Susan's Place Transgender Resources

Hello all!

I am new here and I hope this is the right place to be! I am seeking to start slowly into a FFS. I am mainly concerned about getting a rhinoplasty, otoplasty (with ear lobule reduction) and brow bossing removal. I would not think that my brow ridge is significantly prominent but speaking to local surgeon he suggested that if I wanted to truly feminize my face then I should seek a surgeon who can soften the brow ridge projection.

I was told Doctor Zukowski was my best bet for a feminized rhinoplasty given that he is one of the better surgeons who makes feminized noses consistently and others reviews. What truly stands out to me is that I have heard from 3 users that Doctor Zukowski tends to be more aggressive with his work thus he strives to achieve a barbie-doll look to most of his patients. In which is what I exactly want.

My questions are just as simple as below.

1. I know Doctor Zukowski does better work with soft-tissue work. From what I read is that he also does good forehead work which he only does endoscopic but only for minimal work. Or is this false? I know a lot of people rave about Dr. Bart, Ousterhout, and others for forehead work.

2. Is it really important to do both Forehead Type (3) reconstruction or Brow Ridge Reconstruction with Rhinoplasty at the same time? Or could I do a nose job with my ears and then come back 1.5 years later to another surgeon to do a revision of my nose and do my forehead contouring?

Beyond this I hope I will be satisfied with Dr. Zukowski. I am rested on him as he was kind on the e-mails before even having my phone consultation, and that from a lot of reviews he seems to be the only surgeon who strives to make people like barbies.

I hope to get a lot of help from you all!

Thank you soo much!

Quote from: icy on February 09, 2017, 02:38:11 AM1. I know Doctor Zukowski does better work with soft-tissue work. From what I read is that he also does good forehead work which he only does endoscopic but only for minimal work. Or is this false? I know a lot of people rave about Dr. Bart, Ousterhout, and others for forehead work.

I think Dr Z has had some phenomenal results with Type I foreheads.  With Type III, he will fill in the gap with bone paste, and I think that limits how much can be accomplished; sometimes it results in more forward projection than I think is optimal.  You won't know what type of forehead you have without seeing X-Rays or certain CT scans -- forehead "type" is determined by the internal thickness of the bone.

Quote2. Is it really important to do both Forehead Type (3) reconstruction or Brow Ridge Reconstruction with Rhinoplasty at the same time? Or could I do a nose job with my ears and then come back 1.5 years later to another surgeon to do a revision of my nose and do my forehead contouring?

You'll get the best results doing both at the same time.  Doing the nose first will make your existing forehead look more prominent for the duration, and rhinoplasty revisions can compromise the integrity of your nose.  Do the ears separately if you want to break things up.

That's my two cents' worth.  :)

Icy,

I have not done research to be able to answer you. We have a lot of members though. This is the correct category and it is usually pretty active.

I also want to share some links with you. They are mostly welcome information and the rules that govern the site. If you have not had a chance to look through them, please take a moment to:

• Site Terms of Service and rules to live by  (https://www.susans.org/forums/index.php/topic,2.0.html)
  
• Standard Terms and Definitions (https://www.susans.org/forums/index.php/topic,54369.0.html)
  
• Post Ranks (including when you can upload an avatar) (https://www.susans.org/forums/index.php/topic,114.0.html.)
  
• Reputation rules (https://www.susans.org/forums/index.php/topic,18960.0.html)
  
• News posting & quoting guidelines (https://www.susans.org/forums/index.php/topic,174951.0.html)
  
• Photo, avatars, and signature images policy (https://www.susans.org/forums/index.php/topic,59974.msg383866.html#msg383866)
  

Once again, welcome to Susan's. Look around, ask questions and join in.

With warmth,

Joanna

Sophia Sage,

Thank you very much for your post. I was told "filling in the gap with bone paste" was not such a good idea for some reasons. I couldn't recall but there were some long-term complications with that from what I was told? So it seems bone paste method isn't the way to go. The challenge really is finding someone who can perfect the nose while doing my brow ridge. In terms about X-Ray or CT Scans which one image is best in order to assess this? To understand what kind of thickness I have of the forehead bone. I assume I can go to my General Practitioner and tell them I want a X-ray of my skull just because?

I hope to get more opinions.

Thank you!

Quote from: Sophia Sage on February 09, 2017, 11:01:22 AM
I think Dr Z has had some phenomenal results with Type I foreheads.  With Type III, he will fill in the gap with bone paste, and I think that limits how much can be accomplished; sometimes it results in more forward projection than I think is optimal.  You won't know what type of forehead you have without seeing X-Rays or certain CT scans -- forehead "type" is determined by the internal thickness of the bone.

You'll get the best results doing both at the same time.  Doing the nose first will make your existing forehead look more prominent for the duration, and rhinoplasty revisions can compromise the integrity of your nose.  Do the ears separately if you want to break things up.

That's my two cents' worth.  :)

If you truly want a Barbie like look, you need a surgeon that can aggresively setback your forhead, glabella, nasion region while also giving you a round curved volumous forehead and a nose that is very petite and upturned.

Link below shows a exaggerated version of that look.

https://ashgutz.wordpress.com/2014/01/27/cleo-de-nile-blank-face/

So basically, a surgeon that can do 1) type 3 reconstruction(might also require use of implant/bone paste for middle/upper forehead) and 2) thin petite upturned nose.

Ypsf09,

Thank you very much for your post. I appreciate you taking time to give me some advice on what to know and say to a surgeon about what I am seeking. When you say setback your forehead is there a specific type of procedure for this or the usual Type 3 reconstruction. Why would you suggest implant/bone-poste for middle/upper forehead?

You have given me a lot to think about I appreciate it soo much

What you described about the forehead and petite upturned nose, is exactly what i want.

How are you doing?

Quote from: Ypsf09 on February 09, 2017, 05:18:18 PM
If you truly want a Barbie like look, you need a surgeon that can aggresively setback your forhead, glabella, nasion region while also giving you a round curved volumous forehead and a nose that is very petite and upturned.

Link below shows a exaggerated version of that look.

https://ashgutz.wordpress.com/2014/01/27/cleo-de-nile-blank-face/

So basically, a surgeon that can do 1) type 3 reconstruction(might also require use of implant/bone paste for middle/upper forehead) and 2) thin petite upturned nose.

Dr Zukowski doesn't use bone paste.  I asked him about it during my consultation with him, and he had a negative opinion of it.  He instead uses fat grafting.

I know that Dr Z has a reputation for being aggressive and producing a barbie-doll look, but that's not always the case.  I had FFS with him last year, and I ended up with a very natural look (which is what I wanted).  I do think it's important to clearly communicate with him to express exactly what you want though.  And really, that goes with any FFS surgeon.  But yes, if you want a barbie-doll look, Dr Z can do that for you too.  :)  I know some 'Z-girls' who look like that, and they're happy - it's what they wanted.

Icy,

You are welcome. In fact I am in the same boat as you in finding the surgeon that can give me a hyper feminine look(I already had type 3 forehead reconstruction, rhinoplasty and genioplasty)


Yes I was referring to a type 3 construction for forehead setback. But this setback using type 3 reconstruction and maybe some burring  too(for supra orbital ridge) would only be for the lower part of the forehead.

http://4.bp.blogspot.com/-Khi98ityDMs/UaN5ScuYfcI/AAAAAAAAJmM/_tQAij0HMvE/s1600/JessicaRabbitMaskCompare.jpg

Above pic shows Jessica rabbits face profile, note how her nasion region( nose bridge between eyes) and lower forehead Region is recessed while her mid/upper forehead comes out.

Aggresive type 3 reconstruction and rhinoplAsty would give you that recessed nasion and lower forehead. Now to take things to the next level and give that doll look, your mid/upper forehead would also need augmentation using fat/bone paste/implant. If you already have a prominent Mid/upper forehead this additional step would be not required.

Also note the real human girl in the pic that's posing jessica rabbit looks very different. Although her nasion and lower forehead is kinda like Jessica rabbit her mid/upper forehead is recessed/sloping which makes her look not as feminine as the real jessica.

Hey Girly!

I appreciate your post. I have seen some of your post as you went to Doctor Z! I am waiting until I have a few post under my belt here so I can be able to private message you girls personally. Good to know, I thought he did use bone-paste unless I read wrong? I heard there were some bad long-term complications about that bone-paste. I am still unsure why Doctor Z isn't favored by many girls who want forehead work. I understand he is best at soft-tissue look. However I think with some pics and some X-rays I can assess my forehead even better. I think my forehead is perfectly fine but I could soften my brow ridge a bit. Otherwise I don't think I would need much change to my forehead.

Glad to know that you said his reputed for his aggressive work that's exactly what I want to hear, and congrats on your FFS :) I wish I could see your pics.

Once again thank you for confirming this for me :)

any advice about my forehead work and can Doctor Z do otoplasty with ear lobule reduction? or making the ear smaller.

Thank you

Quote from: Mirya on February 09, 2017, 06:26:50 PM
Dr Zukowski doesn't use bone paste.  I asked him about it during my consultation with him, and he had a negative opinion of it.  He instead uses fat grafting.

I know that Dr Z has a reputation for being aggressive and producing a barbie-doll look, but that's not always the case.  I had FFS with him last year, and I ended up with a very natural look (which is what I wanted).  I do think it's important to clearly communicate with him to express exactly what you want though.  And really, that goes with any FFS surgeon.  But yes, if you want a barbie-doll look, Dr Z can do that for you too.  :)  I know some 'Z-girls' who look like that, and they're happy - it's what they wanted.

Thank you for your post :) I will get back to you later tonight as I want to give you a detailed response. Could you message me? I don't think I can however. I appreciate that we are on the same boat. How did your Forehead Type-3 Recon + Rhinoplasty + Genioplasty go? How recent was it and did you like the work. I assume thats why you want a revision?

What doctors are you looking at and what look do you want?

I hope to stay in touch :)

Quote from: Ypsf09 on February 09, 2017, 07:10:48 PM
Icy,

You are welcome. In fact I am in the same boat as you in finding the surgeon that can give me a hyper feminine look(I already had type 3 forehead reconstruction, rhinoplasty and genioplasty)


Yes I was referring to a type 3 construction for forehead setback. But this setback using type 3 reconstruction and maybe some burring  too(for supra orbital ridge) would only be for the lower part of the forehead.

http://4.bp.blogspot.com/-Khi98ityDMs/UaN5ScuYfcI/AAAAAAAAJmM/_tQAij0HMvE/s1600/JessicaRabbitMaskCompare.jpg

Above pic shows Jessica rabbits face profile, note how her nasion region( nose bridge between eyes) and lower forehead Region is recessed while her mid/upper forehead comes out.

Aggresive type 3 reconstruction and rhinoplAsty would give you that recessed nasion and lower forehead. Now to take things to the next level and give that doll look, your mid/upper forehead would also need augmentation using fat/bone paste/implant. If you already have a prominent Mid/upper forehead this additional step would be not required.

Also note the real human girl in the pic that's posing jessica rabbit looks very different. Although her nasion and lower forehead is kinda like Jessica rabbit her mid/upper forehead is recessed/sloping which makes her look not as feminine as the real jessica.

Quote from: icy on February 09, 2017, 02:56:04 PMIn terms about X-Ray or CT Scans which one image is best in order to assess this? To understand what kind of thickness I have of the forehead bone. I assume I can go to my General Practitioner and tell them I want a X-ray of my skull just because?

I had X-rays back in the day, that was sufficient, but some CT scans (that show the actual thickness of the bone) will do the job as well.  I don't know if Dr Z requests them or not, certainly the surgeons that do Type III will; you usually need a prescription to get the scans done.  Your GP might write them up for you, not "just because" but after explaining you're looking to have work done. 

Whether burring the orbits and brow ridge for you will work depends on the bone thickness and the sinus cavity behind the bone.  If the bone is very thin, I think you're better off going with a surgeon who does Type III.  If the bone is thick, it could be significantly reduced through Dr Z's techniques.

According to Dr O's book on the subject, about 85% of the people he saw had Type III foreheads. 

I'm on my mobile now so I will do my best to respond without typos so if I'm not mistaken if I need a lot of work done on my forehead then doctor Z is the person to consult. However as you said if my forehead doesn't need much work then I should see a specialist who reconstructs foreheads. " If the bone is thick, it could be significantly reduced through Dr Z's techniques. "

I could say I don't have a dominant brow ridge just need to soften up. However I do want to upload a pic of the nose I want. I am forever grateful to have a lot of you agreeing on doctor Zukowski being perfect to be aggressive on making my nose like a Barbie doll.

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi.imgur.com%2Flh2lVNM.jpg&hash=600378131e0e1701b1a1b2275d166c92b470e50e)

Quote from: Sophia Sage on February 09, 2017, 07:44:14 PM
I had X-rays back in the day, that was sufficient, but some CT scans (that show the actual thickness of the bone) will do the job as well.  I don't know if Dr Z requests them or not, certainly the surgeons that do Type III will; you usually need a prescription to get the scans done.  Your GP might write them up for you, not "just because" but after explaining you're looking to have work done. 

Whether burring the orbits and brow ridge for you will work depends on the bone thickness and the sinus cavity behind the bone.  If the bone is very thin, I think you're better off going with a surgeon who does Type III.  If the bone is thick, it could be significantly reduced through Dr Z's techniques.

According to Dr O's book on the subject, about 85% of the people he saw had Type III foreheads.

Quote from: icy on February 09, 2017, 09:54:07 PMI'm on my mobile now so I will do my best to respond without typos so if I'm not mistaken if I need a lot of work done on my forehead then doctor Z is the person to consult. However as you said if my forehead doesn't need much work then I should see a specialist who reconstructs foreheads. " If the bone is thick, it could be significantly reduced through Dr Z's techniques. "

I could say I don't have a dominant brow ridge just need to soften up.

Not quite.

The thickness of the bone has nothing to do with the amount of projection you have with your brow ridge.  It's not something that can be determined without looking "inside" via an X-ray or CT scan.  It doesn't matter if you need "a lot" of work or only some subtle "softening" -- if the bone is thin then you're better off with a Type III surgeon, because you can't take much if anything off of thin bone, regardless of how much or little it projects.  On the other hand, if the bone is thick, Z would be a good choice for subtle softening or extensive revision. 

Most plastic surgeons can give you that nose, btw.  Some may argue, however, that it's not the best aesthetic for your face, depending on other factors, primarily the length of your midface, as most women with long faces (and hence pretty long noses) don't have Barbie-swoop noses; such swooping noses tends to look "unnatural" in such a context.

But it's your nose, your face; in the end, I think you should ultimately do whatever best serves your needs and intentions. 

Sophia Sage,

Thank you for clarifying that. I am a noobie when it comes to all of this. I am forever grateful to have you and the amazing members here to help me out. It is very hard to know and recognize which surgeon is best for what as everyone has their own opinion. However I am happy to hear from you that you mentioned that Doctor Z is great for the forehead contouring if the bone is thick. I do not know why people always talk bad about him for forehead work and they always say go to another surgeon as he isn't suitable for bone-work. Ideally if I can squash out my rhinoplastic and forehead contouring (brow ridge) under one operation than that is great. I am just trying to feel comfortable with everyone's opinion here as from "->-bleeped-<-" and some research some do not like him not sure why but maybe because he tends to be aggressive and give everyone a super-feminized barbie look. Well for some like myself, I like it.

I will go ahead and get a X-ray or CT scan and ask my general pracitioner that I need it, as a cosmetic surgeon is requesting it. So I can e-mail it to surgeons. The obvious reasons why I am leaning towards Doctor Z is because he is here in USA and also of kind of work I am seeking as he gives that barbie look.

I tried to consult with many surgeons about my nose and they do not like that nose so that is why I am possibly going to stick with Doctor Z.

Quote from: Sophia Sage on February 10, 2017, 12:02:08 AM
Not quite.

The thickness of the bone has nothing to do with the amount of projection you have with your brow ridge.  It's not something that can be determined without looking "inside" via an X-ray or CT scan.  It doesn't matter if you need "a lot" of work or only some subtle "softening" -- if the bone is thin then you're better off with a Type III surgeon, because you can't take much if anything off of thin bone, regardless of how much or little it projects.  On the other hand, if the bone is thick, Z would be a good choice for subtle softening or extensive revision. 

Most plastic surgeons can give you that nose, btw.  Some may argue, however, that it's not the best aesthetic for your face, depending on other factors, primarily the length of your midface, as most women with long faces (and hence pretty long noses) don't have Barbie-swoop noses; such swooping noses tends to look "unnatural" in such a context.

But it's your nose, your face; in the end, I think you should ultimately do whatever best serves your needs and intentions.

Quote from: icy on February 10, 2017, 01:27:06 AM
I am just trying to feel comfortable with everyone's opinion here as from "->-bleeped-<-" and some research some do not like him not sure why but maybe because he tends to be aggressive and give everyone a super-feminized barbie look. Well for some like myself, I like it.

I get the impression that the ->-bleeped-<- crowd (which skews toward a younger demographic) favors Dr Spiegel.  You have famous YouTubers like Stef Sanjati and Gigi Gorgeous who posted videos about their FFS experiences with Spiegel.  I'm sure that's had a very positive effect on Dr Spiegel's reputation.

People seem to have forgotten that Dr Zukowski has some famous FFS patients too.  Such as Michelle Hendley.  I guess it was about 5 years ago, so people already forgot that he did her FFS.  :)  But if you look at her now, she looks stunningly beautiful without looking fake.  I don't know why people keep equating 'aggressive' with 'plastic' or 'fake'.  Michelle looks undeniably feminine and beautiful but also quite natural.

Mirya, are you on the chat currently?

I added you to my ' buddies list ' here however I think I am still new here to private-message so I must wait.

Thank you for your response, I know you went with Dr. Z for your work :)

You could be right about that! I mean they all are good, it seems you have to pick someone with the reviews, looks, and such that you want.

Quote from: Mirya on February 10, 2017, 02:13:41 AM
I get the impression that the ->-bleeped-<- crowd (which skews toward a younger demographic) favors Dr Spiegel.  You have famous YouTubers like Stef Sanjati and Gigi Gorgeous who posted videos about their FFS experiences with Spiegel.  I'm sure that's had a very positive effect on Dr Spiegel's reputation.

People seem to have forgotten that Dr Zukowski has some famous FFS patients too.  Such as Michelle Hendley.  I guess it was about 5 years ago, so people already forgot that he did her FFS.  :)  But if you look at her now, she looks stunningly beautiful without looking fake.  I don't know why people keep equating 'aggressive' with 'plastic' or 'fake'.  Michelle looks undeniably feminine and beautiful but also quite natural.

Icy,

If you glance through the links I sent, one of them talks about avatars and sending pms. You can receive them but you can't reply till you hit 15 quality posts.

Glad to see you are getting some good interaction.

warmly,

Joanna

Quote from: icy on February 10, 2017, 01:27:06 AMI tried to consult with many surgeons about my nose and they do not like that nose so that is why I am possibly going to stick with Doctor Z.

There's one thing I don't like about that nose -- it's flatly broad at the bridge.  The curvature is lovely, but most noses get narrower at the bridge instead of wider.  That flat wideness is actually an aesthetic I've seen in a lot of Dr O noses, and I think it just looks kind of funny, unnatural.

Speaking of Doctor O, my impression is that Deschamps-Braly, who took over Dr O's practice in San Francisco, can be every bit as "aggressive" as Dr Z.  In fact, I think most facial surgeons can and will be aggressive... if that's what the patient wants (and, likewise, they can go more conservative if that's what the patient wants).  Deschamps-Braly, however, can do Type III foreheads.

So in terms of choosing doctors for their aesthetics, I'd make that more of a priority only if you're not precisely clear on the aesthetics you're looking for in the first place. 

By the same token, though, being precisely clear on your aesthetics doesn't mean your sense of aesthetics is actually good -- meaning, you might not actually like the gestalt effect of certain individual choices once they're in place.  One might have a "be aggressive as possible" approach in mind, but that doesn't necessarily mean that, say, a maximal scalp advancement is going to look good on you based on your facial proportions.  And there are some areas where there are limits to how far you can go -- like, with jaw recontouring, you might not be able to go as far as you want because of where the mental nerve (that innervates chin) lies, as it travels through a "mandibular canal" that shouldn't be breached.  This, in turn, might need to inform other aesthetic choices so that the gestalt of your face "makes sense." In my opinion, proportions and balance matter a lot more than we tend to realize at first glance. 

Thank you very much. I am really glad to be apart of this great forum! :)

Quote from: Joanna50 on February 10, 2017, 11:25:38 AM
Icy,

If you glance through the links I sent, one of them talks about avatars and sending pms. You can receive them but you can't reply till you hit 15 quality posts.

Glad to see you are getting some good interaction.

warmly,

Joanna

Sophia Sage,

Hello darling!

Thank you for your time and detailed response. As you may not know I am ethnic and I tend to have a big "honker" on my nose and it completely devastates me as it does not appeal to my look. I actually like that nose in fact I can show another nose that I will say that is acceptable. I understand that previous picture is a bit too much but that would be my dream nose otherwise a nose like this.

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi.imgur.com%2FJWEYygI.jpg&hash=fba204fcf0cf18c4b4402adef455fe56d87d8e17)
(https://www.susans.org/proxy.php?request=http%3A%2F%2Fi.imgur.com%2FEOQYARt.jpg&hash=3eb6f900c3a325a9ac130389204d29d240adc3fe)

As you can see it is very small and natural. Most US surgeons do terrible jobs on noses. In fact most FFS surgeons I have seen, have not impressed me with their noses.

You are right. Any surgeon can be aggressive depending on what the client needs and we can't always just every person and every picture we saw, in order to judge the surgeons work. I could consider Dr. Deschamps-Braly. In fact I think I have heard more positive than negative about him than any other surgeon. The only issue is, is that I am not able to see his kind of owrk to be able to make a judgement.

My question currently is would it make any difference if I broke down my FFS piece-by-piece so for example if I could do say my rhinoplasty first, then do my forehead with jaw/cheek recontouring. I know everyone says "No do it all at once" however it seems every surgeon has a specialty and skill for one thing. Obviously forehead/jaw/chin I'd need a craniofacial surgeon, and a nosejob i would need a plastic-surgeon. However this may sound terribly bad to say but would it make a difference to do all my FFS all at once in terms of seeking ultimate beauty outcomes? Or rather doing my surgery piece-by-piece will not have any delay in healing or harm my beauty outcomes? I hope this makes sense.

Thank you gals!

Quote from: Sophia Sage on February 10, 2017, 11:54:39 AM
There's one thing I don't like about that nose -- it's flatly broad at the bridge.  The curvature is lovely, but most noses get narrower at the bridge instead of wider.  That flat wideness is actually an aesthetic I've seen in a lot of Dr O noses, and I think it just looks kind of funny, unnatural.

Speaking of Doctor O, my impression is that Deschamps-Braly, who took over Dr O's practice in San Francisco, can be every bit as "aggressive" as Dr Z.  In fact, I think most facial surgeons can and will be aggressive... if that's what the patient wants (and, likewise, they can go more conservative if that's what the patient wants).  Deschamps-Braly, however, can do Type III foreheads.

So in terms of choosing doctors for their aesthetics, I'd make that more of a priority only if you're not precisely clear on the aesthetics you're looking for in the first place. 

By the same token, though, being precisely clear on your aesthetics doesn't mean your sense of aesthetics is actually good -- meaning, you might not actually like the gestalt effect of certain individual choices once they're in place.  One might have a "be aggressive as possible" approach in mind, but that doesn't necessarily mean that, say, a maximal scalp advancement is going to look good on you based on your facial proportions.  And there are some areas where there are limits to how far you can go -- like, with jaw recontouring, you might not be able to go as far as you want because of where the mental nerve (that innervates chin) lies, as it travels through a "mandibular canal" that shouldn't be breached.  This, in turn, might need to inform other aesthetic choices so that the gestalt of your face "makes sense." In my opinion, proportions and balance matter a lot more than we tend to realize at first glance.

Quote from: icy on February 10, 2017, 03:19:00 PMI actually like that nose in fact I can show another nose that I will say that is acceptable. I understand that previous picture is a bit too much but that would be my dream nose otherwise a nose like this.

Just to be clear, I have no complaints about the curvature you're looking for, which we see both here and with the other example you've posted.  With this new set of pictures, though, we only get a view from the side, and as such we aren't seeing the width of her nose as it appears head-on.  I think what's more feminine is a nose where the nose has this same kind of curvature in profile, while from the front reaches its narrowest width at the bridge, right between the eyes.  The other nose got wider at the bridge, which makes it look like it's been "worked on," and with a measure of crudeness at that, in my opinion.

QuoteI could consider Dr. Deschamps-Braly. In fact I think I have heard more positive than negative about him than any other surgeon. The only issue is, is that I am not able to see his kind of owrk to be able to make a judgement.

To see his results, you need to consult with him in person; he doesn't post results online.  I do think it's worth while to make a short list of 2-4 surgeons and have consultations in person before deciding who you'll go for.  That also gives you a deeper sense of what they're capable of and whether this is the person you want operating on your face.

QuoteMy question currently is would it make any difference if I broke down my FFS piece-by-piece so for example if I could do say my rhinoplasty first, then do my forehead with jaw/cheek recontouring. I know everyone says "No do it all at once" however it seems every surgeon has a specialty and skill for one thing. Obviously forehead/jaw/chin I'd need a craniofacial surgeon, and a nosejob i would need a plastic-surgeon. However this may sound terribly bad to say but would it make a difference to do all my FFS all at once in terms of seeking ultimate beauty outcomes? Or rather doing my surgery piece-by-piece will not have any delay in healing or harm my beauty outcomes?

It's fine to do your facial surgery in stages, like splitting the upper face and lower face into two different sessions, and this is not uncommon, actually. 

However, it's preferable and advised to do your nose and forehead at the same time, because the bridge of the nose connects to the glabella of the forehead; these structures are linked and contiguous.  The risk of doing rhinoplasty by itself ahead of time is that it may need to be revised anyways upon doing your forehead, which either adds a measure of risk to your nose -- the cartilage in your nose is much more delicate than your bones are -- or could otherwise result in an aesthetic that's not as unified and consistent as you'd like. 

Oh my god Sophi Sage,

I love you dearly. I wish I can do something for you in exchange. You have given me a lot of insight. I'm out now at a party but I will respond to my ideas here. So honestly it isn't a lot of information to digest.

I think I will follow as you said. I think doctor Deschamps-Braly will be perfect to do for my forehead and rhinoplasty. I will do bottom face else where after a year. Only reason due to money and it may be affordable to do my forehead type 3 and rhinoplasty and do my chin and jaw with someone else.

Since doctor Z isn't a craniofacial surgeon I think doctor Deschamps-Braly is my best bet. Do you have an idea of the cost for forehead type 3 and a nose job? Also do you think if I show him the pics he may be aggressive to give me such look?

Thank you

Quote from: Sophia Sage on February 10, 2017, 07:50:47 PM
Just to be clear, I have no complaints about the curvature you're looking for, which we see both here and with the other example you've posted.  With this new set of pictures, though, we only get a view from the side, and as such we aren't seeing the width of her nose as it appears head-on.  I think what's more feminine is a nose where the nose has this same kind of curvature in profile, while from the front reaches its narrowest width at the bridge, right between the eyes.  The other nose got wider at the bridge, which makes it look like it's been "worked on," and with a measure of crudeness at that, in my opinion.


To see his results, you need to consult with him in person; he doesn't post results online.  I do think it's worth while to make a short list of 2-4 surgeons and have consultations in person before deciding who you'll go for.  That also gives you a deeper sense of what they're capable of and whether this is the person you want operating on your face.

It's fine to do your facial surgery in stages, like splitting the upper face and lower face into two different sessions, and this is not uncommon, actually. 

However, it's preferable and advised to do your nose and forehead at the same time, because the bridge of the nose connects to the glabella of the forehead; these structures are linked and contiguous.  The risk of doing rhinoplasty by itself ahead of time is that it may need to be revised anyways upon doing your forehead, which either adds a measure of risk to your nose -- the cartilage in your nose is much more delicate than your bones are -- or could otherwise result in an aesthetic that's not as unified and consistent as you'd like.

Quote from: icy on February 10, 2017, 03:19:00 PM
would it make a difference to do all my FFS all at once in terms of seeking ultimate beauty outcomes? Or rather doing my surgery piece-by-piece will not have any delay in healing or harm my beauty outcomes?

It probably won't make any difference to your ultimate aesthetic outcome, but it will sure make a difference to your bank account.  OR/anesthesia fees were about $4000 when I had FFS with Dr. Z.  You will need to pay something like that every time you have another procedure, so keep that in mind.

With kindness,

Terri

Quote from: icy on February 10, 2017, 10:21:41 PMI think I will follow as you said. I think doctor Deschamps-Braly will be perfect to do for my forehead and rhinoplasty. I will do bottom face else where after a year. Only reason due to money and it may be affordable to do my forehead type 3 and rhinoplasty and do my chin and jaw with someone else.

Since doctor Z isn't a craniofacial surgeon I think doctor Deschamps-Braly is my best bet.

Well, you don't know if you've got a Type I or Type III forehead until you get your x-rays/CT scans; you can't tell by looking in the mirror or at photographs.  If you have a Type I forehead, Z might well be your best bet.

Before jumping to conclusions about Deschamps-Braly, or anyone else, do some more research.  There are plenty of other surgeons in the U.S., and there are very good options in Spain (Facial Team) and Asia that might suit your pocketbook better, despite the extra travel.  What's important is that you actually understand what's available, why procedures are done the way they're done, and who can best serve your needs given your own preferences and what you've got to work with and what you can actually afford.

Your process has just begun. 

Terri,

Thank you for your response. I understand it is better to do it all at once. I just did not know why people recommended to do it all at once. I assumed for the benefit of the results.

If I am not mistaken you went with Doctor Z, you look amazing! I just have to figure out what kind of forehead work I need before I can make any conclusions.

Quote from: Maybebaby56 on February 10, 2017, 10:42:25 PM
It probably won't make any difference to your ultimate aesthetic outcome, but it will sure make a difference to your bank account.  OR/anesthesia fees were about $4000 when I had FFS with Dr. Z.  You will need to pay something like that every time you have another procedure, so keep that in mind.

With kindness,

Terri

You are absolutely right about that. To be honest my forehead does not look too masculine thats the good thing. So once I get my CT/X-rays do I send them over to surgeons and then they would be able to tell me?

You are right about jumping to conclusions I just want to get it done and get it over with, at least my forehead/nose. Deschamps-Braly is great but it seems the cost for forehead is about $8-9K + $7500 for a nose job and OR/Fees will be maybe another $4000. $20,500 for just forehead and nose wow.

I am forever thankful for you and everyone here. I hope I am not annoying anyone.

Quote from: Sophia Sage on February 11, 2017, 12:13:59 AM
Well, you don't know if you've got a Type I or Type III forehead until you get your x-rays/CT scans; you can't tell by looking in the mirror or at photographs.  If you have a Type I forehead, Z might well be your best bet.

Before jumping to conclusions about Deschamps-Braly, or anyone else, do some more research.  There are plenty of other surgeons in the U.S., and there are very good options in Spain (Facial Team) and Asia that might suit your pocketbook better, despite the extra travel.  What's important is that you actually understand what's available, why procedures are done the way they're done, and who can best serve your needs given your own preferences and what you've got to work with and what you can actually afford.

Your process has just begun.

Hi.

I think one of the "general wisdoms" about rhinoplasty and FFS is, that it is best donwtogether - or if it has to be separated, first do the forehead and later "fit" the nose to that. Otherwise the transition from nose to forehead will not be right and a rhinoplasty surgeon can not always "guess" how the forehead will be  after a forehead surgery, especially if it is a type 3. I am a bit unlucky with the forehead as well - I only need slight changes there, but apparently that still needs a type 3 surgery as my bones are not very thick - which probably is the reason in the first place why I do not have that much of a prominent forehead...

Which surgeons did you compare for forehead and nose work? Only US surgeons or did you also look at the international ones like Suporn, PAI, Facialteam, Bart, or the ones in South America?

I recently have started to consider doing forehead and nose separately as well as I hear a lot of negative comments about Rhinoplasty done by FFS surgeons. I was thinking of Facialteam for the forehead, but I read a few times that people were unhappy with the nose. Sadly doing the nose separately means more time, an additional surgery with additional downtime and additional costs.

Quote from: anjaq on February 11, 2017, 07:39:15 AMI am a bit unlucky with the forehead as well - I only need slight changes there, but apparently that still needs a type 3 surgery as my bones are not very thick - which probably is the reason in the first place why I do not have that much of a prominent forehead...

The prominence of a forehead has nothing to do with the thickness of the bone.  Very thin bone can still bow outwards to a great degree. 

QuoteI read a few times that people were unhappy with the nose. Sadly doing the nose separately means more time, an additional surgery with additional downtime and additional costs.

It's a very good reason to actually consult with doctors in person and see a number of results; they always have more in the office than are published online.  More importantly, they can serve as a reference point for explaining what we want, because doctors tend to use technical language that we haven't mastered.

When I consulted with Meltzer, I explained this very aspect of the nose, how I thought it should be, and he said that would be no problem -- and looking at results, it was very easy to point to a nose and say, "like this, not like that."  Dr O, on the other hand, was kind of firm in his own sense of aesthethics, and said that's just how it had to be; I never really got a technical explanation from him as to why. 

I ended up going with Meltzer, and was very happy with my nose. 

Quote from: anjaq on February 11, 2017, 07:39:15 AM
Hi.

I think one of the "general wisdoms" about rhinoplasty and FFS is, that it is best donwtogether - or if it has to be separated, first do the forehead and later "fit" the nose to that. Otherwise the transition from nose to forehead will not be right and a rhinoplasty surgeon can not always "guess" how the forehead will be  after a forehead surgery, especially if it is a type 3. I am a bit unlucky with the forehead as well - I only need slight changes there, but apparently that still needs a type 3 surgery as my bones are not very thick - which probably is the reason in the first place why I do not have that much of a prominent forehead...

Which surgeons did you compare for forehead and nose work? Only US surgeons or did you also look at the international ones like Suporn, PAI, Facialteam, Bart, or the ones in South America?

I recently have started to consider doing forehead and nose separately as well as I hear a lot of negative comments about Rhinoplasty done by FFS surgeons. I was thinking of Facialteam for the forehead, but I read a few times that people were unhappy with the nose. Sadly doing the nose separately means more time, an additional surgery with additional downtime and additional costs.

Have u considered anyone in the us? I have a consult with Dr Lee. I'm astounded by how many ladies opt to go out of
The country rather than the us. I would think staying in the us would be cheaper even if the PS is higher. Thanks!

Quote from: icy on February 11, 2017, 01:09:32 AM
Terri,

Thank you for your response. I understand it is better to do it all at once. I just did not know why people recommended to do it all at once. I assumed for the benefit of the results.

If I am not mistaken you went with Doctor Z, you look amazing! I just have to figure out what kind of forehead work I need before I can make any conclusions.

Icy if that's your pic in the avatar, I dream of a forehead like yours!!

Quote from: TigerLilyNYC on February 11, 2017, 12:42:03 PM
Icy if that's your pic in the avatar, I dream of a forehead like yours!!

If that is Icy's picture in her avatar, she doesn't need FFS at all.

PS, What's Up Tiger Lily?  (I have been waiting to say that for a while - I crack myself up) You look pretty good yourself.  What's this I hear about people clocking you?  You look fine.

~Terri

Quote from: Maybebaby56 on February 11, 2017, 01:27:27 PM
If that is Icy's picture in her avatar, she doesn't need FFS at all.

PS, What's Up Tiger Lily?  (I have been waiting to say that for a while - I crack myself up) You look pretty good yourself.  What's this I hear about people clocking you?  You look fine.

~Terri

Thanks, Maybebaby! My profile reveals my heavy bossing🙁 Soon I hope to have it smoothed out!

Quote from: TigerLilyNYC on February 11, 2017, 12:40:30 PM
Have u considered anyone in the us? I have a consult with Dr Lee. I'm astounded by how many ladies opt to go out of
The country rather than the us. I would think staying in the us would be cheaper even if the PS is higher. Thanks!

If that was directed at ICY, I think she has so far mostly or only considered US surgeons. Me, I consider international surgeons, since I am not from the US and the US seems to be pretty expensive when it comes to medical services. I would not hold back spending another $5k or a bit more if a surgeon definitely is better than what I can get internationally but so far I have the impression that all of the well known surgeons, US or international seem to sometimes do good work and sometimes they do something I would not want. I have not the impression that there really can be said some of them are generally better or worse... so it is hard for me to decide and if all things are equal, I would rather stay local in Europe and/or spend less money. Again, if I would get the impression that a particular surgeon would do a much better job - or be much better in retaining nerves and minimizing other permanent damages - I would not shy back from travelling again, as I did for the VFS.

Thank you very much,

If I had $30K to fork I would easily do doctor Deschamps. However I don't. That's the problem. I don't even know how my forehead is i mean it makes absolutely no sense as people say if you need minimal work you need a good surgeon and if your forehead is thick and boney then you are good. How's that possible. You're right about doing them together or just forehead first. I may do my forehead first as it may be cheaper. Let's see the quotes from doctor Deschamps.

My only fear is that I read someone here had bone paste on their forehead and it decayed after time is this true? I was thinking of doing forehead first and do my nose in turkey. I know Iran is the best for nose jobs. Most American surgeons lack the realization of the beauty for noses. I think the nose really defines the beauty of FFS. The Nose has to be very thin, narrow and especially the nose tip nostrils has to be small and refined.

Does anyone know Deschamps price on forehead work? I assume $12-14K

I'll upload a pic here of the noses I find beautiful.

Quote from: anjaq on February 11, 2017, 07:39:15 AM
Hi.

I think one of the "general wisdoms" about rhinoplasty and FFS is, that it is best donwtogether - or if it has to be separated, first do the forehead and later "fit" the nose to that. Otherwise the transition from nose to forehead will not be right and a rhinoplasty surgeon can not always "guess" how the forehead will be  after a forehead surgery, especially if it is a type 3. I am a bit unlucky with the forehead as well - I only need slight changes there, but apparently that still needs a type 3 surgery as my bones are not very thick - which probably is the reason in the first place why I do not have that much of a prominent forehead...

Which surgeons did you compare for forehead and nose work? Only US surgeons or did you also look at the international ones like Suporn, PAI, Facialteam, Bart, or the ones in South America?

I recently have started to consider doing forehead and nose separately as well as I hear a lot of negative comments about Rhinoplasty done by FFS surgeons. I was thinking of Facialteam for the forehead, but I read a few times that people were unhappy with the nose. Sadly doing the nose separately means more time, an additional surgery with additional downtime and additional costs.

Sophia Sage,

You're awesome. I'm glad your experience with doctor Meltzer did well for you. Do you think there is orther surgeons who are very good with forehead reconstructions besides doctor Deschamps. I am not sure even why people call him the king of foreheads maybe because doctor O taught him everything.

In this case should I seek someone a bit affordable if I'm going to do forehead first and nose after. If so how much time should I wait until I do my nose, if I do my forehead work.

Maybe I can see doctor spiegel or someone else who is good at foreheads as well.

Thank you

Quote from: Sophia Sage on February 11, 2017, 12:14:44 PM
The prominence of a forehead has nothing to do with the thickness of the bone.  Very thin bone can still bow outwards to a great degree. 

It's a very good reason to actually consult with doctors in person and see a number of results; they always have more in the office than are published online.  More importantly, they can serve as a reference point for explaining what we want, because doctors tend to use technical language that we haven't mastered.

When I consulted with Meltzer, I explained this very aspect of the nose, how I thought it should be, and he said that would be no problem -- and looking at results, it was very easy to point to a nose and say, "like this, not like that."  Dr O, on the other hand, was kind of firm in his own sense of aesthethics, and said that's just how it had to be; I never really got a technical explanation from him as to why. 

I ended up going with Meltzer, and was very happy with my nose.

Lily,

You're gorgeous what work have you got done and where?

No that's not me. I wish!! That's Yasmine Petty. I think she went to doctor O

Quote from: TigerLilyNYC on February 11, 2017, 12:42:03 PM
Icy if that's your pic in the avatar, I dream of a forehead like yours!!

Quote from: icy on February 11, 2017, 10:23:12 PM
Lily,

You're gorgeous what work have you got done and where?

No that's not me. I wish!! That's Yasmine Petty. I think she went to doctor O

Thanks for your kind words, Icy! I haven't gotten any work done yet. It's not that noticeable in my pic, but I have extreme bossing that I'm desperately trying to find the right PS to correct. And also I'm wearing a wig which I think serves to do some feminizing. I have almost no real hair due to alopecia. Ugh!

I have learned from here that it is wise to be patient and I think we should.

If I was to fly out I would see DiMaggio or Facial Team. They are consistent with their reviews.

Locally I am sure there are a lot but I would imagine Lee, Spiegel and Deschamps will be completely over priced. I wish I could afford Deschamps for a Forehead contouring and nose job but $24-28K? C'mon!

Quote from: TigerLilyNYC on February 12, 2017, 10:35:57 AM
Thanks for your kind words, Icy! I haven't gotten any work done yet. It's not that noticeable in my pic, but I have extreme bossing that I'm desperately trying to find the right PS to correct. And also I'm wearing a wig which I think serves to do some feminizing. I have almost no real hair due to alopecia. Ugh!

This seems like the proper place to put this sine its a questiob
N regarding a statement made in this thread.  Forgive me if it appears a hijack as thats not my intention.

      I have a consult with Dr. Z in April. If he doesn't do an x-ray or scan when I am there, as Sophia suggested, then how will he possibly be able to assess what needs to be done? It has me a bit concerned as I just assumed he'd take an X ray at the consult.  Was I not given sufficient info when the appt. was made?

You should take your time. If not personal to ask what work do you want done with doctor Z?

I think you should get X-rays and CT scan and ask your local physician to request it do you can show the doctors.

Quote from: jentay1367 on February 12, 2017, 08:24:10 PM
This seems like the proper place to put this sine its a questiob
N regarding a statement made in this thread.  Forgive me if it appears a hijack as thats not my intention.

      I have a consult with Dr. Z in April. If he doesn't do an x-ray or scan when I am there, as Sophia suggested, then how will he possibly be able to assess what needs to be done? It has me a bit concerned as I just assumed he'd take an X ray at the consult.  Was I not given sufficient info when the appt. was made?

Sophia Sage,

So I wanted to kindly ask you again. There is no problem doing procedures piece by piece? I want to ultimately do my forehead with doctor Deschamps however with rhinoplasty thats 28K.

So I'm wondering if I could féminise my nose first as much as possible and do my ear pinning surgery. So then I can gather money to do my forehead and jaw/chin operations.

I understand it's better to do forehead with nose however would it be a problem if I do my nose first and follow up with a revision in 1.5-2 years when money is sufficient.

I could consider Cardenas, DiMaggio, and facial team. However I feel confident to do it in USA. Maybe I'm paranoid however I hope I can do my nose with doctor Z or Deschamps first and come back a year and a half later to revise my nose to make ultimately thinner and smaller with forehead work with a cranio surgeon

Thank you

Quote from: Sophia Sage on February 11, 2017, 12:14:44 PM
The prominence of a forehead has nothing to do with the thickness of the bone.  Very thin bone can still bow outwards to a great degree. 

It's a very good reason to actually consult with doctors in person and see a number of results; they always have more in the office than are published online.  More importantly, they can serve as a reference point for explaining what we want, because doctors tend to use technical language that we haven't mastered.

When I consulted with Meltzer, I explained this very aspect of the nose, how I thought it should be, and he said that would be no problem -- and looking at results, it was very easy to point to a nose and say, "like this, not like that."  Dr O, on the other hand, was kind of firm in his own sense of aesthethics, and said that's just how it had to be; I never really got a technical explanation from him as to why. 

I ended up going with Meltzer, and was very happy with my nose.

Just to chime in a little; if you have your nose done like you are wanting without the forehead, the surgeon may not remove any bone (osteotomy)that sits at the top of the bridge of your nose between your eyes, so that may deepen the radix which would make any existing brow bossing look a lot more prominent.

Hi Icy....I don't pass so my goal is to do just that.  So my intention will be to ask him what and how much. That will give me a basis to go from and some kind of reference point. I intend on getting a quote from FT as well. Braly is out....too expensive. So first, I want opinions from a professional.  Without that, I have no way to know where I'm at or what I need. It's simply too hard to be objective about yourself.

Thank you!

Interesting! The forehead surgery info is a bit confusing. As I look at my forehead it isn't bad or dominantly masculine. Since doctor Z maybe cheaper and well reputed. I'm considering to do these procedures with him and after 1.5 year to go to another surgeon or go to doctor Deschamps.

So with doctor Z I will ask him to do my ears, nose and perhaps possibly forehead burring and recontouring all at once.

To be honest I don't know the difference with forehead burring and contouring compared to forehead reconstruction type 3

I wish someone can explain to me like I'm 5 and show some images. I also want to know if I do the forehead burring and recontouring and say 1.5-2 years later I consider forehead type 3 reconstruction, would this interfere with the results as I have done the former first?

I'm sorry to be annoying

I wouldn't be informed if It wasn't for this amazing community.

Thank you

Quote from: kittenpower on February 12, 2017, 10:24:19 PM
Just to chime in a little; if you have your nose done like you are wanting without the forehead, the surgeon may not remove any bone (osteotomy)that sits at the top of the bridge of your nose between your eyes, so that may deepen the radix which would make any existing brow bossing look a lot more prominent.

Forehead type 3 reconstruction:

https://www.youtube.com/watch?v=oXSnTil9HFA&feature=youtu.be

Forehead burring/contouring: in this video they use implant, some surgeon use fat/bone paste or nothing.

https://www.youtube.com/watch?v=JMy_hvYhWg8&feature=youtu.be

Quote from: icy on February 12, 2017, 09:55:24 PMSo I wanted to kindly ask you again. There is no problem doing procedures piece by piece? I want to ultimately do my forehead with doctor Deschamps however with rhinoplasty thats 28K.

So I'm wondering if I could féminise my nose first as much as possible and do my ear pinning surgery. So then I can gather money to do my forehead and jaw/chin operations.

As I said before, it's possible to do things piecemeal in the fashion you suggest, but I don't think it's wise. First, the more you split up your work into separate sessions, the more expensive it's going to be.  Every time you go in, there's an additional charge for the operating room, anesthesia, and so forth, in addition to the doctor's fees for his work.  If you're looking to gather your money, then, it will ultimately take longer for you if you cut into those savings to do some lesser work ahead of time.

Second, you only want to do your nose once, if at all possible.  Most of the nose isn't bone, it is cartilage, and it can only take so much work before it degrades.  Because the nose connects contiguously to the forehead, it usually needs work when you get your forehead done.  But they won't be able to do as much if it's already been worked on; this can limit the results available to you.  So it really is for the best to have any nose work done at the same time. Now, does this mean you can't get a good result doing the nose first, with a subsequent revision when you have your forehead done?  No, but it does mean there's more risk of getting a sub-par result (or worse).

Don't limit yourself to Deschamps-Braly when it comes to your forehead.  Until you see a lot of results, you won't know which surgeon's aesthetic is most closely aligned with yours.  With Deschamps-Braly, those results aren't posted online, you have to see him in person and have a proper consultation. 

Given that cost is an issue for you, I wouldn't rule out getting work done overseas if you have a Type III forehead. In fact, I'd strongly recommend it.

In brief, a Type III forehead has thin bone, regardless of how far it "sticks out," and so to change the shape it must be removed, then either reshaped (by breaking it down and putting it back together) or replaced using a prosthetic.  It's then put back.  There is no theoretical limit to what can be done, other than the shape of the skull and how the forehead fits into place.

Type I foreheads have thick bone, again regardless of what the visible shape is.  When the bone is thick, it can be shaved down without being removed.  The limiting factor is the thickness of the bone -- if you want to set your forehead and brow ridge back by say 5mm, and the bone is 7mm thick, then this is feasible. 

Quote from: Ypsf09 on February 13, 2017, 02:42:10 AM
Forehead type 3 reconstruction:

youtube.com/watch?v=oXSnTil9HFA

Forehead burring/contouring: in this video they use implant, some surgeon use fat/bone paste or nothing.

youtube.com/watch?v=JMy_hvYhWg8

Fixed this for you.

It appears Zukowski has no need for nor desire for you to bring Xrays or other imaging types to his consults. The following is an interesting note from Zukowski's site. I went looking for answers regarding Xrays and need at consults since I got no feedback from a previous post here and ran into this info:

From M. Zukowski's site:

QuoteIn over 22 years of doing endoscopic forehead lifts, I have never had to convert to a open procedure.  In over 18 years of working with the gender community, I have never requested a patient to get a x-ray to determine sinus thickness. The anatomy is predictable and with experience and the 20x magnification capabilities of endoscopy, you can determine bone thickness. Besides, most sinus x-rays that patients show me are deliberately over penetrated to make the bone seem thinner than it is

So there it is. You either are willing to have Type I work where he feels skull Xrays to be unhelpful, or you go to someone else for Type III and have the open technique performed where it would seem to me that an Xray would be redundant as their going in anyway. But obviously, some surgeons feel that if they can get away with Type I, it's the better choice.

The following is more insight to his perspective on the different techniques:

QuoteEndoscopic minimal scar surgery has revolutionized the way that all surgeries have been performed since the mid 1990s. People that badmouth this technique simply cant do it. The endoscope is a lighted fiberoptic camera system that magnifies the operative site 20 times and displays the image on a high definition screen.  The endoscopic biplaner variant browlift is an advanced 21st century technique that replaces open browlifts and takes into account the use of the endoscope which is a tool that helps a surgeon work in a more closed or distant space. Endoscopic techniques avoid some of the built in complications of open techniques, such as permanent hair loss, longer scars, cut sensory nerves with resultant permanent numbness to the six inches of scalp behind the scar, or cutting and invading into the sinus with the risk of permanent sinus dysfunction in the form of sinus headaches and runny, drippy noses. Of great concern to you, the patient, should be the fact that open techniques are fraught with complications that are independent of how good or how bad your surgeon is. They're built into the technique.