So As the title points out, it's been 6 years since I transitioned and after BA, GCS, Tracheal shave, and even FUT Hair transplants to round out my hairline, I feel pretty good about where I'm at. I'm at 2 jobs since my 'transition on the job' employment and people either don't know about my past or they just don't say anything. I'm also re-married to a great supportive guy and we're in a good position financially.
Throughout all of that, the forehead still bugs me a LOT. My brow ridge is pretty prominent , mostly from the side but also with bad lighting, it causes the 'shadows in the eyes' look. The nose is kind of secondary and makes sense to take care of with the forehead.
So I'm starting out researching and I want to stay in the US.
So far, I'm consulting with 5 doctors:
1. Mardrossian
2. Harrison Lee
3. Toby Mayer
4. Spiegel
5. Deschamps-Braly
So I think I'm going for a full forehead scalp advance, reconstruction, and brow lift and then rhinoplasty...slated for Early 2017. Gives me time to consult, research, and save for it.
So far I had a skype consult with Mardrossian and felt pretty good about it. He addressed my concerns of swelling similar to someone else on the forums that swelling in the forehead isnt too bad because the skin is thin and stretched. Wondering if that is the majority concensus or not though.....whether forehead/eye swelling is usually only for a few days, week, etc.
I was also at first wary of doing a scalp advance because I thought it mean tdoing more FUT hair transplants and after doing it once, I don't want to do it again....apparently I had the wrong idea and it's really just pulling the whole hairline/scalp forward. For those that have done it, does that initial stretch hurt/cause headaches for days/weeks after?
Both Mardrossian and Mayer have mentioned chin implants but I just don't want to go there. I want minimal recovery time and really only the problem areas that bother me.
Planning on keeping this thread up to date as I go along.
Well, If you're looking for forehead reconstruction and actual removal of masculine brow ridge (instead of just smoothing), you can easily cross dr. Mayer off your list, because he doesn't perform forehead reconstruction. I don't know if dr. Lee does it now, but I know he didn't do forehead reconstruction in the past, and he had to have his colleague dr. Gary Alter in surgery room who would perform type 3 reconstruction on his patients.
Swelling around eyes is hardcore for a week.. but it reduces in next week or two. There is no noticeable swelling in forehead. All the swelling goes down and it stays in your lower face regardless if you had any lower face work or not. How much and how long it stay it's depends from person to person, and how much work and care you actually put in, like using ice packs and doing facial massage. Generally it starts to get better after a week. Some people look presentable after third week... some other clearly look like they had facial surgery even after 2 months. We all react and heal differently.
Scalp advance doesnt hurt or cause headaches... whole area behind forehead incision (on top of scalp) will be temporarily numb, so you wouldnt even feel much. You might feel some tension...
If two surgeons you consulted already suggested chin implant, you must have somewhat receding chin. It's not feminine trait as some people might think it is in comparison with strong male forward projected chin. Receding chin is not aesthetic, and it mostly affects facial balance. Ideal feminine chin is at 2% receding angle (male is 0%). Chin implant is least invasive procedure, and it can also have a narrowing effect on your chin (besides improving projection), without performing any invasive osteotomy. It is inserted through small inside-mouth incision.
Personally, I would advise against chin implants, and suggest you to go for more invasive sliding genioplasty, if you decide to resolve receding chin problem.
You cant expect or wish for minimal recovery if you plan on having rather invasive facial surgery. Its not like you will have only rhinoplasty, or only upper blepharoplasty. Recovery takes its time on not just your face but whole body. As you mentioned you have good job, and you're in good position financially, you probably won't have a problem with taking 6-7 weeks off, and have more than enough time to recover. Having additional chin implant or sliding genioplasty won't really in any way effect your recovery time.
The only US doctor I would let do my forehead is Dr Deschamps-Braly as he trained under Dr O, the only FFS surgeon in the US who in my opinion produces desirable forehead results. I find the others' forehead work substandard considering what *I* would hope to achieve from the surgery. If you just want a flatter forehead, of the ones you've mentioned, I'd probably go to Spiegel because his work is what I'm most familiar with. If money was no object, Deschamps-Braly would be my pick without hesitation. I'm sure others disagree, but this is just my opinion.
It's also worth noting, that if you desire the nasal radix to be lowered, Dr O is the only doctor I've seen do this dramatically.
With the strong $US and weaker Euro, many US girls are now travelling to Europe for surgery.
The prices are a lot cheaper to start with and results that I have seen over here in Europe are just as good or even better than various US surgeon's post-op patients I have seen while in the USA including myself and I am a 'Z' girl.
Still you have plenty of time to make your final choice and I wish you all the best.
Hugs
Paula ( from the UK )
Quote from: Lagertha on November 25, 2015, 12:48:26 PM
Well, If you're looking for forehead reconstruction and actual removal of masculine brow ridge (instead of just smoothing), you can easily cross dr. Mayer off your list, because he doesn't perform forehead reconstruction. I don't know if dr. Lee does it now, but I know he didn't do forehead reconstruction in the past, and he had to have his colleague dr. Gary Alter in surgery room who would perform type 3 reconstruction on his patients.
Yeah I have heard that about some of these surgeons. I figured I'd at least consult with a few of them though.
Quote
Swelling around eyes is hardcore for a week.. but it reduces in next week or two. There is no noticeable swelling in forehead. All the swelling goes down and it stays in your lower face regardless if you had any lower face work or not. How much and how long it stay it's depends from person to person, and how much work and care you actually put in, like using ice packs and doing facial massage. Generally it starts to get better after a week. Some people look presentable after third week... some other clearly look like they had facial surgery even after 2 months. We all react and heal differently.
Yeah basically hoping to take 3ish weeks off of work.
Quote
Scalp advance doesnt hurt or cause headaches... whole area behind forehead incision (on top of scalp) will be temporarily numb, so you wouldnt even feel much. You might feel some tension...
Thanks for the info!
Quote
If two surgeons you consulted already suggested chin implant, you must have somewhat receding chin. It's not feminine trait as some people might think it is in comparison with strong male forward projected chin. Receding chin is not aesthetic, and it mostly affects facial balance. Ideal feminine chin is at 2% receding angle (male is 0%). Chin implant is least invasive procedure, and it can also have a narrowing effect on your chin (besides improving projection), without performing any invasive osteotomy. It is inserted through small inside-mouth incision.
Personally, I would advise against chin implants, and suggest you to go for more invasive sliding genioplasty, if you decide to resolve receding chin problem.
Interesting. Yes I know my chin is pretty small and caused a huge overbite when I was a kid....which I got fixed back then but at this point, it's just another thing I'd need to recover from....and my chin doesn't bother me.
Quote from: BellaSwan on November 25, 2015, 01:55:58 PM
The only US doctor I would let do my forehead is Dr Deschamps-Braly as he trained under Dr O, the only FFS surgeon in the US who in my opinion produces desirable forehead results. I find the others' forehead work substandard considering what *I* would hope to achieve from the surgery. If you just want a flatter forehead, of the ones you've mentioned, I'd probably go to Spiegel because his work is what I'm most familiar with. If money was no object, Deschamps-Braly would be my pick without hesitation. I'm sure others disagree, but this is just my opinion.
I do hear lots of good things about him and a lot of reference to Dr O as well. He'll be the last one I consult with because I'll probably fly to san fran to consult.
Quote from: Paula1 on November 25, 2015, 05:38:52 PM
With the strong $US and weaker Euro, many US girls are now travelling to Europe for surgery.
The prices are a lot cheaper to start with and results that I have seen over here in Europe are just as good or even better than various US surgeon's post-op patients I have seen while in the USA including myself and I am a 'Z' girl.
Still you have plenty of time to make your final choice and I wish you all the best.
Hugs
Paula ( from the UK )
Thanks! Yeah just rather stay in the US. I'll pay for it, I know....but that's ok.
Quote from: Debra on November 25, 2015, 11:35:51 AM
So As the title points out, it's been 6 years since I transitioned and after BA, GCS, Tracheal shave, and even FUT Hair transplants to round out my hairline, I feel pretty good about where I'm at. I'm at 2 jobs since my 'transition on the job' employment and people either don't know about my past or they just don't say anything. I'm also re-married to a great supportive guy and we're in a good position financially.
Congratulations, sounds like life is good.
Quote from: Debra on November 25, 2015, 11:35:51 AM
Throughout all of that, the forehead still bugs me a LOT. My brow ridge is pretty prominent , mostly from the side but also with bad lighting, it causes the 'shadows in the eyes' look. The nose is kind of secondary and makes sense to take care of with the forehead.
I completely relate to "shadows in the eyes" look. Just to let you know you could still have under eye darkening post FFS, it can be hereditary. I still have some even after a large reduction in my forehead. Also you could still have some eye "hooding" depends on the location of frontal sinus posterior wall. In my case it was right above my eye. Dr Mardirossian told me that was probably the case based upon the photos I provided. Only X-rays can give you that insight prior to surgery.
Quote from: Debra on November 25, 2015, 11:35:51 AM
So I'm starting out researching and I want to stay in the US.
So far, I'm consulting with 5 doctors:
1. Mardrossian
2. Harrison Lee
3. Toby Mayer
4. Spiegel
5. Deschamps-Braly
So I think I'm going for a full forehead scalp advance, reconstruction, and brow lift and then rhinoplasty...slated for Early 2017. Gives me time to consult, research, and save for it.
So far I had a skype consult with Mardrossian and felt pretty good about it. He addressed my concerns of swelling similar to someone else on the forums that swelling in the forehead isnit too bad because the skin is thin and stretched. Wondering if that is the majority consensus or not though.....whether forehead/eye swelling is usually only for a few days, week, etc.
Forehead swelling is marginal, cheek swelling and lower face was greater. Cheek swelling was still subsiding 5 weeks after surgery, but my list of procedures was about as extensive as you can get.
Quote from: Debra on November 25, 2015, 11:35:51 AM
I was also at first wary of doing a scalp advance because I thought it meant doing more FUT hair transplants and after doing it once, I don't want to do it again....apparently I had the wrong idea and it's really just pulling the whole hairline/scalp forward. For those that have done it, does that initial stretch hurt/cause headaches for days/weeks after?
No headaches after surgery, I was out an about walking about the city less than 7 days post-op. I know what headaches are too, I've had chronic sinus and migraine headaches for over 40 years. I think I've had one sinus headache since surgery and that is most likely related to nose swelling related to rhinoplasty. It can take at least 6 months for nose swelling to subside.
Quote from: Debra on November 25, 2015, 11:35:51 AM
Both Mardrossian and Mayer have mentioned chin implants but I just don't want to go there. I want minimal recovery time and really only the problem areas that bother me.
That should help a lot, anything done to the chin will cause numbness in your lower lip and chin area.
Quote from: Debra on November 25, 2015, 11:35:51 AM
Planning on keeping this thread up to date as I go along.
Your chin might not bother you now, but it might after you get your forehead done. The more feminine something is, the more masculine the rest looks. I wouldn't go for a chin implant. They are unnecessary. If Dr Deschamps-Braly does what Dr O does, he can give you a very aesthetic chin without any need for an implant
Lol no need to get prissy. He does the genioplasty, lengthens the chin, fixates the elongated chin into position with plates and screws and fills the empty space between the chin and the rest of the jaw with some sort of paste. In time, bone will grow there again.
I don't agree that any decent plastic surgeon can do it. I don't think they'd risk implants if they could. I understand what you mean that if you come from a place of severe under development, they can both be used. I'm sure if the under development is severe enough, an implant is warranted. All surgeries have limitations, including the sliding genioplasty. However, in the case of a MtF that would mean the jaw would have to be within female standards already, because implants add mass, and most decent chin implants wrap around the jaw a little, so you really have to start from a very petite point. I have no issues with implants in and of themselves (I think Angelina Jolie's facial implants are perfection, for example), but I wouldn't get one personally. That being said, I guess I should allow room for the unlikey, but very possible, event that some of us might need a chin implant ;)
Actually it's a part of training in regular Aesthetic, Reconstructive & Plastic Surgery programs.
In severe cases, they would only use sliding genioplasty. In less severe cases, with needed projection improvement in just lower frontal part of chin, it would be prefered to use an implant. Whether to use implant with lateral support or frontal-only "button" implant, depends on case to case. The lateral support part, on C shape implants is very thin (unless those implants more masculine effect), so it doesnt really add more than mm or so to the jawline.
Forgive me, I meant to say do it *well*. Is it really part of regular training? I've encountered many plastic surgeons who don't offer the procedure. I suppose it's because they can't do it well. And I've seen enough before and afters from many plastic surgeons to know that many who do offer can't do it well either.
No, but it's adding width to already masculine features. If you're female, those extra mm probably won't do too much, even if you have your entire facial structure enhanced (like Angelina), but in MtF transsexuals it's just not the same. Conversely, if you already have a very defined bone structure (like Gigi Gorgeous) you may be inclined to keep your square jaw because you think it's "modelizing" but in transwomen I find it just makes us look like.. transwomen. Obviously, everyone can feel free to disagree, but that is my opinion.
Yes practically all are trained in doing this. It's not exactly anything special or anyhow advanced. One just needs enough training and experience. Not cutting any nerves is the only really complicated aspect of it. I wouldn't go to a plastic surgeon who havent done it enough times. I wouldn't be scared about them ->-bleeped-<-ing up the shape, or not doing it "well" as you put it.. I would be affraid for messed up nerve and worst case scenario permanent numbness.
It's not really part of common "offerings" or advertising procedures... they much more often offer and promote chin implants. it's much easier money for them. That doesnt mean that they don't do sliding genioplasty and do it well.
If one has masculine and wide jaw, it can be reduced. reducing it for another mm or so, isnt really a problem, if thats the case for implant.
Quote from: Lagertha on November 26, 2015, 03:07:35 PM
Yes practically all are trained in doing this. It's not exactly anything special or anyhow advanced. One just needs enough training and experience. Not cutting any nerves is the only really complicated aspect of it. I wouldn't go to a plastic surgeon who havent done it enough times. I wouldn't be scared about them ->-bleeped-<-ing up the shape, or not doing it "well" as you put it.. I would be affraid for messed up nerve and worst case scenario permanent numbness.
It's not really part of common "offerings" or advertising procedures... they much more often offer and promote chin implants. it's much easier money for them. That doesnt mean that they don't do sliding genioplasty and do it well.
If one has masculine and wide jaw, it can be reduced. reducing it for another mm or so, isnt really a problem, if thats the case for implant.
Lagertha,
I think BellaSwan has this about right. Most of the very best soft tissue plastic surgeons will not do any bone work other than what is required for nose jobs. If they have to do bone work - - they refer it out to another plastic surgeon who is also further specially trained in jaw surgery or craniofacial work. Are their exceptions? Yes.
Some plastic surgeons offer implants because they are not comfortable doing heavy duty bone work - - and offering implants as a "solution" keeps the patient from going to see another surgeon.
You really want to see a surgeon who is trained in both plastic surgery and then also specially trained in jaw/orthognathic surgery. If implants are the right way to get the desired result - - they can tell you that. If bone surgery is the better way, they can tell you that, too.
With implants, you can get an implant infection years down the road. Just as a result of an unrelated common tooth or other systemic infection. They can erode bone or tissue. But, sometimes they are still the right choice.
Quote from: myfairlady49 on November 26, 2015, 07:06:22 PM
You really want to see a surgeon who is trained in both plastic surgery and then also specially trained in jaw/orthognathic surgery.
I had consultation few months ago with a local plastic surgeon about something else, but I also asked him few things about sliding genioplasty, because I'm not completely happy with chin implant (like the visual side, dont like the feel, and if I sleep on my face, it can cause some discomfort). He said he is pretty much doing it on a regular basis, even more often than implants.
Quote from: Lagertha on November 26, 2015, 07:46:48 PM
I had consultation few months ago with a local plastic surgeon about something else, but I also asked him few things about sliding genioplasty, because I'm not completely happy with chin implant (like the visual side, dont like the feel, and if I sleep on my face, it can cause some discomfort). He said he is pretty much doing it on a regular basis, even more often than implants.
As I mentioned, there are undoubtedly exceptions, and it appears you found one.
But I just did a mental count, and I know or am aware of the details related to five board certified plastic surgeons that completed standard programs. None of those five do any bone work, except for rhinoplasties. One of those is a really well known plastic surgeon. The others have well regarded practices in the geographic areas where they work.
Quote from: deeiche on November 26, 2015, 09:30:22 AM
Congratulations, sounds like life is good.I completely relate to "shadows in the eyes" look. Just to let you know you could still have under eye darkening post FFS, it can be hereditary. I still have some even after a large reduction in my forehead. Also you could still have some eye "hooding" depends on the location of frontal sinus posterior wall. In my case it was right above my eye. Dr Mardirossian told me that was probably the case based upon the photos I provided. Only X-rays can give you that insight prior to surgery.
Good to know, thanks. Yes life is pretty good. ;)
Quote
Forehead swelling is marginal, cheek swelling and lower face was greater. Cheek swelling was still subsiding 5 weeks after surgery, but my list of procedures was about as extensive as you can get.No headaches after surgery, I was out an about walking about the city less than 7 days post-op. I know what headaches are too, I've had chronic sinus and migraine headaches for over 40 years. I think I've had one sinus headache since surgery and that is most likely related to nose swelling related to rhinoplasty. It can take at least 6 months for nose swelling to subside.That should help a lot, anything done to the chin will cause numbness in your lower lip and chin area.
All great info, thank you! =) How bad was the nose swelling? Dr. Mardrossian made it seem like it would swell some but not be any bigger than your previous nose or something (because the final result was smaller).
Quote from: BellaSwan on November 26, 2015, 11:00:51 AM
Your chin might not bother you now, but it might after you get your forehead done. The more feminine something is, the more masculine the rest looks. I wouldn't go for a chin implant. They are unnecessary. If Dr Deschamps-Braly does what Dr O does, he can give you a very aesthetic chin without any need for an implant
That's true, I'm hoping it's not the case. Since it's an underdeveloped chin, I've never felt like it outs me in any way.
Quote from: Debra on November 26, 2015, 11:38:51 PM
Good to know, thanks. Yes life is pretty good. ;)
All great info, thank you! =) How bad was the nose swelling? Dr. Mardrossian made it seem like it would swell some but not be any bigger than your previous nose or something (because the final result was smaller).
The nose swelling seems to be more internal than external, but I also had nasal valve repair. Does that make sense? I did not notice having a larger nose, but more a restriction in my breathing. My breathing is much better than post surgery and continues to improve.
Quote from: BellaSwan on November 26, 2015, 01:40:07 PM
I don't agree that any decent plastic surgeon can do it. I don't think they'd risk implants if they could. I understand what you mean that if you come from a place of severe under development, they can both be used. I'm sure if the under development is severe enough, an implant is warranted. All surgeries have limitations, including the sliding genioplasty. However, in the case of a MtF that would mean the jaw would have to be within female standards already, because implants add mass, and most decent chin implants wrap around the jaw a little, so you really have to start from a very petite point. I have no issues with implants in and of themselves (I think Angelina Jolie's facial implants are perfection, for example), but I wouldn't get one personally. That being said, I guess I should allow room for the unlikey, but very possible, event that some of us might need a chin implant ;)
Angelina Jolie had facial implants? Wow I guess you learn something everyday. Is that why she seems to have grown into such an angular middle aged woman? Dem cheek bones and her jaw projection is insane but still pretty.
Quote from: BellaSwan on November 26, 2015, 02:37:31 PM
Forgive me, I meant to say do it *well*. Is it really part of regular training? I've encountered many plastic surgeons who don't offer the procedure. I suppose it's because they can't do it well. And I've seen enough before and afters from many plastic surgeons to know that many who do offer can't do it well either.
No, but it's adding width to already masculine features. If you're female, those extra mm probably won't do too much, even if you have your entire facial structure enhanced (like Angelina), but in MtF transsexuals it's just not the same. Conversely, if you already have a very defined bone structure (like Gigi Gorgeous) you may be inclined to keep your square jaw because you think it's "modelizing" but in transwomen I find it just makes us look like.. transwomen. Obviously, everyone can feel free to disagree, but that is my opinion.
The thing about medical professions is that its really up to the individual if they want to master a procedure. Its one thing to be "trained" in something and do it a few times (or once or not at all) its another to decide you want to master that to the point where you are comfortable doing it over and over as a working professional. Could be why you see many surgeons drop certain procedures from their skill set even if they technically received enough training to perform them. I am really mostly speculating though, I am not in medical school or in a surgical residency ha.
Angelina Jolie has had a plastic surgery load worthy of mist trans women haha! But she is gorgeous, yes.
Quote from: deeiche on November 27, 2015, 07:40:42 AM
The nose swelling seems to be more internal than external, but I also had nasal valve repair. Does that make sense? I did not notice having a larger nose, but more a restriction in my breathing. My breathing is much better than post surgery and continues to improve.
Oh interesting, ok. What's the valve repair exactly?
Quote from: Debra on November 27, 2015, 11:38:21 PM
Oh interesting, ok. What's the valve repair exactly?
Revision Rhinoplasty Textbook Page 6 (http://therhinoplastycenter.com/revision-rhinoplasty-textbook-page-6/)
Nasal valve collapse can sometimes occur after rhinoplasty, I had two in the early to mid-80's. Looking at the bottom of my nose with my head tilted back my right nasal passage was very restricted. When I inhaled through my nose it would seal closed. I used to wakeup with a sinus headache every morning. About 15 years ago I started wearing breathe rite strips every night. I went from daily sinus headaches to every couple of weeks. On the weekends I used to wear breathe right strips for almost the entire day.
Since the surgeon was doing a rhinoplasty anyway to match my reconstructed forehead I asked them about repairing my nose issue too. Dr Rossi said he could do it as an additional procedure as nasal valve repair required a cartilage graft. At this point in time I am very happy with the result. My sinus headaches have been almost non-existent post-surgery. Of course they may also have occurred because I have almost no frontal sinus after Type III surgery. :)
Quote from: Paula1 on November 25, 2015, 05:38:52 PM
With the strong $US and weaker Euro, many US girls are now travelling to Europe for surgery.
The prices are a lot cheaper to start with and results that I have seen over here in Europe are just as good or even better than various US surgeon's post-op patients I have seen while in the USA including myself and I am a 'Z' girl.
Still you have plenty of time to make your final choice and I wish you all the best.
Hugs
Paula ( from the UK )
Hi !
I fully agree with that I had FFS with Dr Bart back on March 2015, and am happy with the results look at topic
St Patrick (https://www.susans.org/forums/index.php/topic,184207.0.html)...
Quote from: deeiche on November 28, 2015, 07:33:59 AM
Revision Rhinoplasty Textbook Page 6 (http://therhinoplastycenter.com/revision-rhinoplasty-textbook-page-6/)
Nasal valve collapse can sometimes occur after rhinoplasty, I had two in the early to mid-80's. Looking at the bottom of my nose with my head tilted back my right nasal passage was very restricted. When I inhaled through my nose it would seal closed. I used to wakeup with a sinus headache every morning. About 15 years ago I started wearing breathe rite strips every night. I went from daily sinus headaches to every couple of weeks. On the weekends I used to wear breathe right strips for almost the entire day.
Since the surgeon was doing a rhinoplasty anyway to match my reconstructed forehead I asked them about repairing my nose issue too. Dr Rossi said he could do it as an additional procedure as nasal valve repair required a cartilage graft. At this point in time I am very happy with the result. My sinus headaches have been almost non-existent post-surgery. Of course they may also have occurred because I have almost no frontal sinus after Type III surgery. :)
Gotcha. Glad it worked out for you, yay!
Alright I had a skype consult with Dr. Mayer today.
In his original email to me, he suggested: Scalp Advance, Brow Shave, Rhinoplasty, Brow Lift, Lip Lift, cheek and chin implants.
I was kind of taken aback because I just don't want to do that much. The main things for me are forehead and nose.
Anyway, we spoke on skype today and he seemed nice. He re-iterated what he suggested but he understood what I wanted to do was what I wanted to do. He kept saying that my chin was VERY recessed and even showed me how far forward it should be (to align with the base of my nose (in profile photos). But he let it go. He also confirmed it wasn't a masculine/feminine thing as much as just balancing out the face in general.
Before the consult, I was struggling with how to ask about Type III with him without being insulting but he just immediately brought it up. He said that he shaved everything down and it always worked for all of his patients that way. He said he's never had to take any sinus walls out and yadda yadda yadda....and claimed that was all just 'marketing'. The way he said it, it did all sound very believable but I've seen too many in the community comment about it to know for sure. I guess I should have asked how he dealt with really thin frontal sinus walls?
He explained a lot about my nose too but frankly it was all kind of confusing....it sounded pretty complex what all he had to do about moving this there and that here, etc.
I wasn't necessarily interested in the lip lift but I asked about it anyway based out of curiosity and he explained how it worked too. Wondering how the swelling / recovery is for that too.
Overall, a pretty good consult, I think though.
He straight up lied about the forehead. I suggest finding another surgeon. He sounds more like a salesman than caring individual. I would find a craniofacial/maxillofacial and aesthetic surgeon,
Quote from: Debra on December 09, 2015, 05:26:29 PM
Before the consult, I was struggling with how to ask about Type III with him without being insulting but he just immediately brought it up. He said that he shaved everything down and it always worked for all of his patients that way. He said he's never had to take any sinus walls out and yadda yadda yadda....and claimed that was all just 'marketing'. The way he said it, it did all sound very believable but I've seen too many in the community comment about it to know for sure. I guess I should have asked how he dealt with really thin frontal sinus walls?
I think you should look here and judge for yourself : http://bevhillstg.com/photo-gallery/
I probably should keep my thoughts for myself.
Quote from: Lagertha on December 09, 2015, 06:14:17 PM
I think you should look here and judge for yourself : http://bevhillstg.com/photo-gallery/
I probably should keep my thoughts for myself.
Yeah that's a really good point....kinda tells all really.
Consults with Spiegal and Deschamps-Braly coming up in 2016 so we'll see how those go.
Not one pleasing result. I'm sure he's a good plastic surgeon but he's a terrible ffs surgeon
Quote from: BellaSwan on December 09, 2015, 06:31:12 PM
Not one pleasing result. I'm sure he's a good plastic surgeon but he's a terrible ffs surgeon
Looking at the web site - - he is *NOT* a board certified plastic surgeon. Yes... he claims "facial" plastic surgery. But you basically can get that just for having become an Ear Nose Throat (ENT) . That board is basically just a marketing / vanity pseudo board.
If you go to www.certificationmatters.org - - and look at his specialty training - - he is an Oto-rhino-laryngologist - - that is, an ear nose throat surgeon. They are not trained as plastic surgeons. Nor as craniofacial surgeon. Nor are they trained to do orthognathic jaw surgery.
He probably does not do type III because he knows he is not trained to do that type of craniofacial bone surgery. If he ever caught a lawsuit due to a bad result (they do happen - - even to good surgeons) he would be in a difficult spot, even if he didn't cause the problem - - because he would have to defend doing the surgery because of his inadequate training to do that type of surgery.
Quote from: myfairlady49 on December 09, 2015, 07:18:13 PM
If you go to www.certificationmatters.org - - and look at his specialty training - - he is an Oto-rhino-laryngologist - - that is, an ear nose throat surgeon. They are not trained as plastic surgeons. Nor as craniofacial surgeon. Nor are they trained to do orthognathic jaw surgery.
Oh wow well I kinda knew I probably wouldn't be going with him but now I am pretty sure haha.
Started setting up a consult with Dr. Deschamps-Braly for June 2016. They've sent me a referral for xrays and I had a heck of a time trying to find the right radiology place that would even do them. Hoping I can get insurance (or at least my deductible) to cover it but if not, I have my FSA too.
I figure my hubs and I are going to Santa Cruz in June for a weekend vacation anyway so making a quick stop in San Fran to see the doc seems like a good option. We'll see how this all goes.
Quote from: Debra on December 15, 2015, 06:51:27 PM
Started setting up a consult with Dr. Deschamps-Braly for June 2016. They've sent me a referral for xrays and I had a heck of a time trying to find the right radiology place that would even do them. Hoping I can get insurance (or at least my deductible) to cover it but if not, I have my FSA too.
SNIP
Hope you don't me for asking several questions. What specific xrays did he request you have, what type of radiology facility and what is the charge?
thanks
Quote from: deeiche on December 16, 2015, 07:14:51 AM
Hope you don't me for asking several questions. What specific xrays did he request you have, what type of radiology facility and what is the charge?
thanks
Panograph and Cephalometric (Lateral and PA) Xrays (2D Imaging). It seems they are dental xrays of some sort so that's why it's been difficult finding the right place. Still working on that.
thanks
Quote from: Debra on December 17, 2015, 08:00:23 AM
Panograph and Cephalometric (Lateral and PA) Xrays (2D Imaging). It seems they are dental xrays of some sort so that's why it's been difficult finding the right place. Still working on that.
Ok today I had a phone consult with Dr. Lee.
I have to say I liked him. He was straightforward and friendly.
He went over my pictures and negated some of the stuff some of the other doctors have said.
1. Dr. Marderossian had said that by doing a brow lift and forehead reconstruction....if he DIDNT do a scalp advance, it might actually make my forehead slightly bigger. Dr Lee said no, that was not the case.
2. Dr Mayer had said that if he feminized the bridge and radix of my nose and fixed the septum/crookedness of my nose, he'd also have to do a bunch of stuff on my nostrils because otherwise I'd end up with a 'pinched' nose look. Dr. lee didn't agree with that either.
He did however suggest a chin implant (or sliding geoplasty but he said most likely my chin is so recessed that there wasnt enough bone to work on....but xrays would tell for sure) and cheek implants.
I'm still saying no to the cheek and maybe slowly getting persuaded towards chin work. I realize I had a huge overbite as a kid and spent years in orthadontristry to fix it.....and definitely have a recessed chin (which has helped me greatly in transition/feminization) but of course I'm still worried about adding too much chin and/or making the recovery any tougher than it's already going to be.
I also asked about lip lift and he said that I could benefit from one as well.
Weirdly enough, I looked up Dr Lee on certificationmatters.org and he is not plastic surgery board certified OR ENT certified but instead he's part of the American Family Board of Medicine.
His website says he had a 1 year fellowship in Facial Plastic and Reconstructive Surgery at UCLA.
And these certs:
06/25/01 Diplomate, The American Board of Facial Plastic and Reconstructive Surgery
04/10/98 Diplomate , The American Board of Otolaryngology: Head and Neck Surgery
02/23/90 Diplomate, The American Board of Oral and Maxillofacial Surgery
Maybe he just hasnt kept up to date with them or something?
Anyway from the consult, he seemed like he knew what he was talking about.
Quote from: Debra on December 17, 2015, 03:48:53 PM
He did however suggest a chin implant (or sliding geoplasty but he said most likely my chin is so recessed that there wasnt enough bone to work on....but xrays would tell for sure) and cheek implants.
I'm still saying no to the cheek and maybe slowly getting persuaded towards chin work. I realize I had a huge overbite as a kid and spent years in orthadontristry to fix it.....and definitely have a recessed chin (which has helped me greatly in transition/feminization) but of course I'm still worried about adding too much chin and/or making the recovery any tougher than it's already going to be.
Receding chin is not a feminine feature. Both men and women have recessed chins. I don't understand how would receding chin help you in transition.. Generally it's unnattractive feature, because it messes up facial balance, and in that sense make your face look less attractive than it would with normally projected chin, but it doesnt add anything to making face look more feminine. Male chin is ideally at 0° angle, and female at 2°. Shure it's better than having strong overprojected hypermasculine chin... but, you would be better off in terms of feminine look and easier transition with 2° angle chin than with recessed chin.
When you look in the mirror... do you like the change that smiling creates on your cheeks?
Quote from: Lagertha on December 17, 2015, 04:40:55 PM
Shure it's better than having strong overprojected hypermasculine chin
^^ Yes. That. Because my chin is recessed it never got bigger and broader. That's all I'm saying.
Thanks for your words about the balancing though....I'm hearing it a lot from the doctors so I'm starting to consider it.
Quote
When you look in the mirror... do you like the change that smiling creates on your cheeks?
Yeah my cheeks are fine and my smile is my greatest most feminine look.
If you like the "prominent cheek-bones look" that smiling creates when muscles raise cheeks up and push forward, but you miss the same effect when you don't smile, is the best way to tell if you would benefit from malar cheek-implants or not.
Quote from: Lagertha on December 18, 2015, 02:13:56 PM
If you like the "prominent cheek-bones look" that smiling creates when muscles raise cheeks up and push forward, but you miss the same effect when you don't smile, is the best way to tell if you would benefit from malar cheek-implants or not.
Gotcha.
Well I scheduled xrays to be done at a local facility in Jan.....for Deschamps-Braly. Won't see him till June though.
Ok just had a skype consult with Spiegel from Boston.
It went rather well. He agreed that my brow ridge would need to be dealt with and that my nose could be both corrected and made smaller.
I asked about his methods for forehead reconstruction and he mentioned that simply 'burring' was not enough and that he did redefine the sinus wall completely to make it work.
He said he could add a slight brow lift but my brows look fine. He also said I wouldn't need a scalp advance (when other docs said I should at least consider it).
I asked about lip lift to show more vermillion and he agreed that would be helpful.
He also (as the other doctors suggested) suggested a chin implant to bring my recessed chin forward and he explained that doing so was feminizing because it makes someone's nose seem smaller. Interesting point.
What's everyone's opinions on chin implants vs sliding genioplasty? After reading Dr O's book, he kind of poopoos implants but at the same time a genioplasty can only do so much and my chin is pretty darn recessed.
Also, I went and had xrays done locally for Deschamps-Braly so that's progress. I still plan on visiting him in San Fran in June as my final consult. If I really don't like him for some reason then I could possibly go visit one of these other docs (most likely Spiegel) in person as well.
Starting to think I might go for this in Oct/Nov instead of waiting till 2017. I'll be able to save for it and borrow from my 401k as well.
Hi Debra,
I think that I have asked you this before and forgive me if I have.
Are you willing to travel to South America or Europe for FFS?
In my opinion the surgeons there are equally as good if not better than some of the US surgeons and cheaper too because of their locations.
For example although not FFS, I am happy to travel to Korea for Voice Surgery with Dr Kim because by all accounts he is the best now. From the UK it's just as cheap to fly to Korea as it is to say the Mid-West.
Hugs
Paula
thanks Paula
I was going to ask Debra the same question.
Quote from: Paula1 on January 11, 2016, 09:42:43 PM
Hi Debra,
I think that I have asked you this before and forgive me if I have.
Are you willing to travel to South America or Europe for FFS?
In my opinion the surgeons there are equally as good if not better than some of the US surgeons and cheaper too because of their locations.
For example although not FFS, I am happy to travel to Korea for Voice Surgery with Dr Kim because by all accounts he is the best now. From the UK it's just as cheap to fly to Korea as it is to say the Mid-West.
Hugs
Paula
No, not really willing to travel outside of the US. I have done all my surgeries here and I think there are good enough options here...even if I end up having to pay a whole lot more. That's ok with me.
That's why I've explored 6 different surgeons from around the US.
I realize FT is great and cheap but I don't want to leave the US. I'm just not comfortable with doing that. I've seen plenty of good results in the US (if done by the right surgeon).
Aside from that, is there anything else you all can comment on? I believe I asked a question even.
I've set my limits between these 6 surgeons (see original post) and I'd appreciate any help in determining which of those surgeons would be the best. I basically think Mayer is out because he doesn't do Type 3 but all the others do. Still waiting on an actual quote from Spiegel as of yet too.
Hi Debra,
Sure I can understand your reasoning.
Likewise I now wish to stay in Europe after my poor experience in the USA and having to pay £10,000.00 in crossing the pond and other expenses for revisions umpteen times ... >:(
I have seen Dr O's girls and Dr DiMaggio girls while in the USA and they all looked good to me. Dr O's girls do tend to look similar but so do my surgeon's regrettably.
If money is no object and Dr O's successor is as good or even better than the grand master, if it was my choice I would go with Dr Deschamps-Braly.
But please don't blame me if you decide on him and you are not happy with the result ... ;)
Quote from: Paula1 on January 12, 2016, 12:41:18 PM
Hi Debra,
Sure I can understand your reasoning.
Likewise I now wish to stay in Europe after my poor experience in the USA and having to pay £10,000.00 in crossing the pond and other expenses for revisions umpteen times ... >:(
I have seen Dr O's girls and Dr DiMaggio girls while in the USA and they all looked good to me. Dr O's girls do tend to look similar but so do my surgeon's regrettably.
If money is no object and Dr O's successor is as good or even better than the grand master, if it was my choice I would go with Dr Deschamps-Braly.
But please don't blame me if you decide on him and you are not happy with the result ... ;)
It's all your fault! LOL Just kidding. That is my current thinking. I will finally consult with him (in person) in June so we'll see. Unless I get a bad feeling about him or a better feeling from the other surgeons or something. Guess we'll see
Quote from: Debra on January 11, 2016, 06:00:19 PM
What's everyone's opinions on chin implants vs sliding genioplasty? After reading Dr O's book, he kind of poopoos implants but at the same time a genioplasty can only do so much and my chin is pretty darn recessed.
I wanted improved chin projection, and I was given a choice to decide between implant or sliding genioplasty. I decided for less invasive implant... and I made a wrong decision. I looks OK, Im very happy with improved projection, but I dont like the feel of implant, as it doesnt feel natural to the touch. When I touch chin with fingers, I can easily feel the implant, and its edges. Which I dont like. I cant say how would sliding genioplasty feel, because as of not I still havent had implant removed and done sliding genioplasty instead. Maybe someday.
I was good canidate for both options. And there wouldnt be a difference in appearance. However some people and some chins, have either a shape which is more appropriate to correct with implant or sliding genioplasty. If your chin is severely recessed, it might not be possible to advance it enough with sliding genioplasty, and implant could give better result aesthically. Sliding genioplasty only advances lower part of chin, which might create strange looking profile above the advanced part of chin.
It is really a question for a surgeon who will be doing your FFS. Keep in mind the fact that some surgeons only do implants, because they arent trained (enough) in orthognatic and maxillofacial techniques. And there is Facial team who doesnt do chin implants, and will always suggest sliding genioplasty.
Thanks Lagertha. Good info and good point about some surgeons only doing one or the other.
I may wait on the chin altogether. Just do forehead nose and lip this time and in a couple years see how i feel about my chin.
Whatever happened to Lagertha?
She decided she had enough of this and deleted the account... and then saw that Kayxo, who was always extremely helpful for others, asked a question herself, and I kind of felt I need to answer one for her, to hopefully help her with her issue. And I prefered old previous mmmmm username I had last year... because it doesn't mean anything...
Quote from: mmmmm on February 09, 2016, 09:45:11 AM
She decided she had enough of this and deleted the account... and then saw that Kayxo, who was always extremely helpful for others, asked a question herself, and I kind of felt I need to answer one for her, to hopefully help her with her issue. And I prefered old previous mmmmm username I had last year... because it doesn't mean anything...
sad to hear. she was always so helpful and educated on stuff
Quote from: Debra on February 09, 2016, 09:01:08 PM
sad to hear. she was always so helpful and educated on stuff
Haha, you didn't understood me... It's me, I'm the same person.. I'll stay for a while, as long as I feel i can be helpful to someone, even if only in a small way, it makes it worth to stick around.
Quote from: mmmmm on February 09, 2016, 11:12:20 PM
Haha, you didn't understood me... It's me, I'm the same person.. I'll stay for a while, as long as I feel i can be helpful to someone, even if only in a small way, it makes it worth to stick around.
Ohhh ok haha. good!
VFFS came back! I'm pretty excited/happy with the results. She essentially confirmed that Forehead reconstruction and rhinoplasty would be very good for feminizing my face.
She also had a lot of good advice about what she thought I did or didn't need on top of that. The chin/jaw recession came up but it's so far recessed that it may not be worth the drastic measures to fix....we'll see what Dr D-B says.
She said that I didn't need scalp advancement, brow lift, lip lift, or cheek implants despite some of the other docs' opinions so that was interesting.
All-in-all, pretty happy and glad I did VFFS. Still waiting till June to see Dr. D-B before making a final decision on surgeon and setting a date (hopefully for November).
Good for you Debra.
Alexandra Hamer of VFFS is great ... 8)
I feel that everyone who is planning FFS should use her services.
If only my original surgeon had followed her advice on how my nose should look ... :o
Also just linking to my xray here: https://www.susans.org/forums/index.php/topic,203467.0.html
Quote from: Paula1 on February 10, 2016, 11:36:00 PM
Good for you Debra.
Alexandra Hamer of VFFS is great ... 8)
I feel that everyone who is planning FFS should use her services.
If only my original surgeon had followed her advice on how my nose should look ... :o
I agree! It's very useful
Great advice Debra ;D, I'm in the midst of using the VFFS myself within the next month or so, so I can get a good gauge of what I would need for FFS. If I could, I would use DeaChamps-Braly myself, figure I would have to live with the results forever, so why not go whole hog :). I'm 3 years a month or so into hrt myself, so I figure I'm a good candidate by now for it. Now to be a penny pincher from now on and make great investments for the future :police:
Quote from: SonadoraXVX on February 12, 2016, 04:27:25 AM
Great advice Debra ;D, I'm in the midst of using the VFFS myself within the next month or so, so I can get a good gauge of what I would need for FFS. If I could, I would use DeaChamps-Braly myself, figure I would have to live with the results forever, so why not go whole hog :). I'm 3 years a month or so into hrt myself, so I figure I'm a good candidate by now for it. Now to be a penny pincher from now on and make great investments for the future :police:
yes!! save away :) It'll be worth it, IMHO.
I'm getting excited to see him in June
Got TSA/Precheck status today! Should help with all my flights this year (including consult and surgery flights)