Hi my lovelies,
Okay, stage 1 of my SRS has gone well (the bilateral orchiectomy) and I'm now planning stage 2 which is my FFS in October / November.
I had a good consultation with Dr Sutin at PAI where we discussed options. Realistically, for financial reasons, I can't do everything in one go but I'm not sure that's a bad thing anyway.
I'm new to the whole FFS area though and know little about it. So any help would be massively appreciated. This is what we're thinking:
1. Lower hairline and brow lift (probably not orbital rim this time as Dr Sutin didn't really think I needed it with my eyes - lucky). I don't need any forehead reconstruction apparently either.
2. Full Facial Lift FFL
3. Tipplasty and Arrplasty (but not full rhinoplasty)
To which I may add a chin shave. I'm just checking the price on that.
The reason for 2. is partly cost but also because I don't want to have a very thin nose that is out of keeping with my face shape.
Another question I have. My hair is all mine and quite full: you probably can't see it on my avatar as it's been 'rebonded' and styled since, and it's longer. So will 1 and 2 leave my own hair in place?
There's so much to find out! Heeeelp?!! :)
Rachel Richenda x
Have you received multiple consults from other surgeons ?
I wouldnt trust one doctor's opinion frankly. I also don't trust when a doctor says any of us don't need some kind of forehead reconstruction. MOST trans women require some sort of reconstruction (usually Type III).....unless a very unique situation and/or started hormones in your teens.
Can you give scientific backing for the forehead statement Debra?
Quote from: Richenda on September 01, 2016, 04:31:47 PM
Can you give scientific backing for the forehead statement Debra?
The only good data available is in Dr. Ousterhout's book on FFS. Probably worth a Kindle download and read. I think he says that something like 85% of all of his patients had protruding frontal sinus that required a Type III forehead surgery with set back of the frontal sinus wall.
Quote from: oneoftwo on September 01, 2016, 07:07:05 PM
The only good data available is in Dr. Ousterhout's book on FFS. Probably worth a Kindle download and read. I think he says that something like 85% of all of his patients had protruding frontal sinus that required a Type III forehead surgery with set back of the frontal sinus wall.
I had read the entire book before my FFS consult... So much good info!!!... I took it with me and Dr O autographed it ...LoL!!!!
Ashley :)
Quote from: oneoftwo on September 01, 2016, 07:07:05 PM
The only good data available is in Dr. Ousterhout's book on FFS. Probably worth a Kindle download and read. I think he says that something like 85% of all of his patients had protruding frontal sinus that required a Type III forehead surgery with set back of the frontal sinus wall.
I meant peer-reviewed academic statistical data rather than a ffs craniofacial surgeon's personal viewpoint. I'd like to see proper hard evidence for his claim that 85% of cis males have significant medial brow ridging requiring reconstruction. I don't mean to appear overly sceptical but it's clearly in the interests of someone getting paid for forehead reconstruction to promote that idea. So proper scientific backing is required.
Anyway, luckily I appear to be in his 15%. I also don't have prominent orbital rims, amongst some other female skeletal features like very thin ankles (as you can probably see from my avatar).
One of the things I admired about my consultation at PAI was telling me what I don't need as well as what I do, even though financially the former isn't in their interests. Hmmm ... did someone mention the word 'trust'? ;)
Quote from: Richenda on September 01, 2016, 11:12:29 PM
I meant peer-reviewed academic statistical data rather than a ffs craniofacial surgeon's personal viewpoint. I'd like to see proper hard evidence for his claim that 85% of cis males have significant medial brow ridging requiring reconstruction. I don't mean to appear overly sceptical but it's clearly in the interests of someone getting paid for forehead reconstruction to promote that idea. So proper scientific backing is required.
Anyway, luckily I appear to be in his 15%. I also don't have prominent orbital rims, amongst some other female skeletal features like very thin ankles (as you can probably see from my avatar).
One of the things I admired about my consultation at PAI was telling me what I don't need as well as what I do, even though financially the former isn't in their interests. Hmmm ... did someone mention the word 'trust'? ;)
Good for you then! I know some other girls on here didnt need it either supposedly. My suggestion wasn't that you necessarily need it....just that it's good to get multiple consults / opinions (if you haven't already)
Ah okay, sorry for misinterpreting. I think you're right about the wisdom of getting some other opinions actually. I will do so.
It is very difficult to say what you need based on your avatar picture. I can hardly see your face there. Perhaps sharing a few photos can give us a chance to evaluate your face
Yes indeed, and I'd love to, but it seems nigh impossible to post pics on here? As far as I can see only photobucket does the trick and that seems the most unwieldy site in history. Would love to be corrected and directed.
I could change my avatar to a close up of my face for a day?!
Or just add a few photos on photobucket. It is the best if you can add front side and 45% pictures so that we can give you a honest opinion
Quote from: Richenda on August 25, 2016, 04:15:01 AM
Hi my lovelies,
Okay, stage 1 of my SRS has gone well (the bilateral orchiectomy) and I'm now planning stage 2 which is my FFS in October / November.
I had a good consultation with Dr Sutin at PAI where we discussed options. Realistically, for financial reasons, I can't do everything in one go but I'm not sure that's a bad thing anyway.
I'm new to the whole FFS area though and know little about it. So any help would be massively appreciated. This is what we're thinking:
1. Lower hairline and brow lift (probably not orbital rim this time as Dr Sutin didn't really think I needed it with my eyes - lucky). I don't need any forehead reconstruction apparently either.
2. Full Facial Lift FFL
3. Tipplasty and Arrplasty (but not full rhinoplasty)
To which I may add a chin shave. I'm just checking the price on that.
The reason for 2. is partly cost but also because I don't want to have a very thin nose that is out of keeping with my face shape.
Another question I have. My hair is all mine and quite full: you probably can't see it on my avatar as it's been 'rebonded' and styled since, and it's longer. So will 1 and 2 leave my own hair in place?
There's so much to find out! Heeeelp?!! :)
Rachel Richenda x
Use Imgur.com when you get on the screen there will be a green button to upload your picture. After the picture uploads. copy the URL and paste the web number to your PM or web comment. I didn't have to sign in the first time I used it. Make sure to set the privacy setting to personal. This will allow you to view and send your photo without public display on Imgur but anyone who has the URL can access it.
Ooooh like it :)
Okay, here we go:
http://imgur.com/a/KP4T2
I would love love love love love love love any thoughts or comments :) These are non-professional and non-photoshopped snaps using a phone, so be gentle-ish ;) :)
x
I have read that the sinus plate is 1.5 mm on 95% of males and thicker on 5%. If you need more than burring of at most 1mm then the plate needs to be removed and re-contoured in order to get the desired effect. The thickness can be determined with an x-ray.
I needed more than 1mm of shaving so I am going with the recontouring. When Dr. McGinn looked at my forehead she said If I wanted it flat then I would need recontouring and recommended a surgeon. That surgeon recommended recontouring, which I will be doing soon.
I'm really not keen on any forehead rebossing etc. I've read too many dodgy things about it and I don't consider it that vital tbh. Maybe my view will change but I'm just not convinced it is a major gender marker. I'd place more store on the eyes i.e. orbital rims as an issue and forehead size which is corrected by lowering hairline and eyebrow lift. Just my take.
Ok my honest opinion
Hairline lowering is very much needed in your case as it will make your head smaller and more feminine. eyebrow lift as well. You don't have a prominent frontal sinus and I think that type 2 forehead work will be enough. I would suggest orbital rims burring as it will open your eyes and make them more feminine even though you can do without it. Face lift will make you look younger so you will benefit from that. I am not sure about your nose because you may need full nose job or perhaps just the tip. It will depend on the forehead work you get. Your chin looks okay to me so i wouldn't touch it.
Wow Reborn.
That is exactly, almost word for word, what Dr Sutin said to me. I mean, seriously, every detail is precisely his opinion too. Which is very very encouraging.
I'm going to try for the orbital rims as I think I may as well whilst I'm there. He also said the same about my chin by the way.
Thank you :)
x
Yeah your eyes are not very shadowed at all so the need for forehead reconstruction not so bad as most of us. Easier to see with a side profile shot though. But from the front, that's my thought.
This is sooooooooo encouraging. Thank you :) xx
I think I 'will' go ahead with the orbital rim work. Dr Sutin said it's more of a toss up: there's a little protusion. If so then with your comments above on board it looks like this:
1. Lower hairline and brow lift plus orbital rim shave
2. Full Facial Lift FFL
3. Tipplasty and Alarplasty
Total cost $14,900. Ouch. Surgery requested for December 2nd.
I don't know what your budget is, but here are some things I see when I look at the 2nd to last photo.
The distance from the upper lip to the nose is long. An upper lip lift would shorten this and feminize your appearance.
An eyebrow lift would be helpful in opening up your eyes.
I agree that your nose could be narrowed to give you a more feminine look.
Lowering of your hairline would feminize your appearance.
If money were no object, I would narrow the jaw and reduce the chin a bit too, but it's probably at the bottom of the list.
That's remarkably close to what Dr Bart said Rhonda :)
I saw Dr Bart van der Ven this afternoon for an excellent consultation. He examined me carefully.
One of his most significant findings was that I am 'lucky to be one of the few with a type I forehead' so he proposes some shaving only of the forehead including orbital rims and NOT reconstruction. This follows an exchange I had with Dr Rossi's agent which was based on photos alone: I got the distinct impression that Dr Rossi's team will try to perform major forehead reconstruction on everyone who comes their way. Neither Dr Sutin (PAI) nor Dr Bart had any hesitation in saying the same thing: 'you don't need it.'
Dr Bart proposed a number of other actions which were detailed and, I have to say, about which I'm delighted. It includes a little shaving of my jaw and chin, some work on my nose and lip, hairline advance and, of course, a brow lift. They will also perform a separate 8-hour electrolyis under i-v pain relief. The work he proposes around my eyes and cheeks sounds terrific.
In a separate op 4 months later I will have a full face lift possibly with blepharoplasty.
I think my decision is made but I will sleep on it tonight :)
There's a fuller more up to date post on this here: https://www.susans.org/forums/index.php/topic,214760.msg1901920.html#msg1901920
Well I slept on the decision for a couple of nights and I have finally made it. Before I declare my hand, I consulted with:
1. Dr Rossi
2. Dr Bart van der Ven
3. Facial Team
4. Dr Sutin at Preecha Aesthetic Institute
I discounted Dr Zukowski for no massively strong reasons so those were 4 of the world's leading non-US FFS places.
After much thought, including nearly a whole day Monday scouring the internet for further reviews and comments, I came to the following conclusions:
1. Dr Rossi
Good quick responses from Amanda their agent. Whilst I liked a lot of their thoughts I get the impression Dr Rossi is basically a one-trick pony: it's forehead reconstruction or nothing. Since I don't have a so-called type III forehead, and am pretty dubious about this whole reconstruction malarkey, this turned out to be a sticking point beyond which we could not budge. They did back down when I told them the findings of both Dr Sutin and Dr Bart.
2. Dr Bart van der Ven
I had a good face-to-face consultation but this turned out to be a different viewpoint to others. Dr Bart doesn't think I need much work on my forehead except to lower my hairline. He thinks I don't have much brow bossing and am not type III so he proposed very little work there. However, to my slight surprise he did want to do a little jaw and chin shaving. No one else thought this was necessary in my case and when I said I'd rather focus on a full face lift to achieve the effect he steamrollered my viewpoint. I was also rather unhappy about his nose simulation. There was almost no difference at all in the before and after and he didn't seem to listen to what I was proposing. I was really quite underwhelmed by his before and after simulation. I also raised with him the issue of operations in a clinic not a hospital and what happens if something goes wrong? He was a bit casual in response on this which I really didn't like. Look at what happened to Kelly Maloney there: things can sometimes go wrong for whatever reason and when they do every second counts. Finally, I emailed them several times and received no reply. Sorry, Dr B, you're very nice but for those reasons I'm out.
3. Facial Team
Appalling at email replies. Simply appalling. Made me feel like I was on a conveyor belt. When I eventually got a response from them they completely agreed with Dr Sutin (see below). "looking at your photos and wanted to congratulate you have a feminine face. And we believe that with a facial feminization'd look great. For your case we suggest a lifting of the lower middle third to lift the soft tissues andcan rejuvenate and feminizarte the same time."
They also operate in a clinic, not a hospital. That's okay providing nothing goes wrong but 8 hours under GA is not a short operation.
Anyway, lousy response timing from them has put me off.
4. Dr Sutin at PAI (Preecha Aesthetic Institute)
He palpated my face, simulating the different face lifts which were impressive. He clearly and unequivocally stated I don't need forehead work except an orbital rim shaving alone if I want (50:50 on that): nothing else was necessary except for lift work and hairline lowering. He was equally clear that the jaw and chin don't need shaving but that a FFL will be perfectly sufficient given my face shape. He offered two clear options on my nose which I liked: unlike Dr Bart he wasn't pushing a full rhinoplasty and conveyor belt nose job. He felt I could alternatively have tipplasty if I didn't want my nose in cast for 4 weeks etc.
I had my bilateral orchiectomy with PAI and they were superb. I really like Dr Sutin.
And the best FFS facial surgery I've ever seen (Warlockmaker) was performed by PAI. These Thais do really know their stuff in this field: they must still be considered the most aesthetically sophisticated and beautiful in the world, surely?
What I particularly like is that they tailor it to your needs. They're also brilliantly quick with email response.
So, for me, it's now a no brainer. I've booked the surgery with Dr Sutin at PAI in December, booked my flight, booked my hotel.
Oh, and PAI is half the cost of Dr Bart and they operate in a superb hospital (Piyvate).
Decision made.
Congratulations on making your decision, Rachel! I think you've done a fantastic job in your search of the various surgeons to find the one that is right for you.
Awww that's so sweet Rhonda. Thank you so much for your kind words :)