your hair forward would really help solidify your female look.   I would also look into getting some laser skin resurfacing for your face to help even out the skin tones and help remove any wrinkles.  To me the other procedures on your list would really just be icing on the cake so to speak and unless you really want to change or enhance your face in some particular way I would be hesitant to just jump in and do procedures someone else recommended.

if you really wanted all those procedures both doctors recommended (or had on their list) a forehead/hair advance/fill in and chin augmentations of some kind so unless your planning on doing something all at once I would look at doing those first (in the order given) then go on from there.

In all honesty, I don't see the need for all the procedures, your bone structure is very within female ranges all over, as you know one year on HRT is barely half the time and your soft tissues will really deliver by year 2.

If you really are craving to have something done I would go for maybe a type 1 (cause that's all that looks like you need)  forehead, there might be a little more to burring down your orbital rims.  Your hairline is the only thing that jumps at me. But when it's that far back, your best bet is to bring it forward is transplants, so in your shoes, I would probably go to Facial Team, even though I didn't go to them.  I would suggest for you to have your cheeks done if you were 2+ years on HRT, but I wouldn't as it is. They always fill in  with more time on HRT . But with 1 year, I wouldn't.

Thank you all for your input!  It is very much appreciated!

I see my hairline as my biggest need.  After that I see my forehead.  I have very small brow bossing, nothing I would worry about, but my forehead does come so far forward that it sets my eyes very deeply.  I would like to do something about that.  And *if* I do forehead surgery, *then* I figured that I need to do that before hair transplants.

If I do go ahead with the forehead work, would it be better to have the hairline incision and have my hairline moved foreward (to be followed up with transplants in the corners and in front of the scar)?

After forehead and hair I see my jaw and chin. I don't see the need for a lot of work, but I would like to narrow them a little.

Julia:
Facial Team is on my short list in part from your experience there. In the quote I received from them, they list 1500 to 1700 units.  I assume that this is a generic estimate.  I don't know how Dr. Simon could have judged a specific estimate for me from a Skype consult.  From their 1500 to 1700 estimate, I figured 1000 was more realistic for me.  Can I ask where you chose to get the incision for forehead work when you went to Facial Team? 

Emily:
I agree with you on the laser!  I've been thinking about getting a fractional laser treatment.

Carly:
I'm hoping you are right about the cheeks in year two of HRT! Although I suspect with me it will be limited by may age.

Thanks ladies!

Kim  :)

Hi Kim

For my work with Facial Team, they did not recommend the immediate hair transplant, as I think they considered the hair around the scar to be a little sensitive to testosterone.  But for the FFS they used a cranial incision, and it was fully hidden in my hair.  Some six months later I used their transplant specialist - Andres Merlo:  he performed a FUSS transplant by taking a 20 square cm section from the occipital zone.  The results are quite good, but I would advocate a dose of reality to you, since coverage might be less than you expect.

Regards
Julia

Hi Kim! First of all just wanted to say that I agree with the others. You look great already :) With that, I want to add that there is nothing wrong with doing FFS procedures in stages. For someone who is not looking for such an aggressive approach, less is usually more. You may try one or two procedures and see how you feel about it after three months, keeping a few more procedures in your pocket if you feel that it wasn't enough.

The main reason is: you want to avoid looking like you had work done, and staging it out can help you avoid going too far all at once.

Congrats on your decision to go in for some FFS, it is incredibly exciting!

Thanks Julia!  A couple questions if I may...

Quote from: Julia-Madrid on May 18, 2015, 04:02:34 AM
they did not recommend the immediate hair transplant, as I think they considered the hair around the scar to be a little sensitive to testosterone. 

Do you know how they determined that?

Quote from: Julia-Madrid on May 18, 2015, 04:02:34 AMThe results are quite good, but I would advocate a dose of reality to you, since coverage might be less than you expect.

Do you mean this for all hairline procedures, or specifically transplants?

Jenny, thanks for the the reply!  I understand what you mean about going too far.  That concern has to be carefully considered.  After that though, I have to be concerned about cost. And it seems that splitting up services adds more costs in travel, hospital expenses, time of work. 

Thanks!
Kim :)

Hi Kim

To answer your questions :D

I'm not entirely sure how they got to their decision not to reuse the strip from the cranial incision.  Reason I say this is that the surgeons from FT said that they didn't think it viable, but when, six months later, I went to see their hair transplant specialist, who works in a different city, he considered that it would have been perfectly viable.  However, I will comment that there was probably very little to transplant, since my hairline scarcely moved after FFS.  I know some girls who have had over 5mm of "retreat" after forehead contouring.

As for the dose of reality, I can only really talk about what I had done, which was an occipital transplant to the temples.  My 1,800 transplants are starting to look good, but the area will always be a little bit thin; I probablyh won't be able to wear my hair pulled back, for instance.

It's not clear from your photos how much area you need to cover, and what type of coverage you will get by using the strip from the cranial incision.  It might be worth exploring this a little, as it may be necessary to have a second transplant, taken from an occipital donor site, in order to get an acceptable density in front.  I would suggest that you make a plan taking into account the possibility of two transplants.

If I reflect on how well the transplants worked, overall I am pretty satisfied.  We older girls need to be realistic about what is achievable - we're not adolescents with that mane of hair.  So, while any transplant will be a significant improvement, we're not going to have Hilary Clinton's hairline, to use an example we would both know.

Not all my experience of the transplant was good - I got a nasty infection after the stiches were removed from the donor site, and I will have some patches where hair will not grow.  It's not noticeable at all, but it was not an expected outcome.

If you want to talk about the transplant issue in more detail, let me know, and we can have a skype call - happy to help :D

Regards
Julia

Thanks Julia!

I have a follow-up Skype scheduled with Dr. Simon on June 3rd.  I'll be trying to dig deeper on the the pros/cons of hairline approaches with my situation.  Don't be surprised in I take you up on your Skype offer after that discussion!  :)

It is funny that you mention Hilary Clinton!  I've talked with my therapist a number of times about the procedure I am considering.  She recommends at most just hairline work, no forehead or other work.

A couple weeks ago when I came in for a session she had a little clipping of Hilary from a magazine.  She said "Look at the size of Hilary's forehead! See! You've got nothing to worry about!"

Thanks!
Kim :)

Kim, you'd be welcome.

Cheers
Julia

You are very feminine. Your need is just to eliminate orbital bone, which is small. Hair transplant. If you want to beautify one lift lip would also be perfect. Most doctors only want to make money with numerous unnecessary procedures. Not like the results of the Simon Facial Team, they think too weak, little transformers. Spiegel beautifies very well, but I think expensive. What is your interest: beautification or national origin? kisses

Juliana