So....I recently had a consult with Dr. Zukowski and also had some pictures done by Alexandra over at Virtual FFS (Huge shout out to her as she did an excellent job!). I have a skype consult scheduled w/ Dr. Spiegel, but that wont happen until July. Anyways, I feel like I need to gather more opinions before I spend a bunch of money on potentially unnecessary procedures (and expose myself to more risk/recovery time). I feel really really exposed in these pics so please be kind! I will really appreciate any and all input, but again try to be kind!!
I feel like my consult with Dr. Z was really really generic and he dominated most of the conversation (as I had read would probably happen), but here is a short summary of my consult and the procedures he wants me to consider:
1. Forehead reduction/contouring + Orbital rim contouring + bring hair line down 1/2" in front and 3/4" on sides
2. Rhinoplasty to reduce broadness of nose
3. Lip lift + plump lips w/ filler
4. Chin contouring to address chin proportions
5. Medpor chin implant to enhance side profile (optional)
6. Jaw angle and masseter muscle reduction/shaping
7. Add soft tissue filler to cheeks, soften laugh lines, round out temporal hollows
8. Trachea camouflaging
9. Minimal scar variant necklift of entire lower face, jaw, and neck
10. Miscellaneous Skin tightening + fat grafting to new bone structure as necessary
Total for procedures: Dr fee + anesthesia fee + facility fee = 25K (good till October 1st of 2016)
Chin implant = 1K more
Overall I feel like I definitely NEED Forehead and orbital rim contouring (and could maybe bring hairline down slightly on the sides ONLY) and definitely a rhinoplasty. I would like to improve my slight chin recession in my side profile, but not sure how "essential" it is. I also think the symmetry between my left and right jaw lines could probably be addressed very slightly along with slight shaping of the chin, but I feel like almost everything else would be extra and may be overkill. Any Opinions?????
The following pics are the ones I had done by Alexandra at Virtual FFS. Please scroll table to the right and click to enlarge as necessary.
The pictures are arranged as follows:
(A) Original
(B) shows brow bossing removal and eyebrow plucking.
(C) includes rhinoplasty.
(D) includes reducing the chin height and setting the chin forwards.
(E) includes cheek filling.
(F) includes lower blepharoplasty and reduction of your jaw on the left side.
(G) includes a lip lift.
A | B | C | D | E | F | G |
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Hi Kaley!
You look very female to me already! I would gender your photos as female with just an eyebrow wax & trim into more of an arch. That is the first thing I notice in your photos and it is cheap and easy to get done!
I agree that the forehead & orbital work also make a big improvement. I see the nose and chin work as making you maybe prettier, but not necessarily more female. I like the narrowing of nose that Alexandra shows from the front, and I like the chin changes that she shows in your profile, but I think that there are plenty of women that have noses and chin like yours (or more masculine) that are not rushing out to get nose and chin work. I don't see any issue with your jaw.
I had skype consults with Dr. Spiegel and Facial Team. Dr. Spiegel gave me a more of a kitchen-sink recommendation, like I think you received from Dr. Zukowski. Facial Team (Dr. Simon) was much more specific with what he thought would really help me. I hope that you get that something like that from Dr. Spiegel. I personally don't think it is helpful to give a laundry list of procedures to someone that looks as female as you do.
Wow, that grid view is pretty cool!
I would say by "C", things are looking pretty darn great for feminization purposes. All the other stuff would be unnecessary in my opinion (less about feminization and more just personal aesthetic/beautificational choice).
I don't think you need a lower eye bleph at all! No eye bags that I can see
For A -> B comparison ... That B result as VFFS shows wouldn't be achievable without forehead reconstruction, unless you are one of the 3% with underdeveloped sinus. What could be done without open "type 3" techinique, would be a little shaving on orbital area, some smoothing on brow bossing (1mm) and filling with bone-paste above the brow bossing, to achieve more rounder effect and visably remove bossing. Which wouldn't look as as good as in virtual photos. I suggest you only consider a surgeon who can perform forehead reconstruction and do a proper lower-forehead setback (which will allow for aggressive orbital remodeling) as this will be the most feminizing procedure on your face. Out of these two you mentioned, Dr. Spiegel can perform this procedure, Dr. Zukowski can't.
I agree with rhinoplasty to reduce broadness... but also little shortening at the tip and improved (more ) bridge wouldn't be bad. Maybe little columella refinement.
Lip lift will definitely help a lot.
I don't think you should have chin implant. And definitely not medpor implant. If you want improved projetion, a sliding genioplasty would be a lot better idea. But I don't think you definitely need it. A properly done chin remodeling could make more than enough difference.
I can't comment on soft tissue procedures, as I don't know enough... Maybe you can divide a surgery, and have the essential bone, and nose things done first.. and then wait and see, if there is anything that needs improvement with altering soft tissue..
Quote from: KimSails on June 15, 2015, 05:06:07 AM
Hi Kaley!
You look very female to me already! I would gender your photos as female with just an eyebrow wax & trim into more of an arch. That is the first thing I notice in your photos and it is cheap and easy to get done!
...
Awww, thanks so much KimSails! The look is still very much a work in progress! Those pics are from the other month and I have definitely put some time into eyebrow shaping since so they are no where near the caterpillars that are pictured! And I'm thinking along the lines you're thinking with the forehead/orbital work and some small work on the nose.
That's kinda disappointing hearing that Dr. Spiegels consult was generic as well...especially since they are charging $100 for the skype consult. Oh wells, I will keep you all posted on how that goes...hopefully it's not too cookie cutter!
I would consider a consult from FacialTeam, but I think Alexandra gave me a really detailed written evaluation already. Also I'm trying to stay within the US due to the cost/distance of flying from Hawaii so FacialTeam is probably not as feasible.
Quote from: Jennygirl on June 15, 2015, 05:16:16 AM
Wow, that grid view is pretty cool!
I would say by "C", things are looking pretty darn great for feminization purposes. All the other stuff would be unnecessary in my opinion (less about feminization and more just personal aesthetic/beautificational choice).
I don't think you need a lower eye bleph at all! No eye bags that I can see
Haha, yea, I was thinking the same thing after I made it! it's just a simple HTML table, but it came out really good for some reason!
And yes, I feel like I would be pretty content by photo "C" so I'm glad thats what you think as well! The money I can save on FFS would help push up my timeline for VFS which I really really wanna get done next summer! Although I wonder how far out you need to book for Yeson voice Center...
In regards to the lower eye bleph, I think I just felt that I needed it due to the dark shadows that create a sort of dreary effect...I might do some kind of dermal filler to deal with this though.
Quote from: mmmmm on June 15, 2015, 06:24:43 AM
For A -> B comparison ... That B result as VFFS shows wouldn't be achievable without forehead reconstruction, unless you are one of the 3% with underdeveloped sinus. What could be done without open "type 3" techinique, would be a little shaving on orbital area, some smoothing on brow bossing (1mm) and filling with bone-paste above the brow bossing, to achieve more rounder effect and visably remove bossing. Which wouldn't look as as good as in virtual photos. I suggest you only consider a surgeon who can perform forehead reconstruction and do a proper lower-forehead setback (which will allow for aggressive orbital remodeling) as this will be the most feminizing procedure on your face. Out of these two you mentioned, Dr. Spiegel can perform this procedure, Dr. Zukowski can't.
.......
Oh no! Are you absolutely sure?? Is there any way to tell if I'm somehow w/in that 3% before cutting?? I really wanted to avoid that huge 8 inch incision if at all possible! Is there a huge difference in recovery time?? Is loss of sensation along the forehead/scalp a huge issue when undergoing the open type 3 technique?? How's the scarring??
I'm regards to the nose...Alexandra had suggested I lower the bridge a little (vice increase) and is what is simulated in picture "C". I do think adjusting the columella slightly would help visually and I would definitely be interested in that!
I also think a lip lift could potentially benefit me, but Alexandra's eval regarding that was as follows:
"You could have a lip lift, but the problem is that because of your tall maxilla, you would probably show too much tooth and may also end up with a gummy smile. It is not completely clear from your pictures, but it looks like you might already have a gummy smile to some extent. This is not a big problem and it is not a masculinity, but in terms of beauty, it is probably best not to emphasise it with a lip lift.
Another issue is that a lip lift leaves a small scar at the base of the nose. Usually this is hidden in the crease where the nose meets the upper lip but in your case this area is very exposed because of the upturned base of your nose. This means that the scar might be slightly more visible on you than it would be on most people."
For some reason the sliding genioplasty procedure kinda scares me, but that is also what Alexandra advised me to do if I was interested in addressing my chin projection. I really like the suggestion on dividing surgery and I may end up doing that because it seems (at least so far) consensus indicates that I definitely could use a brow bossing/forehead/orbital contouring along with some nose work. No real essential essential work on the lower face, but I like the idea of addressing chin projection at some point in time in the future!
X-ray/CT-scan would reveal if you have small sinus, which means thick(er) frontal wall bone. Even in this rare cases Facial team and dr. Di Maggio prefer to do proper type 3 reconstruction instead of just shaving.. It's not just for achieving a better result (Alexandra has a well written topic about that on her page http://www.virtualffs.co.uk/Forehead.html ), it's also a lot safer, because even on thick enough bone, the stronger outside surface would get shaved and completely removed, which is not a good idea.
It's impossible to avoid incision. You mentioned hairline advance in front and in corners. That's only possible with incision (or hairtransplant). I don't think you really need hairline advance in front, so incision could be hidden half inch behind hairline, and would only be used frontally to advance the corners. You could later have little hairtransplant just to cover the scar in corners, and round it a bit if needed (not neccessarily). You could also have full coronal incision, which means a whole incision is made behind hairline.
Even scar isn't that bad.. It looks scary in the first month or so.. but right after it is healed enough, you can start using scar silicone gels which help with fading. I'm little more than 5 months after FFS now, and it is barely visable. Noone else would notice it.
Sensation loss on scalp is unavoidable. But it is temporary. It was a little weird at first, but you get used to it after a month or two. Its impossible to say how long before it is back to normal. It varies from person to person. In my case, it slowly started to come back after 2 months.. and now almost feels completely normal. It's not something that you should be worried about. Even if it takes 1 year to fully return, thats a small price to pay to have a great feminization in upper face area.
The biggest deal is, that if your forehead isn't set back in ideal position (for your face), it becomes very limited to what can be done with orbital rims. Sufficiently remodeled orbital area will naturally change the expression of the eyes, and with that, the expression of whole face. Eyebrows will be set in the natural position, which is defined by supraorbital ridge and its shape. Surgeons who can't feminize enough orbital rim area, because they can't do a forehead reconstruction to allow that, will do too much eyebrow lift and place eyebrows in unnatural position, which will change eye expression and make most patients happy... but it looks unnatural in large majority of cases. For me, personally, this is the by far the most important thing to consider when deciding about FFS, procedures and surgeons.
I think Alexandra made a good suggestion for a nose shape, without changing too much of character. You could also think about different shapes, maybe keeping the tip a little higher, just tiny bit shorter, and only lowering the bridge, for straigher nose bridge. You definitely should think a lot about nose, before making any decision. Maybe play with photoshop a little to see what a small changes can do.
I can't really say much about lip lift and tall maxilla based on those photos... but looking now again, Alexandra may have a point. But this is one of the things you should discuss with a surgeon during in-person consultation. It shouldn't be a problem to arrange that you would pay later if you decide to have it done, or have money returned if it is decided to not do it.
Don't worry about that scar. It would be little, and they would make shure to close it properly.
Sliding genioplasty sounds scary... even rhinoplasty doesn't look too nice, when you look at during surgery photos. It's not a problematic procedure. Surgeons like chin implants, because it means a lot less work for them. I have small frontal-only chin implant, and I decided for implant instead of sliding genioplasty, because of easier recovery. While it looks great, Im happy with that.. and while there wouldn't really be much if any change in looks with sliding genioplasty.. I'm not happy with how it feels. It feels a little unnatural. I can definitely feel its shape.. and I'm thinking about having it removed someday (in future), and have sliding genioplasty.
I think Alexandra little exaggerated with a frontal projection.. Half that much would be better. Again, if at all.
Seconded, to get that result in the vffs you would probably need a type 3 reconstruction. Z only does type 1 & 2 (shave or shave & fill)
I'd look into facial team and DiMaggio. Spiegel is too conservative in my opinion. Actually I think DiMaggio's aesthetic closely matches the style of forehead/eyebrow position/nose profile as shown in the vffs. Brow that gently slopes into nose.
Facial team seems to make the brow to nose profile a bit more angular and the nose more detailed (less like a simple scoop). I think it looks more natural, but probably won't match that vffs as much as DiMaggio would.
I had an upper lip lift and fat grafting to the upper lip area.
All that the fat grafting did was negate the upper lip lift by making the distance longer again ( so the upper lip lift needs redoing ) and frankly the swollen appearance looks wrong.
Quote from: Paula1 on June 15, 2015, 05:44:40 PM
I had an upper lip lift and fat grafting to the upper lip area.
All that the fat grafting did was negate the upper lip lift by making the distance longer again ( so the upper lip lift needs redoing ) and frankly the swollen appearance looks wrong.
That sucks.
Yeah I consider lip lift to be a last resort. Half of the results I've seen (regardless of trans or cis) have not looked very natural to me.
I considered it when I was obsessing over FFS and looking at every possibility, but ultimately I am very glad I choose to go conservative with things. I always recommend being conservative at first if the person already has a good starting point (not needing aggressive work). Such is the case here, I think she needs very little to have a great result. Less is more
Thank you guys so much for all the input and for sharing your personal experiences! I think I have a really good idea of how I want to proceed now! The type 3 forehead re-construction sounds kinda scary to me, but if it will give me the best result than I'll definitely look into it. Does everyone agree that I absolutely need a Type 3 forehead re-construction or would I be able to get away with just the minor contouring during a type 1/2 procedure?? I only ask because I do want to proceed as conservatively as possible while still achieving a nice softening of the forehead/brow ridge area.
Read this http://www.virtualffs.co.uk/Forehead.html and build your own opinion on what you think is the superior approach, and what would be a better option for you. Opinions of others are worthless if you don't understand the differences yourself.
Reconstruction might sound scary, but it is the much safer option compared to shaving already thin bone wall...
Quote from: Kaley on June 17, 2015, 01:32:12 AMThe type 3 forehead re-construction sounds kinda scary to me, but if it will give me the best result than I'll definitely look into it. Does everyone agree that I absolutely need a Type 3 forehead re-construction or would I be able to get away with just the minor contouring during a type 1/2 procedure?? I only ask because I do want to proceed as conservatively as possible while still achieving a nice softening of the forehead/brow ridge area.
It'll probably give you the best results, but "absolutely need"? Absolutely not! Your forehead is already within normal female ranges.
My advice would be to spend the next week looking at women's faces in real life (and not on surgeon's web sites, Virtual FFS, or the internet.) As you're out and about at the mall or the supermarket, look at their foreheads in profile. Some have that smooth "post Type 3" look, but many actually don't. Lots have a slightly protruding brow, and lots have sloping foreheads, etc.
I know this'll come across as heresy here, but unless you're endowed with significant bossing, your forehead will probably pass as female if the rest of your features are soft, and if you have long hair, makeup, and all the other cues.
Now, does the Type 3 give dramatic results? Yes - but again, only if you're endowed with a prominent brow in the first place. (And the "logic problem" part of the whole FFS game is that yes, 90% of FFS patients probably could use a Type 3 procedure, but that's why they're getting FFS in the first place! It's not the case that 90% of all transwomen need Type 3 procedures; it's 90% of those who are so masculine-looking that they have to have FFS to pass. The rest of the transwomen who pass without opting for FFS do so just fine without a surgeon reconstructing their foreheads.)
It's marketing. Frightens us into thinking that 90% of transgender women as a whole need a Type 3, but in reality it's only 90% of transwomen opting for FFS surgery who would benefit from a Type 3. (And again, even that's clearly vague wording; again, just go out and look at women's foreheads in profile. They are in no way perfectly flat and vertical across the board, not even close! A Type 3 forehead reconstruction is by no means necessary, but it can be beneficial.)
To keep the Type 3 disciples happy, I do admit that a Type 3 forehead reconstruction does pretty much place the upper third of the face firmly into female territory. And perhaps the 90% statistic is true in that 90% of FFS patients must have a Type 3 reconstruction to obtain that perfectly vertical lower forehead. But it's certainly not the case that a perfectly vertical and smooth forehead is what every other woman out there has, and I'd even wager that it's not even anywhere close to that number. Maybe half at most? Perhaps less?
Then again, from a practical perspective, if you're under anesthesia and the surgeon has that part of your head open anyway, then you might as well go whole hog and get the Type 3 done if you've got the money to spend.
During my FFS research, and in speaking to many plastic surgeons (including many great facial surgeons who aren't part of the official FFS club), I got the distinct impression that the more well-known FFS outfits are often selling procedures we don't need at grossly inflated prices. Not saying that the big name FFS surgeons are scamming the trans community, but I am saying that they've carved out a rather lucrative niche for basic facial surgery that most board-certified plastic surgeons can perform with their eyes closed. A rhinoplasty that any good plastic surgeon can perform for $7,500 suddenly becomes a $15,000 nose job when done by an FFS surgeon, and looks exactly the same as the cheap one! When I read some of the posts from people who pay 30, 40, 50 thousand dollars for what amounts to something that would cost 20 thousand if not done by a "FFS surgeon", it makes me question whether those doctors are merely taking advantage of the trans community and our insecurities.
My opinion, that's all. Just question the 90% statistic that's thrown around constantly, because it's obviously slick marketing and unsubstantiated by real life observations.
I agree with everything you write, but I want to add another piece of information from a long term, 30 year post transition, view.
Over time the face ages, what was once hidden by smooth skin, good muscle tone and fat, now becomes more apparent. Just take a look at older cis women. I think you see they become more androgynous as they age, some hide it by layering on makeup, but it still happens. Hence why older cis women were the original target audience for cosmetic surgeons. I definitely don't think everyone, 90%, needs FFS to "pass" but I suggest you consider saving for FFS at some time in your future.
I'm pretty close to deciding on a surgeon for FFS. I do not look forward to surgery at almost 60. I know from personal experience, recent sports related injuries, that I don't heal as quickly as I once did.
Quote from: StartingOver on June 17, 2015, 09:05:57 AM
It'll probably give you the best results, but "absolutely need"? Absolutely not! Your forehead is already within normal female ranges.
My advice would be to spend the next week looking at women's faces in real life (and not on surgeon's web sites, Virtual FFS, or the internet.) As you're out and about at the mall or the supermarket, look at their foreheads in profile. Some have that smooth "post Type 3" look, but many actually don't. Lots have a slightly protruding brow, and lots have sloping foreheads, etc.
I know this'll come across as heresy here, but unless you're endowed with significant bossing, your forehead will probably pass as female if the rest of your features are soft, and if you have long hair, makeup, and all the other cues.
Now, does the Type 3 give dramatic results? Yes - but again, only if you're endowed with a prominent brow in the first place. (And the "logic problem" part of the whole FFS game is that yes, 90% of FFS patients probably could use a Type 3 procedure, but that's why they're getting FFS in the first place! It's not the case that 90% of all transwomen need Type 3 procedures; it's 90% of those who are so masculine-looking that they have to have FFS to pass. The rest of the transwomen who pass without opting for FFS do so just fine without a surgeon reconstructing their foreheads.)
It's marketing. Frightens us into thinking that 90% of transgender women as a whole need a Type 3, but in reality it's only 90% of transwomen opting for FFS surgery who would benefit from a Type 3. (And again, even that's clearly vague wording; again, just go out and look at women's foreheads in profile. They are in no way perfectly flat and vertical across the board, not even close! A Type 3 forehead reconstruction is by no means necessary, but it can be beneficial.)
To keep the Type 3 disciples happy, I do admit that a Type 3 forehead reconstruction does pretty much place the upper third of the face firmly into female territory. And perhaps the 90% statistic is true in that 90% of FFS patients must have a Type 3 reconstruction to obtain that perfectly vertical lower forehead. But it's certainly not the case that a perfectly vertical and smooth forehead is what every other woman out there has, and I'd even wager that it's not even anywhere close to that number. Maybe half at most? Perhaps less?
Then again, from a practical perspective, if you're under anesthesia and the surgeon has that part of your head open anyway, then you might as well go whole hog and get the Type 3 done if you've got the money to spend.
During my FFS research, and in speaking to many plastic surgeons (including many great facial surgeons who aren't part of the official FFS club), I got the distinct impression that the more well-known FFS outfits are often selling procedures we don't need at grossly inflated prices. Not saying that the big name FFS surgeons are scamming the trans community, but I am saying that they've carved out a rather lucrative niche for basic facial surgery that most board-certified plastic surgeons can perform with their eyes closed. A rhinoplasty that any good plastic surgeon can perform for $7,500 suddenly becomes a $15,000 nose job when done by an FFS surgeon, and looks exactly the same as the cheap one! When I read some of the posts from people who pay 30, 40, 50 thousand dollars for what amounts to something that would cost 20 thousand if not done by a "FFS surgeon", it makes me question whether those doctors are merely taking advantage of the trans community and our insecurities.
My opinion, that's all. Just question the 90% statistic that's thrown around constantly, because it's obviously slick marketing and unsubstantiated by real life observations.
Quote from: StartingOver on June 17, 2015, 09:05:57 AM
Now, does the Type 3 give dramatic results? Yes - but again, only if you're endowed with a prominent brow in the first place.
BS! I practically didn't have visable brow bossing.. zero bossing on one side, and only minor 1mm bossing on other side. Upper two thirds of forehead were already perfect with the right angle and curve.. Lower third was what continued the curve from middle third into supraorbital ridge, which itself wasn't masculine but wasn't ideally feminine either. Shaving only would be enough to remove that 1mm of bossing on one side and it would allow to feminize orbital rims by some amount. While that would be almost pointless of doing for a minimal change that it would made... a type 3 reconstruction and little magic from dr. Di Maggio himself, resulted in complete set-back of whole lower third of forehead, and ideal natural transition from forehead to orbital area. It also made a possibility for smooth transition between forehead and nose, and allowed a proper reduction of redix, which made a big difference for aesthetics. That's quite a lot of difference compared to what shaving type1 would do for a patient like me, despite the fact that I had less masculine forehead that 90% (...probably more) of all mtf population not just those who seek FFS.
Quote from: StartingOver on June 17, 2015, 09:05:57 AM
It's not the case that 90% of all transwomen need Type 3 procedures; it's 90% of those who are so masculine-looking that they have to have FFS to pass. The rest of the transwomen who pass without opting for FFS do so just fine without a surgeon reconstructing their foreheads.)
... More than 50% of FFS patients don't need FFS to pass. They have it because they want it, not because they need it. Shure some need FFS because they would never pass without it. Many, like me for example, had it for other reasons. For me it was about reversing the changes which happened during puberty, and erasing any single trace of androgynous from my face, and to improve my self-image with the aesthetic part of result... Other people have other reasons, but many in their late teens and 20s have reasons similar to mine.. Times when only older, rich and terribly masculine trans women were to afford FFS with the only doctor in the world who performed it, are long gone.
Quote from: deeiche on June 17, 2015, 09:40:06 AMI do not look forward to surgery at almost 60. I know from personal experience, recent sports related injuries, that I don't heal as quickly as I once did.
You'll do just fine! It's not the most pleasant experience, I'll be the first to admit, and it's sometimes a sloooow healing process, but you're not almost 60, you're still in your 50s! Glass half full and all that...
I hope my post just above yours doesn't come off the wrong way. I heartily recommend FFS. I simply know for a fact that an experienced facial surgeon working in any major metro area in the US can get almost any one of us 90% of the results that Facial Team, Zukowski, or Spiegel can provide but at a discount of 50% or more. And for the price some of the FFS surgeons charge these days, that's a saving that could finance SRS (or a downpayment on a house, or that new car you want, or a healthy addition to your future financial security.)
And I don't particularly buy the idea that working on transgender faces is a unique challenge for a plastic surgeon that needs special skills; maybe the Type 3 forehead procedure, but that's really about it, and as I've explained it's rarely "necessary" (although might be "nice") unless you're cursed with caveman-style bossing. The bread and butter work of any board certified plastic surgeon who specializes in face work is rhinoplasties, cheek implants, brow lifts, Type 1 and 2 forehead work, chin and jaw work etc. They spend their lives making both male and female faces more beautiful or balanced, and they're all well versed in anatomy, aesthetics, and modern techniques.
I've noticed over the time I've been lurking here (years now) that there's a worrying increase in the number of girls who are throwing extraordinary amounts of money at Official FFS without doing any research beyond looking at the famous and extremely expensive Official FFS surgeons and not looking at the other options out there. The posts are generally "I've looked at Spiegel, now having a consult with Dr. Bart and Skyping with Facial Team next week, OMG how can I afford $35,000 in FFS???" as if there are literally only like five guys in the entire world who are competent to perform feminization surgery. It's as if FFS is now a "thing", where beforehand it was just regular plastic surgeons doing regular plastic surgery. I'm always dismayed when I read posts about "should I pay for FFS or SRS"? Well girls, you can have both if you spend your money wisely. There's a lot of glossy marketing by the Official FFS surgeons. And I'm always dismayed when I see posts written about how someone can never afford FFS, when the truth is they just can't afford FFS with the Official FFS surgeons. They can afford it if they bothered to look locally.
My general advice? If you've got the money to spend, then the Facial Team or Spiegel will do an awesome job. Go for it. I fully endorse their services, and they're damn good at what they do. Like, really good. I won't go so far as to say that they're the best, because there's plenty of talented surgeons out there who can make faces beautiful, and results are individual. If you're like many of us and have to save for years to afford this kind of surgery, then in addition to getting consults with the big names you owe it to yourselves to visit a few of your local plastic surgeons who will almost certainly be able to do much the same thing at a fraction of the cost.
Quote from: mmmmm
...a type 3 reconstruction and little magic from dr. Di Maggio himself, resulted in complete set-back of whole lower third of forehead, and ideal natural transition from forehead to orbital area.
Quote from: mmmmmFor me it was about reversing the changes which happened during puberty, and erasing any single trace of androgynous from my face, and to improve my self-image with the aesthetic part of result
Not going to argue with you. You're talking about achieving "perfection", and for that a Type 3 will get you there. I'm talking about achieving "within feminine ranges". The OP asked whether a Type 3 was absolutely necessary, not whether it would help her get to some standard of female facial perfection (and whether such perfection even exists beyond a surgeon's desire for huge fees is debatable and for another place and time.)
Quote from: mmmmmTimes when only older, rich and terribly masculine trans women were to afford FFS with the only doctor in the world who performed it, are long gone.
Hmm. Not buying this. Not given the prices I'm starting to see quoted for basic plastic surgery. FFS is turning back into something that is unaffordable for most of us, except for those who decide to use competent, local surgeons for their work. The Official FFS surgeons are becoming more and more exclusive and unaffordable. There are plenty of more cost effective options for those who look more widely, as there always have been.
My only issue is the way that the FFS debate these days is pretty much turning into "you gotta go to Spiegel or Di Maggio and have a Type 3 or you're wasting your time". That's plainly not true, and in many cases it's harmful, especially from an economic and emotional perspective for those who mortgage their lives for it, or who will never afford it and think they'll always be ugly. If you want to throw huge sums of money chasing perfection, go for it. I've no complaint about that and I'll happily admire beautiful post-FFS trans faces as much as everyone else. But when such advice reaches the level of dogma, it needs to be spoken up against.
My position stands. Type 3? Necessary - rarely. Beneficial - often.
Quote from: StartingOver on June 17, 2015, 11:11:40 AM
Beneficial - often.
Well, that's the whole point of this... most people have FFS because it is benefitial, and some have it because it necessary for them.
We talked it is necessary for OP to have type 3 reconstruction if she wants to have a result as presented on virtual FFS pictures. What kind of result she wants and what will make her happy, is for her to decide.
There isn't any significant difference in price for type 1 or type 3 procedure. If you have a chance to make it right, for an overall better and optimized result, why not do it right. That's my argument. Don't ever trust a local plastic surgeon with shaving frontal sinus wall, especially if you are his first patient with such request. Adios...
Quote from: mmmmm on June 17, 2015, 12:04:14 PM
Well, that's the whole point of this... most people have FFS because it is benefitial, and some have it because it necessary for them.
Not arguing with you. I had FFS because it was beneficial, not because I needed it. But when we're looking at FFS from a "benefit" standpoint rather than a "necessity" standpoint, only the most financially well-off can ignore the economic realities of FFS. It's extremely expensive, and I would only encourage someone to blindly go to a top FFS surgeon without examining the local alternatives if that person absolutely needed a type 3 forehead procedure to pass. If they'd be happy with a type 1, a brow lift, and a rhinoplasty, then they'd probably be happy with the results of a local plastic surgeon and keeping the difference $15,000 they'd save, which is a huge step towards paying for SRS. (And jeez, a consult with a local plastic surgeon should be a common sense step anyone considering FFS takes, if only for a second opinion. The big name Official FFS docs seem rather fond of suggesting lots of minor additional procedures that aren't necessary except for helping the doc make the next BMW payment, especially during those Skype consults where there's little chance they can actually examine your face properly.)
QuoteWe talked it is necessary for OP to have type 3 reconstruction if she wants to have a result as presented on virtual FFS pictures. What kind of result she wants and what will make her happy, is for her to decide.
Of course. I thought it was fairly obvious that if she wants to look like she has had a type 3 reconstruction like in the pictures, she needs to get one. The point is that I personally don't think she needs one. Would it be great to get it done? Sure! It does make a difference in the photos, and it's a wonderful procedure. But it doesn't make the difference between passing and not passing, and many cis-women have foreheads that look just like hers does now. Therefore, it's not absolutely necessary, which was the question she actually asked.
QuoteThere isn't any significant difference in price for type 1 or type 3 procedure. If you have a chance to make it right, for an overall better and optimized result, why not do it right. That's my argument. Don't ever trust a local plastic surgeon with shaving frontal sinus wall, especially if you are his first patient with such request. Adios...
That's a bit simplistic. Sure, not much difference between the cost of a type 1 or a type 3 procedure if you're looking at any particular surgeon's price list in isolation. But there's a huge difference between going to an Official FFS surgeon who will perform a type 3 procedure and one locally who will perform a type 1, especially when additional procedures (and "FFS mark-ups" on all of those other procedures) are added in. And that's not even mentioning the cost of travel, accommodation, and the inability to have regular follow-ups because once you travel back to Hawaii from Boston, you're screwed if you need to see Dr. Spiegel again. Suddenly, basic and competent FFS performed by the local plastic surgeon (which would, for example, include a type 1 forehead and a rhinoplasty) goes from under $10,000 everything included to a $35,000 cross-continent excursion (including flights, hotels etc., and far more if you want a companion to come with you.)
Careful with the misconception about the local docs too. I'm not talking about laying down in the office of some backass town's family practitioner and asking him to shave your skull. I'm saying that in any major metro area with a good hospital (e.g. any of the top fifty cities in the US), there's going to be experienced plastic surgeons who can perform full-range FFS with their eyes closed, although they may shy away from a type 3 forehead reconstruction. Just because they haven't specifically branded their web sites around a narrow service like FFS, doesn't mean they haven't done it, can't do it, or won't do it. Remember, they make their money catering to some rather vain women who want to look as feminine as possible. They don't want to push that regular business aside by being known as the "transgender" doctor - half their regular clients would run because they don't want to end up looking like a transgender woman. But most plastic surgeons will (and have) happily and successfully operated on transgender women even if they don't brag about it online.
Again, if money is no object, then I repeat that you might as well go to the big name FFS guys. They're amazing surgeons. But few of us are in that position. For many of us, we might find that for the money we're able to afford, a type 1 forehead, a rhinoplasty, brow lift, and tracheal shave done locally will be far more feminizing that blowing the entire lot on a type 3 forehead, a plane ticket, and nothing else.
And it goes without saying that nobody should be a guinea pig for an inexperienced surgeon (although it's rumored that Spiegel lets his trainees operate, but that's not something I've confirmed.) But by the time a plastic surgeon is board certified, he or she has certainly done more than enough basic facial procedures to not screw things up.
mmmmm, I'm not arguing with what you're saying. You're right. A type 3 forehead is the gold standard. It's just that not everybody wants or needs the gold standard, and their idea of the gold standard and what constitutes perfection could well be different from yours. I almost fell into the type 3 trap, thinking that I should have it because everyone else wants one and because the pictures look really pretty. Given unlimited funds, I'd have jumped at the chance to go down that route. But on balance, I'm very happy that I stayed local, had more of my face worked on for the money I had available, and got extremely good value out of my surgeon without paying the Official FFS mark-up.
My transition budget, for example, is about $50,000, maybe a little more. FFS cost me $15,000, and I had work done that Spiegel wanted $35,000 for, and Zukowski wanted just under $30,000. When I factor in that I've also got to pay for SRS and finish up electrolysis, the high end quotes were thoroughly unrealistic. Could I have borrowed that money to pay for the fancy Official FFS? and maybe get slightly better results? Sure, and then I'd have been paying it off for a decade instead of getting out there and living my new female life while I was young enough to really appreciate it. Or I could have blown my SRS budget on the fancy FFS and then been angry with myself that I had to wait another five years with a penis to save up the cash to pay for that procedure. As it stands, my SRS budget is still in the bank, and I'm ready to take that next step and finish the physical part of my transition. I don't want to be in transition forever, nor in debt forever from trying to make every single thing perfect.
Just offering some real world practical advice here. Is it a compromise? Of course it is (depending on your point of view.) But that's life for many of us.
:police: :police: :police:
Cool it down a little and take a break gals.
Let's drop it and let some others chime in to Kaley if they want.
Thank you!
Kaley- the best course of actions is to get the bilateral skull xrays and speak with multiple surgeons about them. I am sure that my xray's would have lead any of the Type 3 surgeons to tell me I "must get a type 3 for success", and yet I had a great result from Type 1. It's your judgement call!
And I would say if you are looking for a great & affordable Type I surgeon in the states, I have nothing but great things to say about Toby Mayer. He's a wizard with suture closure and natural looking noses. A true perfectionist.
If you don't mind going to San Francisco CA for the surgery, Dr. O is working in an advisory/assissting capacity with Dr. Deschamps-Braly to pass the FFS baton as it were. I am quite happy with my results with them, although I'm pretty sure it would cost a bit more to get all that list done. I had a type-3 forehead reduction with them as well as several other procedures.
Personally, I'd avoid getting a chin implant. If you do the chin advancement as described in Dr. O's book, you wouldn't need it anyway. But I think from your pictures I would stop after nose/brow and chin. The nose and brow procedure have to be done at the same time, but you don't have to do everything at once otherwise. If you're worried about widow's peaks, you might want to do a hairline procedure, but from your picture I can't tell if you have any issues with them. As your hairline is now, it seems fine, and I can't see any recession from your pictures. Just know that if you have any issues growing hair through your scar tissue, you may have to get transplants to obscure visible scarring.
I totally understand wanting FFS, and it has helped my self esteem a lot. It also had the added benefit of showing my family how determined I am, and makes the world see a different person than who I used to be outwardly. Nevertheless, good luck, and I hope you find the right surgeon for you and are happy with the results :D
Quote from: Jennygirl on June 17, 2015, 10:37:35 PMKaley- the best course of actions is to get the bilateral skull xrays and speak with multiple surgeons about them. I am sure that my xray's would have lead any of the Type 3 surgeons to tell me I "must get a type 3 for success", and yet I had a great result from Type 1. It's your judgement call!
And I would say if you are looking for a great & affordable Type I surgeon in the states, I have nothing but great things to say about Toby Mayer. He's a wizard with suture closure and natural looking noses. A true perfectionist.
Great advice, and Jennygirl is living proof that Type 1 surgery can be very effective (as am I). I was told by the big name FFS surgeons that I
must have a Type 3 to get the best results. To a surgeon who can perform a Type 3, every forehead looks like it needs fixing with a Type 3 procedure. I went for the Type 1 because the entire surgery package was cost-effective, subtle, and the surgeon was wonderful and local. No regrets whatsoever. And many of the "cheap" FFS surgeons had, in my opinion, some rather ugly results that looked not particularly feminine and very artificial. One of my main goals was to still look like "me" afterwards, not someone who had obviously had plastic surgery. Small changes were perfect, not a sledgehammer approach to reconstructing the entire face. I tend to find that the more plastic surgery one has and the more invasive it is, the more obvious it ends up being. And looking at faces that are have obviously been worked on, it's sometimes far easier to figure out that the person underneath used to be male. It stands out in a crowd for the wrong reasons, not the right reasons. Blend in, don't stick out.
The forehead is just one piece of the beauty/femininity/passing puzzle - and that's a puzzle with a thousand pieces. Nose, skin texture, hair, ears pierced, makeup, hairline, boobs, posture, mannerisms, speech, movement, clothing, hand size, etc. The list goes on and on. One can have the flattest, smoothest, most beautiful forehead in the entire world and still be pegged as a guy 99 times out of 100 if the other things aren't right. Some of it is luck, some of it is hard work, some of it is a case of being able to throw money at the problem to fix it.
Shop around when it comes to surgeons. Go with who makes you feel comfortable. Don't obsess over the forehead.
Woah!! Got a little heated there, but thanks again for all the replies! I really actually appreciate the competing views!
My situation is such that I am definitely going to have to travel a pretty good distance to get any decent facial surgery done as I don't think there are many reputable (if any) surgeons in Hawaii who perform this type of surgery. Cost isn't a HUGE deal, although I don't want to spend over 30K in total on the face since I want to do voice within 6 months or so after doing the face. Cost of GCS also isn't an issue since my insurance will cover it after getting the necessary approval(s).
As I stated previously, I will be consulting with Dr. Spiegel on July 15th and just set up a consult with the Facial Team on June 25th. I do want to minimize overall downtime and leave taken from my job as much as possible so if I can get everything done at one time by one Dr that would be preferable! Especially due to the distance I would have to travel for this! So I feel like I don't want to go to anyone specifically because they are the best at X or Y, but rather at their work in totality.
I will definitely look into Dr Toby Mayer and Dr. O/Dr Deschamps-Braly! And I will try to get the xrays done if I can to potentially help the eval process. As far as the Type 1/2 vs Type 3 debate...I don't think I care TOO much either way and obviously don't have MAJOR issues w/ passing, but I do want to minimize as much masculinity as possible on my face. I absolutely hate what testosterone has done...really wish I had the courage to tell my parents when I was a pre-teen/teen and knew with 100% certainty that something was really wrong. So, I will try to trust in the particular Dr's techniques and definitely go with whomever makes me feel most comfortable with everything, but I really like the VFFS simulated forehead result and it would seem that it will only be possible to achieve with the Type 3 procedure so I am definitely strongly considering it!
Hey, it looks like you want to stay in the States, if so you might want to contact Dr Mardirossian for a Skype consult. He trained under Dr Spiegel and now has his own practice. I seriously considered him but ended up deciding on Dr Rossi.
Quote from: StartingOver on June 17, 2015, 02:13:23 PM
Careful with the misconception about the local docs too. I'm not talking about laying down in the office of some backass town's family practitioner and asking him to shave your skull. I'm saying that in any major metro area with a good hospital (e.g. any of the top fifty cities in the US), there's going to be experienced plastic surgeons who can perform full-range FFS with their eyes closed, although they may shy away from a type 3 forehead reconstruction. Just because they haven't specifically branded their web sites around a narrow service like FFS, doesn't mean they haven't done it, can't do it, or won't do it. Remember, they make their money catering to some rather vain women who want to look as feminine as possible. They don't want to push that regular business aside by being known as the "transgender" doctor - half their regular clients would run because they don't want to end up looking like a transgender woman. But most plastic surgeons will (and have) happily and successfully operated on transgender women even if they don't brag about it online.
StartingOver,
I really think there are sound reasons for not using typical plastic surgeons for most FFS work. One of my close personal friends is a successful ABPS Brd Certified plastic surgeon. We have dinner together every month or so. Practices in a major metro area. I raised this same issue you raised a few weeks ago when I asked for some comments on some before / after pictures I had seen. The whole reason FFS surgery
is FFS surgery is because one has to alter the bone structure to get the desired result. Even the very good general plastic surgeons who are board certified by the Am Brd of Plastic Surgery - - normally do not do any serious bony work. Or very little. They almost ALL just do soft tissue work. That is 98+% of their practice. Breasts, face lifts (totally soft tissue), lipo suctions, tummy tucks - - all of that is just soft tissue work. And that is the vast majority of their practices. They rarely ever see an FFS patient just due to the raw demographic statistics and they rarely do any serious bone work that would prepare them and keep them comfortable doing that type of work.
Many of the best of them are uncomfortable doing simple facial implants. The very best facial plastic surgeons that are famous nationally for their soft tissue work - - often simply refuse to do bone work and refer those patients to the surgeons specially trained in craniofacial and maxillo-facial or orthognathic surgery. There is a reason surgeons spend the extra two or three years learning to do bone work. You can't learn to do that right by practicing on patients ! If it were as routine as you suggest - - why on earth would those surgeons ever waste two or three years of their productive careers learning to do that facial bone work ?
Quote from: myfairlady49 on June 19, 2015, 12:11:32 AMThe whole reason FFS surgery is FFS surgery is because one has to alter the bone structure to get the desired result.
Except that this isn't actually true - and my comments were generally aimed at the OP who, in my opinion, doesn't
need any bone work performed other than a Type 1 forehead, and that's something any facial plastic surgeon can do. FFS does not
have to involve alterations to the bone structure.
Sure, you're absolutely right - in many cases, where the underlying facial structure is too far to the male side of things, bones do have to be altered and one should seek out an experienced surgeon to do this. But in many cases, significant feminization can be achieved with a good brow lift, a little forehead recontouring (in those who don't have huge brow bones), and a very feminine rhinoplasty. This would still constitute FFS, even though bones aren't really being restructured or altered in any significant manner.
I'm not trying to discourage anyone from undergoing FFS. I'm merely trying to highlight the fact that there are other options out there which are extremely effective solutions for those of us blessed with faces that aren't particularly masculine to begin with, or who aren't blessed with money.
Would I ever recommend someone with a prominent brow bone or a huge square jaw to go to a local plastic surgeon for a Type 1 or jaw work? Of course not. FFS surgeons do have a role to play. But for mild feminization that doesn't involve jaw work, chin work, or necessarily require a Type 3 forehead reconstruction? The local expert in plastic surgery may be a choice worth checking out.
My agenda in giving this advice? (I do have one!) There's a far wider trans community out there than exists on this board. Many of them get advice here without participating. Many in the trans community are unemployed, underemployed, uninsured, poor, etc. I want them to know that FFS isn't an impossible goal. There are cost-effective options available. For a girl struggling out there with a heavy (fleshy) brow, or a huge masculine nose, or high hairline, whatever needs to be tweaked, they don't necessarily need to save up their pennies for a decade to be able to afford surgery in Mexico or Boston or Chicago or Marbella or wherever the handful of FFS surgeons operate, and they don't necessarily have to give up their dreams of looking more feminine. They might be able to have their own FFS needs met very cheaply (in a relative sense) by looking at local plastic surgeons, many of whom can make a face just as beautiful as the big name FFS surgeons (whose work - in many cases - to me looks so invasive that the results are anything but natural and beautiful.)
Just throwing it out there in the spirit of sharing information. Not trying to start a fight! We're arguing semantics here: your definition of FFS is "surgery that includes major bone work to make a male face look as feminine as possible," while my definition of FFS is "any surgery that causes a face to look more feminine."
Remember that FFS isn't a "thing"; it's just the collective name for a standard set of routine cosmetic procedures that typically can be used to feminize a face (other than a Type 3 reconstruction, which is something of a niche procedure.) One can pick and choose which procedures out of that set one needs; it's not all-or-nothing, and if one wants soft tissue FFS, it's still FFS!
OMG...
That's the only surgery I had because that's the only surgery I needed!!!!! And for where I had it, who performed it, and the overall package of care I received, it's cheap.
Could I have traveled overseas to some foreign country for cheaper surgery in dubious surroundings with zero hands-on follow-up care; a surgeon I'd never met before and who I chose based on internet reviews, "best case" pictures and perhaps a Skype consult; spent more money on all kinds of procedures that were "recommended" but certainly not "necessary"; a miserable recovery away from home and family; and ended up looking like someone who had clearly done too much? Sure.
Or could I have gone to another US surgeon for an (unnecessary for me) Type 3, chin work, jaw contouring, cheek implants, a lip lift (which always seems to look artificial), and all manner of procedures that I could afford but didn't need? Sure.
But I'm very comfortable with the work I had done, it's absolutely beautiful (my surgeon is frickin' artist), and it's backed up with the guaranty of a surgeon I consulted with numerous times in person before having surgery, a top-class US hospital, recovery at home and with family, regular follow-ups for the next year, and the peace of mind that if anything didn't go right or anything goes wrong in the future, my surgeon is ten minutes away and can fix it. And no travel or accommodation costs.
FFS isn't linear: the more we get, the prettier we become, just isn't true. It's a bell curve: many of us could use a little, there's a point where the procedures we get give us a peak of prettiness, then adding in more procedures actually makes us uglier (or less passable.)
(Perhaps I should have made it clearer that I wanted to stay in the US for my surgery. I'd never let a surgeon who hadn't examined my face in person start hacking away at it. But that's just the level of risk I wanted to accept.)
Again, just highlighting options. So many people see FFS as like an all-you-can-eat buffet at Golden Coral: how much food they can they fit on their plate for the cheapest price; the more the better, right? (No, wrong.) There's intangibles that need to be considered; quality, location, comfort with the surgeon and his or her team, minimizing the risk of errors that can't be corrected, safety, recourse (legal and medical) if things did go wrong, etc.
This is important: I'm not saying that people should avoid FFS surgeons. I'm not saying that local surgeons are better. I'm merely saying that as part of a thorough research process prior to jumping into relatively minor FFS that doesn't necessarily require a Type 3 forehead reconstruction, you'd be very wise to see what the best local plastic surgeon can offer.
Expanding options, that's all.
Ultimately you have to choose the right surgeon based on YOUR personal needs, not what someone else says you need. Also, because faces vary so widely, there is no way to deem one procedure "proper" over another.
It's always a good idea to know what the surgeon's most practiced procedure is. If those techniques line up with your main goals, then perhaps they are the best decision.
Take Toby Mayer, for example. His specialties (rather what he is known for) are suture closure, scar-hiding hairline procedures, and extremely natural looking rhinoplasty. That is why I chose him. As well, I wanted the subtle touch rather than the bazooka approach that Dr. O suggested. If I felt that I needed more help in the forehead department, my choice would have been different- as Dr. Mayer only does Type I.
Once again, this is all personal choice. There is no proper way to do FFS.
Just wanted to say thanks again to everyone for providing all of the really great feedback, personal opinion, and experiences! I was honestly pretty clueless before, but now I have a really good idea of what I want to for sure have done! I'll try to keep everyone updated after my upcoming consults with The Facial Team and Dr. Spiegel and hopefully a couple more surgeons suggested here that I have begun researching.
Update for everyone!
So, I just recently did a skype consult with the Facial Team (Dr. Capitan) and (despite the skype connectivity issues), I was really impressed! I received the quote today and wanted to know what you all think.
Procedure | Cost (EURO) | Cost (USD) |
Forehead Reconstruction | 4500 | 5025.60 |
Rhinoplasty | 3600 | 4020.48 |
Hospital Fees/Meds/OR/2 nights room/board | 2500 | 2792.00 |
General Anesthesia | 1600 | 1786.88 |
Material Costs/Pre&Post op CT scan | 1100 | 1228.48 |
TOTAL | 13300 | 14853.44 |
| | |
OPTIONAL Procedures | Cost (EURO) | Cost (USD) |
Chinplasty/Sliding Genioplasty | 3500 | 3908.80 |
Immediate Microcapillary Transplant | 6590 | 7359.71 |
So...any thoughts on cost? Seems really reasonable and definitely well under my budget of 25K. I will probably add on the chinplasty/sliding genioplasty, but I am sorta wondering what you guys think about the hair transplant. It was suggested by Dr. Capitan that if I wanted to fill in the corners of my hairline we could go the hair transplant route to help. Its hard to tell when my hair is down (or even when loosely tied back as in my pictures from the first post in this thread), but if I pull it back really tightly to make a pony tail, it sorta exposes a slightly masculine hairline as my corners are not fully filled in. I will try to post a picture later tonight to show this. Is the pricing quotes for the hair transplant in line with other surgeons who do this? Would I be able to get this done at a later time for a better price with comparable results? If I decide do it at a later time with a different surgeon, what is the recovery/down time?
So, I'm thinking Dr. Spiegel will definitely come out costing more for the same procedures, but does anyone have an idea around how much more?? Is his markup even really worth it? I'm probably going to cancel my Skype consult with Dr. S (scheduled for july 15) and apply that $100 to my deposit for the Facial Team because the price seems really good and all of my correspondence with them so far has been excellent! Overall thoughts???
I think that price will be hard to beat for sure.
Lots of people seem to love their results from Facial Team, so I would say go for it- especially if you have good feelings about them!
Quote from: Kaley on June 26, 2015, 09:37:29 PM
Would I be able to get this done at a later time for a better price with comparable results? If I decide do it at a later time with a different surgeon, what is the recovery/down time?
Definitely. Their price for hairtransplant is on higher side of what you can find. But if you don't have affordable option locally, it still means travel costs, etc...
Much cheaper option is to improve the hairline surgically and close the corners as much as possible (with combinational incision). And then later use hairtransplant for some roundening, or just to cover any visable parts of scar which didn't heal ideally, or maybe you even won't have to do anything.
They can easily do hairline correction if you request.. but they do have this agenda to promote their hairtransplant option and take $7000+ more from you. They even started saying how very high hairlines are the ideal feminine hairlines (which is complete BS), because they are unable to do any significant hairline lowering in the front (for those who need it). Hairtransplant which they can offer is not thick enough for natural looking hairline lowering in front and closing the corners. But it is great for closing/roundening of corners. Now this depends on whether you want to pay $7000+ for closing of corners, or you want to do it with surgical approach and then later pay $1000 or $2000 for little roundening.
(There isn't any real recovery for hairtransplant alone)
Question: What's the most natural approach, the combinational surgical incision or the hair transplants?
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Hi Kaley,
I have surgery scheduled with Facial Team for September 7th. I went back and forth over which hairline approach to use. In the end I will be doing the hairline incision *without* the immediate transplant. Facial Team (Dr. Simon) initially recommended the crown incision and immediate hair transplant. After a second Skype consult, I sent in more pictures of my hairline and hair density. After conferring, Dr. Simon and their hair transplant doctor both ended up recommending the hairline incision for me instead (no immediate transplant).
My initial quote contained the same transplant quote as you and I also thought it was very expensive. With either approach I was going to need additional transplants, done locally. I still have more research to do in choosing a local transplant doctor, but the best price I've found for a seemingly reputable practice is $4/follicle unit if you do a lot of them. For the Facial team quote to be that low, you would need about 1800-1900 follicle units transplanted
The original quote I received said to expect 1500-1700 follicle units in the transplant. In the follow-up consult I asked if I should expect less than that given my low hair density. Dr. Simon said that I should expect a minimum of 1500 units, the "typical" range is more like 1800-2200 units but that they quote the lower range to be conservative. That would seem to make the Facial Team quote competitive rather than expensive.
However, if *you* don't need that many transplants (or maybe don't really need *any* transplants) then the Facial Team quote to you would be expensive and/or unnecessary. Choose the approach the works best for your situation!
Here's the pics I promised!
(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi1021.photobucket.com%2Falbums%2Faf332%2Fkklask%2FKaley%2Fth_DSC00118.jpg&hash=2708d642429dfa3d20d80568c0e1751816069741) (http://s1021.photobucket.com/user/kklask/media/Kaley/DSC00118.jpg.html)
(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi1021.photobucket.com%2Falbums%2Faf332%2Fkklask%2FKaley%2Fth_DSC00117.jpg&hash=d334aac9567a529870dced288eb4724a1865fe64) (http://s1021.photobucket.com/user/kklask/media/Kaley/DSC00117.jpg.html)
According to Alexandra's VirtualFFS evaluation: "Hair transplants look more natural than a scalp advance and you don't end up with a scar along the hairline."
Alexandra also told me the following in her eval: "I am sending you a copy of your frontal with the lupuhai rule drawn on so that you can see how your hairline is low. I therefore disagree with Dr Zukowski. Not only that but lowering your hairline by means of a scalp advance would leave you with a permanent scar long the hairline. If you have forehead surgery with the incision over the top of your head (this hides the scar under your hair) it would have the effect of raising your hairline slightly. This would be mildly feminising for you and I have simulated the effect."
Dr. Capitan also suggested the crown incision w/ hair transplant for my case. I think that would be the best option for me. I feel like I don't absolutely need a hair transplant, but it could help a little. My hair is still fairly short and I hardly ever tie it back into a tight pony tail, but I can probably hide it with some bangs anyways. I wonder if there is any wiggle room in price if I tell them I only want say 1000 follicles harvested and transplanted?? I'm not quite sure how many transplanted follicles would give me a decent amount of coverage in the corners? I guess I should send the Facial Team the pics of my harline corners so they can evaluate better.
Just a quick update!!
I paid the 2000 Euro deposit and my surgery date is set for December 11th with the Facial Team! Total cost came out to 15690 Euro which includes the chinplasty/sliding genioplasty option (after a 10% discount for doing pictures). I chose not to do the hair transplant option as the cost was a little too much for me at just under 6000 Euro. Maybe in the future I will pursue hair transplants, but as of right now I'd rather put that money towards voice feminization surgery which I am planning on doing next summer.
Thank you to everyone who contributed information!! It really helped me with my decision and I look forward to giving more updates as the surgery date nears!
♡Kaley