Susan's Place Transgender Resources

Hey everyone! Wow, it's been a while hasn't it? Not sure if anyone here will even remember me, so here is a link to my previous voice surgery thread (https://www.susans.org/forums/index.php?topic=196493) to provide some context. I just wanted to say, I am now officially booked for surgery at Yeson! :D I booked a date for surgery, and booked a flight/hotel. I will be in Korea from June 20th to the 29th, so if anyone else is planning to be there during that period and wants to meet up, be sure to let me know. ;) Just an FYI though, apparently the summer is the most expensive time to fly to Korea. I would've waited until later in the year to get a better fare, but during the summer was really the only time I could work things out logistically (accounting for the fact I won't be able to speak for at least a month after surgery).

Anyway, I talked a lot earlier in this thread about how I was on the fence about doing this surgery, since I do have a very passable voice, and I have actually been having a lot fewer issues with it lately than I was when I originally made this thread. But still, the allure of having a proper feminine singing voice and no longer dealing with the strain and effort of using a trained voice is too much to pass up. I decided on Yeson, because I felt like their surgery technique would offer the highest chance of improving my voice and the lowest chance of messing up what I already have. That being said, there is always that lingering doubt, and I will probably use the results of this surgery as a metric to decide if I want to pursue other transition related surgeries in the future.

I would also like to say, as far as why I stopped posting, I had a really hard year last year... I mean, I talked a lot about how poorly my life in general when I was still posting, but last year brought things to a whole new level. That's all I really want to say about that for now, but the good news is, I'm in a better place now than I have been in a long time. I'm feeling good about my transition, and life in general, and I really haven't been dwelling on gender dysphoria that much at all. I guess when you become occupied with even bigger problems, even gender dysphoria has to take a back seat. And anyway, I was already feeling better about my dysphoria, as my last topic (https://www.susans.org/forums/index.php/topic=203431) had mentioned, so it seemed like the right time to bow out.

But I do want to post about my surgery experiences for the benefit of anyone else who might consider voice surgery. I'm not sure if I'm the best example, since the outcomes and expectations are probably different for me than for someone who is having the surgery because their voice can't pass at all. But I'll do my best to provide my perspective on the process and hopefully it will help someone out.

I am still here and I remember you. After surgery you will still need to used a trained voice however it will be much less of an issue hitting the feminine range. In my case, I still need to use a head voice but instead of a 180 HZ maximum pitch, I can now hit around 700 HZ. As for singing, my old voice was so bad, I never learned how to so to. If I wanted to sing, I would have to take lessons starting with the basics.

Hmm... do you think that's still true if your voice is in the androgynous range to start out with though? I would think that at a certain point the line between using a trained voice and just speaking naturally would start to blur. Well, I guess I'm going to find out how it goes either way. ;) I really do hope I can sing well after the surgery though. I can sort of force myself to sing in a female range now, but the strain pretty much destroys my voice if I do it for any amount of time. Oh, and I remember you too. ;) Nice to see you're still around providing helpful advice as always.

You still need the proper resonance though you don't have to pitch your voice nearly as much as before unless you want to hit the really high notes. Now my voice has had plenty of time to heal, I find that I can still go well into the male range with the chest voice so the bottom end wasn't lifted all that much but the upper end and total range has been greatly extended. CTA is the only way to really eliminate the bottom end but that's something that Yeson doesn't offer. I also debate the value of CTA unless you are dealing with a really low voice. The other disadvantage of CTA is that it limits the range so it's not appropriate if you want to sing.

Resonance is actually something I was sort of wondering about. I have heard people comment who had gone to an actual professional voice therapist that my resonance was really good, but I never specifically worked on my resonance at all. I don't know why I have good resonance, because it was never something I put any thought or effort into. What is the typical way you are supposed to work on training resonance?

Hi Miyuki,

I look forward to hearing about your experience.  I just had surgery at Yeson a month ago, and I am just starting to speak again.  It is tough and I do sound a bit raspy right now, but each aday I am able to say a few more words.  In fact I was able to order something from the store today without having to write it down.  Huge accomplishment.  My Mom even commented that I sounded better.  The voice training starts in a month and Yeson does provide some vocal exercises to help with voice placement.  I start all of these next month :)

Best wishes to you.
-Sarah

Women normally used a head voice though some use the chest voice. As there vocal cords are already pitched higher, they  don't need to tune the larynx as much. As your starting voice was already  up there, you will approach it more like a CIS woman would using the larynx for some filtering but not as much as you did before surgery. It will somewhat depend on how much of a tie you get. Mine was up there at 50% but I suspect the doctor will decide on less. That will determine how much additional pitch you will have to add in to hit the desired range.

Quote from: Inarasarah on March 07, 2017, 04:33:37 PM
Hi Miyuki,

I look forward to hearing about your experience.  I just had surgery at Yeson a month ago, and I am just starting to speak again.  It is tough and I do sound a bit raspy right now, but each aday I am able to say a few more words.  In fact I was able to order something from the store today without having to write it down.  Huge accomplishment.  My Mom even commented that I sounded better.  The voice training starts in a month and Yeson does provide some vocal exercises to help with voice placement.  I start all of these next month :)

Best wishes to you.
-Sarah

I'm glad to hear your recovery is going well. I am a little nervous about the recovery and the whole not talking for a month thing, but I planned everything so I'm doing it at a time where I won't have any obligations that would require me to speak, so hopefully it's not too much of a problem. By the way, I'm curious, what did you find that was fun and interesting to do in Seoul? I don't really have any specific plans for my time there other than surgery and playing hours upon hours of pop'n music at the nearest arcade. :D

Quote from: Dena on March 07, 2017, 06:44:06 PM
Women normally used a head voice though some use the chest voice. As there vocal cords are already pitched higher, they  don't need to tune the larynx as much. As your starting voice was already  up there, you will approach it more like a CIS woman would using the larynx for some filtering but not as much as you did before surgery. It will somewhat depend on how much of a tie you get. Mine was up there at 50% but I suspect the doctor will decide on less. That will determine how much additional pitch you will have to add in to hit the desired range.

I wonder if this is why I had an easier time training my voice than most do. I've heard about the whole head voice vs. chest voice thing, and I am pretty sure I never actually used a chest voice. Even when I try to speak in a way that makes my chest vibrate more, it just feels weird and unnatural to me. So maybe that's why the only thing I really needed to work on was pitch.

Quote from: Miyuki on March 08, 2017, 01:14:26 AM
I wonder if this is why I had an easier time training my voice than most do. I've heard about the whole head voice vs. chest voice thing, and I am pretty sure I never actually used a chest voice. Even when I try to speak in a way that made my chest vibrate more, it just feels weird and unnatural to me. So maybe that's why the only thing I really needed to work on was pitch.

It could be. We had one member who went to Yeson and her voice was totally feminine right out of the box. She told us she had a very sing song voice when she was younger and her father hated it. I suspect she was very used to feminine speech patterns as well as at least a partial head voice. Her voice what one that violated the 50% surgery, 50% therapy rule as all she needed was surgery.

^BUMP^

Well, the day has arrived! Technically tomorrow, but today I have been very busy packing and getting ready, so I thought I might as well revive this thread too. The plan is, leave on the 19th (tomorrow), arrive on the 20th, pre-op on the 21st, surgery on the 22nd, and post op on the 28th. So far I don't have any particular plans for my time in Korea other than bumming around video game arcades. ;D If anyone has any suggestions please let me know. ;)

Just a quick update from my iPhone, a much bigger one will follow later. I had surgery today and everything went perfectly, I'm currently in the recovery room, where I will be for several hours, and after that I can return to my hotel. One thing I learned from Dr. Kim is that long term use of a trained voice is not good for you. He estimated I was using my voice something like 13 times harder than a normal person would. It's going to be a challenge to learn how to adapt to my new voice, but if I trained my voice once, I can do it again. ;)

Congratulations on your surgery. I have used a trained voice for over 35 years and their wasn't any damage to my voice when Dr Haben looked at it. I think the correct wording is abuse of a trained voice isn't good for you. My therapist was very clear about what I should and shouldn't do with my voice and those are the lessons I pass on when working with people on the site. My therapist wrote the book on treating damaged voice without surgery using only therapy.

Okay, full update time! First of all, sorry to leave everyone hanging, but it has been an extremely busy few days and this is the first real downtime I have had. I left early Monday afternoon and got here late Tuesday evening. The original plan was to arrive by around 6PM, but my connecting flight was delayed and I didn't actually get here until after 9PM. Then there was a long taxi ride, getting settled, and by the time all was said and done my brother and I got to bed by about midnight.

Then on Wednesday it was my pre-op appointment. There was some free time in the morning, but since we both wanted to sleep in, we pretty much went to the pre-op first thing. They had me do a ton of different tests, one of which was really difficult for me to do since I couldn't stop gagging, and after that I was able to talk to Dr. Kim. He told me that the tests showed, among other things, that I had an extremely bad vocal tremor and that I am using my voice something like 13 times harder that normal to compensate for it. This didn't really surprise me, since I knew I always pushed my voice extremely hard, and that it made me highly suceptable to vocal strain. So no surprise, he said I needed Botox, and that I will probably even need a follow up Botox injection in six months. He also thinks I should follow up with a voice therapist to help unlearn all the bad habits I have accumulated using my trained voice over the years. Overall, I was just extremely impressed with the whole process, and how knollegabable and intelligent Dr. Kim was,  and it really made me feel validated about my descision to come here.

After the pre-op, my brother and I decided to get dinner at a Japanese resturaunt near the hotel, as a sort of celebratory dinner/last meal.  The menu was only in Japanese/Korean (and unfortunately my kanji skills are still a bit lacking, but our server spoke English and helped us order. It was pricy, but wow, it was the best sashimi I have ever had! I guess the standards here are just different, because I've had sashimi tons of times in the US before, so it's not like I'm new to eating it. The sake was great too, even though I ordered one of the less expensive bottles (well, relatively at least).

After dinner, I wanted to to to get to a Korean arcade, but it was getting late, and our original plan of taking the bus didn't seem like a good idea, so we had to figure out how to get a taxi. I was going to use uber, but it quickly became apparent this was not a cost-effective option in Korea, so we had to figure out the Korean Taxi app Kakao Taxi. With an online guide, it wasn't too difficult, but then most Korean Taxi drivers don't speak a word of English, so I had to show them on the map where we wanted to go. In general, there really don't seem to be a lot of people here who speak very much English unfortunately, so communication is always a problem.

We only had time for a few hours at the arcade, and unfortunately I had a bit of trouble getting used to the controls. For pop'n music the buttons had a very different feel than my arcade controller at home, which would probably take a few days to get used to. For Tekken, they don't use Sanwa sticks, but instead use Happ sticks, which I am not used to at all. So basically, a lot of the time I just couldn't do the move I meant to. Nothing a little practice couldn't fix, but again, it takes time. After the arcade it was back to the hotel for sleep, because surgery check-in was at 8AM the next day.

In the morning we again woke up, got ready, and headed to Yeson. We are staying at the Princess Hotel incidentally, which is less than 10 minutes away from Yeson on foot, so travel there and back was very convenient. Due to the effects of anesthesia my memory of the morning is a little hazy, but basically I remember I put on scrubs, then they gave me an IV, and they wheeled me into the surgery room, and a few minutes later I was out. After waking up, they kept me in a side room to recover. For lunch I had mushroom soup, which was probably the best "hospital" food I have ever eaten. Incidentally, they did say solid food shouldn't be a problem from this evening on, which makes sense since the surgery wasn't in the esophagus, but it was something I was concerned about, so it was good to know. After resting for a number of hours with my brother, I was called out to meet Dr. Kim again. He showed me some pictures of the surgery (which apparently only lasted and hour) and went over some post-op stuff. Incidentally, he expects my final post-op pitch should settle at around 230Hz, so well within the female range. I am certainly not complaining. ;) Although personally I think he might have overestimated my base pitch a little due to my inability to produce my natural pitch on command, so I think 220Hz might be more like it (which is still incredible). After meeting with Doctor Kim, I went back to the room, went over my medication instructions, walked around a little, and then after the IV finished I was able to go.

For dinner, my brother and I both bought buckets of ice cream at a convenience store. I got green tea ice cream, and he got berry flavored. Then he went to bed early because he is pretty jet lagged and this trip has been pretty exhausting for him. That first day of travel was probabably the longest day of his life. Personally I've had worse, but it was still a grueling experience. I really am glad to have him with me though, this would have been so much harder to do on my own, and not very much fun either...

So, that is the story up until now. One thing I am happy to report, is that even though my throat is feeling a bit sore, I am otherwise feeling pretty normal, and I don't think I will have to miss out on too much fun while I'm recovering. I still plan to take it easy tomorrow just to be safe, but after that, I should be able to do pretty much anything that doesn't recquire talking. The not talking part really is going to be the hard part, but I'll manage somehow. I guess thats pretty much everything. I probably won't do any update posts in the next few days unless something noteworthy happens, but if anyone has any questions, let me know and I would be happy to try and answer them. ;)

Quote from: Dena on June 21, 2017, 11:15:35 PM
Congratulations on your surgery. I have used a trained voice for over 35 years and their wasn't any damage to my voice when Dr Haben looked at it. I think the correct wording is abuse of a trained voice isn't good for you. My therapist was very clear about what I should and shouldn't do with my voice and those are the lessons I pass on when working with people on the site. My therapist wrote the book on treating damaged voice without surgery using only therapy.

Thank you! :D Yea, I know lack of formal training probably puts me at much higher risk of vocal abuse. And now it looks like I am going to need training just to unlearn all my bad habits. :P But you know, I basically go by what sounds like "my" voice in my head to determine how far to push it, and I'm not sure if a therapist could talk me into settling for less, so I really think this was the right way to go for me.

Miyuki, thank you so much for posting details and your progress!  And congratulations on your results.  The information you have provided is a great help for others. 

Hey, so who is up for some before and after... pictures??? Yea, since I won't be able to do proper voice samples for quite some time, pictures will have to do for now. So here is before the procedure:
(https://s15.postimg.org/tqwgixvqj/image.jpg)

And here is after:
(https://s15.postimg.org/tfjljx4ob/image.jpg)

Dr. Kim said the white stuff was just debris, not any sort of scarring. Overall, results look pretty incredible! Hopefully they will sound just as good.

Looking great! Best wishes on recovery. I'm headed there myself very soon to see if Dr. Kim can salvage the unscarred portion of my voice and get me back to sounding more like a normal human. Reading your posts is getting me excited and also gives me a good idea of what to expect. Best of luck keeping silent :)

My experience with Yeson was that it really was a world class operation. I would have absolutely no reservations reccomending it to anyone having issues with their voice. I read some of your earlier posts, and I'm very sorry for what you've been through. I really look forward to hearing if Dr. Kim thinks he can do anything for you.

I had vfs with Yeson 18 months ago, and like you, I had a bad vocal tremor which the tests showed. Recovery was a real emotional rollercoaster. My voice was raspy and broken for about a year. Resonance got worse too. I didnt know how to use my vocal cords too as straining (the way I used to speak pre vfs) would cause me to have male resonance. I had to learn  howI to speak again from scratch to achieve that sweet, natural female voice.  After about a year of trial and error (during which I got really depressed), I started to see the end of the tunnel. I now hsve a normal female voice that flawlessly passes on the phone; however, if I party too much (drink, shout, get exposed to cigarette smoke) my voice starts to break again.

Vfs can increase ur pitch; however, it does not improve your resonance and can make ur voice frail and weak. Further, vfs is only 50 % of the solution at best,. The other 50% is speech therapy especially if you were speaking the wrong way pre vfs ie straining. Some of the damage caused by straining is irreversible according to Dr Kim.

I'm sorry your recovery was such a struggle. :( I hope the damage isn't permanent... I was abusing my voice for a good 3 years prior to surgery, which is not good, but some people force trained voices for decades, so I guess it could be worse. One advantage that I do have is that my untrained voice was kind of high anyway. Dr. Kim measured it at 158hz, although personally when I measured it after not speaking for a while and giving my voice time to cool down, I got more like 145-150. Anyway, my voice was never really worse than androgynous, so I don't think I have to worry too much about sounding male again, except maybe in that first month of talking before the Botox wears off. But in any case, I'm okay with just taking it slow, doing the exercises, and letting my voice cone back in it's own time. I always knew it would take a year to achieve the full results anyway.

Luckily, my voice hasnt been permanently damaged.  I have now regained a normal speech pattern. Pre vfs I had a voice was in the lower female rage.  My preop relaxed pitch was at 170 hz which was a big plus to start with.  However, as i got to learn since vfs,, resonance plays a bigger role in achieving a female voice than pitch itself( as long as your relaxed pitch is above 165 hz). Some post vfs girls came back on here with voice recordings averaging 250 hz but still sounded male as their resonance was not under control.

When you reach your 2 month mark postop, you'll need to start taking speech therapy sessions to adapt to using your newly created vocal cords and achieve that natural  feminine voice. In mythe experience, speech therapy is as important as the surgery itself.


Good luck with your recovery!
Hugs,

Wow, 170hz is really high for pre-op. But yea, it's absolutely true about resonance. Funny you should mention it, at a support group I attended someone was asking for tips on their voice, and I measured it in a pitch meter assuming it would hit 160hz max. As it turns out, it hit over 200hz, but because they didn't have good resonance, it still sounded more like a male/androgenous voice to me. But I didn't really have any tips for resonance since it's something that just kind of happened for me without me specifically working on it. I'm really starting to wonder what will be in store for me when I start using my new voice, and how my resonance will hold up. Should be very interesting...

In other news, I am now home safe and sound and completely exhausted after being up well over 24 hours. ;)

First thing  to do when u start speaking is not to strain the way you used  to do preop. It just won't work post op, and will lead to your voice breaking, sending it back to your chest, giving u a male resonance. Resonance is basically using your head voice and speaking softly instead of using your chest voice. If you look at the sheet of exercisers given toto you by Yeson, you'll find a set related to resonance.

Okay, I think I understand. I'll just make sure to take it easy and not push things and hopefully I'll be able to feel out the right way to use my new voice without too much trouble. :) And yea, I will make sure to start doing the exercises as soon as I am able to. Thanks for the advice. ;)

Hey everyone, just a quick little update. As of today, I have started talking again! So far, my voice seems to sound okay, though it is a bit hoarse. Even on day one my untrained voice is being read as feminine which is surely a good sign. ;) Right now though, it is still a bit hoarse, and seems to strain easily, and my pitch range is pretty limited. My low range especially is just gone. Before, overuse of my trained voice had given me a pretty severe vocal tremor when I tried to go low, but now I don't have that range at all. The lowest I was able to hit on the pitch meter was about 130hz. Anyway, my speaking voice right now seems to be in the 160-180hz range, which is about where my trained voice was (maybe a little lower on a really good day), but still well below the 230hz Dr. Kim predicted I would have in a year after things have fully healed. Here is a quick recording so you can hear, that even on day one, I really don't sound too bad ;): https://clyp.it/fn554zax?token=6e19c03e5ac5cdec346fb29582e5078f

Sounding great already! I know there is improvement to come but with this as your starting point I know you're going to have such an amazing result.

For only a month after surgery it's early to judge but so far it's sounding good. It is feminine but because you are still dealing with swelling from the surgery I am not going to make suggestions until you have had more time to heal and I can hear a more finished voice. I suspect you could still pick up 20-30 HZ and more on the high end over the next few months.

There was a chart in the material from Yeson that showed the expected progression was something like male to gender neutral pitch transition between 2-3 months, then gender neutral to female between 3-4 months, and then final pitch after a year. I'm not sure how close that is to reality though, given my own results, and since I have seen videos of people earlier on in their healing whose voices were in the female range. Maybe it's more to keep people from freaking out if their voice heals slowly and they don't sound very good at first. Anyway, I'm not sure if I really want or need to go too much over the 200hz mark. I always said that the trained voice I had was fine, and that I didn't really need it to be higher per say. I just wanted it to be easier and more natural to use. I'm not even sure what 230hz would sound like, but I am worried it might be a bit high for me.

A pitch of 230 HZ isn't that high and it has the advantage that you don't have to strain at all when you speak. Even if you get a little sloppy with your voice, there is still sufficient range available that you aren't going to fall out of the feminine range.

As for healing, mine took about a year and there was a gradual increases in pitch so I suspect that the basic idea behind the Yeson chart is correct. Just how much improvement you could expect might vary. In my case, I had a bunch of swelling that took a long time to fade. If your swelling goes down faster, I think you would see  the improvement much sooner.

The graph of improvement didn't apply to me. In my case, pitch was higher after surgery then it started to fall gradually. after that. However, the biggest problem I encountered post-vfs was not pitch. It was resonance a few months later when botox started to.wear off (I had botox done). You stilll need a trained voice post vfs (in terms os resonance) to achieve that natural feminije voice. Vfs improves pitch only.

Hi Miyuki,

Thank you for share your experience here. As my pitch is very low, I am considering go voice surgery. But somebody said that the voice will come back to original voice after a period of time. I now hesitate should I go voice surgery and look for a voice trainer.

Quote from: naomi62343 on July 23, 2017, 10:02:54 AM
Hi Miyuki,

Thank you for share your experience here. As my pitch is very low, I am considering go voice surgery. But somebody said that the voice will come back to original voice after a period of time. I now hesitate should I go voice surgery and look for a voice trainer.

That isn't true with the current surgery. Older versions of the surgery didn't fuse the cords and only tied them. The tie could come undone causing the cords to return to their original length. I recommend that everybody see a speech therapist before considering surgery. The surgery carries risk of failure so if you can produce an acceptable voice without surgery, therapy is a better option. Even after you have surgery you will still require therapy  and much of what you would learn if you see a therapist before surgery still applies.

In my case, even with therapy, my voice was around 130-140 HZ. It couldn't be forced above around 180 Hz so if I was to reach the feminine range, surgery was my only option. As my voice sounded masculine, I had little to lose if the surgery failed.

With Yeson, an exceptionnal small number of girls have reported an insignificant pitch improvement; however, their voice didn't go back to what it was pre-vfs. In other words, you can only win!

Has it been another month already? How time flies... Well, I recorded another voice sample today, and I have to say, this is probably the best I have ever sounded in a recording, pre or post-op: https://clyp.it/uh3pphsy?token=065ae23d80731e565ff6edf50b3933b8 So yea, I am pretty happy with how things have been progressing, but I do have to say, the first month was rough. Like really, really rough. To start out with, it can be easy to get freaked out by how bad your voice is when you first start talking. It sounds bad, and it feels bad to talk. Your voice never does what you want it to, and if you try to push it it starts to hurt and then you have to just stop talking for a while to let it rest. My voice still is not what you'd call 100%, and there are times where I have more trouble controlling it then others, but it has improved massively from where it was when I first started talking. Hopefully by the end of the next month it will feel more or less normal. I just wanted to kind of stress this point a bit, because I haven't heard people talk as much about the first month of recovery from Yeson, but I for one can definitely confirm it sucks. Not as bad as not talking for a month, but still pretty bad. Anyway, that's more or less all I had to say. Unless anyone has questions, I'll be sure to post another update next month. ;)

The voice is settling in nicely. It was just a tad bit lower than I expected but it sounds full, feminine, contains inflection and should pass the telephone test without any problems. At this point I don't see any issues that need to be addressed.

Yea, so on that point, I did put it through the pitch analyzer, and it seems that my overall pitch is still sitting mostly in the 160-200Hz range, but I did gain in inflections that go well over 200Hz. Also, even though the range is still similar to my trained voice, I am not reaching nearly as hard to speak in that range, so my speech patterns just sound a bit more natural and less forced. I pretty much said going in that I wanted my trained voice to be my speaking voice, and that I didn't really think I needed it to be higher, so I am completely happy with this result. If it does go up more as it heals that fine too, but I'm happy either way.

The voice will develop mor eand more over many months. Especially if you had anything like a
"vocal tremor" or strained voice before. I am still seeing change after over 2 years now.

However I wish the vocal tremor could be better adressed. I still have some of that - I think the proper diagnosis in my case at least may be a mild spasmodic dysphonia. It sometimes makes my voice weak or broken for a short while. Especially in the morning it can happen to me and I think i found a connection to anxiety issues - if I had a night with anxiety issues that keep me up for some hours , the voice spasms are much worse on the next day.

So being relaxed about the voice is quite an important part in it working at the desired pitch and clarity, really

Sounding fabulous, Miyuki! I'm so glad your surgery is turning out well.

You sound female to me.. youre probably in the lower female range but still female.

Hi everyone. So I am long overdue for an update. To make a long story short, for a while there my voice actually seemed to be getting deeper instead of higher, and I was having some serious concerns about it, but I didn't want to post here without really knowing what was going on and potentially creating fear, uncertainty, or doubt without cause. I did see a doctor and had my vocal chords examined, and it turns out everything basically looked okay. They were even impressed by the almost complete lack of scar tissue where my vocal chords were fused. They did however notice my vocal chords seemed very irritated, and though they weren't really able to explain why (other than possibly acid reflux which I'm pretty sure I don't have), but they thought it may just go away on it's own. And it does seem to have improved, although I'm still getting a lot of mucus buildup on my vocal chords which forces me to clear my throat a lot, which is definitely not helping the matter. In general, my voice has actually been sounding pretty good and feeling reasonably usable for the past few weeks, and it still seems to be getting better.

But (yes there always has to be a but with these type of things), in a way I am still finding myself a little disappointed with the results. The most obvious cause for disappointment is that my current base pitch seems to be settling at around 165-170Hz. My best estimate of my true completely untrained pitch (which was difficult for me to estimate since I went for so long using only my trained voice) is between 135-145Hz, meaning even in the best case, I gained about 35Hz. To put it in absolute terms, they said I could expect an approximately 70Hz increase, but I seem to have gotten about half that. Now I didn't need that much pitch, so my disappointment isn't nearly as great as it might have been if say I started with 100Hz as my base pitch. And I did say I would ultimately be happy if my previous trained voice became my speaking voice, which is essentially what I got. But even so, I guess on reflection, having saved up for nearly a year, put myself through the whole trip, and the recovery (not talking for a month was not fun), at a certain point you start to say to yourself, wow, this better be worth it.

Other than that my biggest complaint is just that the general feel of using my voice still feels "unnatural" at times. Its a bit harder to put my finger on this one, it's just that the feeling of using my voice in a way that it was not strictly speaking intended to be used is still not completely gone. I'm not really sure what I was expecting on this one... I guess it's just a matter of the fact that my natural pitch is just a bit lower than the way I like my voice to sound, so I still have to use kind of the same technique I did with a trained voice, just to a much lesser extent. If my pitch had gone over what my trained voice was, I could have just relaxed my voice and not cared, but I am very particular about the way my voice sounds, so yea...

Well, all that being said, how about some of the good points? For example, I can now laugh in a female pitch and have it sound right. Before this was just not possible, and I basically ended up having to mute my laughter to keep from sounding weird. Also, the horrible vocal tremor I developed seems to be gone, and regardless of the fact that the results from the surgery were not ideal, it is still way easier for me to talk now, and I don't ever feel like I strain my voice by just speaking normally. And finally of course, regardless of my personal reservations, everyone I talk to says my voice is sounding really great. So even with my personal concerns (and obviously there is still more time for some marginal improvement), I can't really complain too much, but I do feel like it's important to let people know that my procedure does appear to have under-delivered somewhat, because voice surgery is such a minefield and it's important people fully understand what the risks and potential outcomes are before getting themselves into it.

Thanks for continuing to share your results. I know it's disappointing when the results don't quite match your expectations but it does sound like you've gained a lot from this and I'm happy for you! Just out of curiosity, do you feel as though your volume is more limited than before?

No, not at all. If anything it's easier to speak at a higher volume, since before I had a lot of trouble maintaining pitch as the volume of my voice increased.

I also ended up at about a 170 Hz base pitch, which is 30 Hz lower than Dr Kim was "aiming" for, I guess. His estimate of my pre OP pitch was 135 Hz, but this is all quite unsure. I know that my real base pitch originally probably was lower as I always felt it was even lower than with most of the boys in school, but I used a trained voice for 15 years, so I did not know what my original pitch was, 135 Hz seemed rather relaxed though. Also now this 170 Hz is sort of the base pitch, while the 135 Hz was measured with me reading a text, if I read a text now it all depends on my mood, intonation etc - the average comes out at 180 Hz a lot, but occasionally I get an 200 Hz average if I sort of put more femininity into the voice. I think this also happens in real life - if I talk to male coworkers in a meeting, I have no doubt my voice is more in the 170 Hz range, while if I a  talking to some guy I want to convince to do something for me or being thankful, the pitch goes up. If I am with other women, the pitch is a bit higher as well...
There is a strong social component to pitch - I read an article yesterday about female voices in Germany - apparently over 20 years, the average pitch of female voices here has dropped from over 200 Hz to 170 Hz because of changes in social positioning, independence, emanzipation etc. In that sens, I am right in the average with my voice, it may well be that I use this pitch because it is the average of other women I perceive and subconsciously adapt it as well. Maybe if i lived in a different country, my pitch would eventuall adapt to a different level. I know for example that my pitch is higher if I speak english.
The voice is flexible - there is barely some real fixed pitch that a voice has, there is maybe a pitch range that is most comfortable but when speaking we always use muscles to make a sound and just how much we use these muscles determines the pitch and this really is highly influenced by the brain as well