Hello again Susan's, it's been a while.
So given the utter lack of information/reviews available on the internet on my chosen FFS surgeon for FFS, and not just as a plastic surgeon for cis people, I figured it would be worthwhile to make a new topic for my upcoming FFS as a sort of braindump.
So anyway, some backstory; early on I considered FFS a goal in my transition, but after my GRS (see here (https://www.susans.org/forums/index.php/topic,196455)), I figured I might be able to get away with not getting FFS. I wanted to try to move on in my life without it. However, dysphoria kept happening in photos and the mirror, misgendering kept happening, and other just plain **** kept happening. My psychological high from being post-op then subsided and then I pretty much realized my fight wasn't over about 6 months post op. So then, enter my FFS shopping experience...here (https://www.susans.org/forums/index.php/topic,214682). You can read all about my financial woes and pricing quotes at that link.
After getting super lucky and immediately landing a new job after being laid off in November, (which has been going GREAT btw) I ended up going with Dr. M. I decided as well that I was not going to rely on insurance at all, but simply savings--this just HAS to be done no matter the cost. Dr. M only costs $20-$21k, he has the credentials and I have the money, plus easy lodging nearby with my grandmother in one of the "active adult communities" in the area for recovery, so I chose him. If I get insurance reimbursement after the fact, that would be nice, but not necessary. I was able to charge the surgery to two new cards anywho, which were paid off immediately with savings for pretty massive sign up bonuses (ie: Chase Sapphire Reserve 100k points (http://www.businessinsider.com/chase-sapphire-reserve-100000-point-sign-up-bonus-points-slashed-2017-1) offer anyone? It's sadly no longer available now :/)
Now, my consult with him went well, however we both spoke with pre-existing knowledge of what the various surgeries entailed (in particular as I had already spoken with Facialteam and Spiegel before I spoke with him). He was knowledgeable and opinionated (answering my question in particular about forehead incision selection quite well), but also was also alot more relaxed than Spiegel or Facialteam and seemed a bit more beauty focused...which tbh, I don't mind. He also was quite a sales guy in terms of procedures. However, my honest opinion is, if I'm spending the price of new car on facial surgery I better look like a damn model following it, not just more feminine ^_^. I did fyi go with everything on his menu that was recommended, which includes the following.
Tracheal Shave
Forehead Contouring (he does type III if needed)
Malar/Cheek Implants
Mandible Contouring
Now, dealing with his office has been relatively straightforward save for one odd clerical mix up when I got a voicemail intended for someone with the same first name as myself, which was swiftly resolved. Galina, my direct contact in his office has been handling my arrangements and a Michele in the office even submitted my surgery for reimbursement via my now current insurance company at my new job, Oxford. I was expecting an outright denial but I actually didn't get it, I actually got this instead for everything except the forehead contouring CPT code (where they asked specifically for proof of visual field obstruction, given how this type of surgery is typically done for that purpose).
"For all requests, a treatment plan that includes ongoing follow-up and care by a qualifying health provider experienced in treating gender dysphoria must also be submitted."
I'm not presently seeing a therapist but given the verbiage of that statement (along with allusions specific to behavioral health in other parts of the document for breast and genital surgery), I figured a statement from my endo would suffice. I have of course contacted her and am awaiting a letter at this time. I'm going to a peer support group regularly up here in CT anyway. I find it works better for just helping me get crap off my mind than a therapist, albeit I probably could use more cis opinions in my life!
Anyway, surgery is in two weeks, I'm flying down on Tuesday the 30th, pre-op office visit the next day, surgery on June 1, and stitch removal on June 12, return to work the next day in CT unless shtf. My pre-ops came back ok, and I'm excited as heck and raring to do this. I'm concerned about how things are going to go (the guy however has great reviews and good result photos on his site, along with a history of presenting at Southern Comfort Trans Health Conference and double board certification), of course, and also about my return to work. I am wondering how the gaggle of cisgender men I work with (I am the only woman working in my department really within a Network Operations Center) are going to react with me coming back to work with a new face (and no...btw, I am not out at work, I'm just a woman in that office). I am NOT using FMLA as I am not yet eligible at my new job and am simply using accrued time off. I guess if I'm not feeling up to it, I'll have to take a leave of absence after my two paid weeks off and pay full price in premiums for a single month of health insurance coverage (which is really the only protection FMLA provides other than a guarantee I'll keep my position--which I doubt they're going to give away anyway as I am basically a skilled worker and my return to work eventually is absolutely guaranteed unless major shtf). We'll see how it goes.
Cheers, stand by for an update ;).
Recent photos btw to give you all a visual reference. The two in my apartment are pretty spur of the moment, other two are day to day. I tend to go sans makeup, it's not my thing.
https://1drv.ms/a/s!AjGZdmPv49mZh6o5A3t67-JURK90kQ
Jessie,
I had my FFS done at Dr Mardirossians office a few months ago. I am happy with the results.
I am in the Miami area. Feel free to PM me if you need any support.
Congratulations!
What is he going to do to your mandible? I think it looks perfect in these photos
Quote from: Celia0428 on May 18, 2017, 04:43:00 PM
Congratulations!
What is he going to do to your mandible? I think it looks perfect in these photos
Thank you for the compliment, but yes, he is. Mandible contouring was recommended by him, Spiegel (saw in person), Facial team (Skype), and Alexandra Hamer from VFFS (I have vffs photos but they're so damn unflattering plus I've already chosen the "menu"...so yeah). At least an implant isn't in order, we're just going to be doing some burring.
I am also considering Dr. Mardirossian. Dani, it appears I can't PM because I'm too new? Could you share your experience? I just posted a new thread here https://www.susans.org/forums/index.php/topic,224074.0.html
Thank you!
So the pre-op visit at Dr. Mardirossian's office went quite well. I've had escalating anxiety over the past few days that really came to because getting down to Florida was a pain in the tuchus. My silly boss scheduled me for a nightshift on Monday night into Tuesday, I then drove into NYC to go to my mom's apartment and rest, but unfortunately parking was excessively difficult because I arrived right around when alternate side parking took effect for Tuesday (dad is picking up my car today off the street). I had to stay up an extra hour or so before napping in the apartment because of the parking issue. Oh...and then my flight was delayed 2.5 hours from La Guardia. Woo!!!
But yeah his office is quite posh. It's enormous (in comparison Mcginn's office was a closet), with many different rooms (there's a separate meeting room, pre – op consult information room, and photo area). I was the only patient there at the time so it was pretty individualized attention (someone was scheduled right after me though). His staff also put me at ease and took my anxiety down from 80 to 0 pretty fast. Early on right before the nurse was about to take my blood pressure the doc came in and said hello. He's quite approachable in person, and seemed even more professional today then he did on Skype. We went over the procedures again, I filled out paperwork, spoke with Carolyn (the nurse) and Galina (office assistant) over the procedures and logistics. We also took photos (Dr. M did this personally). We were originally scheduled to have stitches removed Monday morning the 12th but due to my mom's insistence we're going to be doing it on Sunday the 11th it looks like (given my flight home is at like 10A on Monday).
Also, during the consult we settled on the following specifics.
A: Large cheek implants would suit my face.
B: Hairline incision mostly only at the corners where I have minor recession. (Through hair elsewhere)
C: Dr. M does type iii forehead if needed, no x-rays in consult though so we'll see in the OR. To be honest, I don't think I'm gonna go crazy about whether he does or doesn't go type iii. Both he and Spiegel said it's likely when I saw them in person; it sounds like they have a similar mindset/aesthetic they're trying to reach.
Anyway, I've been put at ease here. We picked up the scripts (antibiotic, zofran, painkiller, prescription mouthwash) and I plan on sleeping early today at my grandma's in Boynton. Cheers.
Thanks for the update Jessie! I know how arduous it is to get to the point where you are. Now it's time for you to relax and let the process happen!! Good luck!
Yes, thanks for the update :) I did a second consult with Dr. Mardirossian and yes, I agree, he definitely puts one at ease. I just put my deposit down and actually am currently scheduled for end of June (though may need to push that back). Feeling good about my decision. I hope things go well :)
Ok...holy ****. The past few days were insane. FFS recovery is like GRS recovery condensed into a much shorter timespan with alot more pain.
So I can tell Dr. Mardirossian did an amazing job on my face even though I'm still swollen and recovering. My forehead is ridiculously flat, I can definitely see the difference with the cheek implants, and my thyroid prominence is 100% gone! I was also an unusual case. Type I vs III is actually a meaningless concept in my case because I congenitally lack a front sinus...meaning I was lucky and I was born without the cavity in my forehead that the doctor would normally have to reseal with a titanium plate after setting back the bone. This of course simply made the surgery easier, all he had to do was burr my forehead and orbits as much as required. This also means alot less complications with headaches and stuff for me when all is said and done!
Anyway, he really stepped up to the plate and gave me great aftercare too, he showed at the hospital twice to check on me personally, and I will be off to his office twice in the next two weeks for checkups/stitch removal before heading home. Biggest issues I have right now is this incessant throbbing (which should settle down starting tomorrow as we're at day 3, when swelling allegedly will start to settle) and difficulty eating/managing my saliva due to the stitches in my mouth immobilizing my mouth (it also may be a bit longer before they dissolve).
If I have any complaints about care...it's not the doctor, he is an amazing person, my complaints would be with Jupiter Medical Center. Now mind you, I'm post op downstairs...my ID has a female name (Jessica) and says I'm female...yet because everyone knew I was in for ffs; I was excessively misgendered by hospital staff. Idk if it was some sort of southern intolerance but it was rather obnoxious to say the least. I clearly remember correcting the admissions person and my pre-op nurse several times, along with some of the post op care people. Then it also took them nearly 2 hours for them to discharge me yesterday when I just wanted to get the hell out of there to get to my grandmother's and relax. Jupiter Medical needs some work when it comes to dealing with Dr. M's patients. We let him know that, and believe me, he was aggravated about it and said he'd talk to the hospital staff. Fyi, in comparison, I had zero issues like that at Lower Bucks Hospital when I had bottom surgery with Dr. Mcginn.
Anyway, next few days are for healing, I'll post photos when I don't look like a car crash victim, cheers @all
Thanks for the update Jessie. I hope you start feeling better soon. That's terrible about the hospital staff but thank you for the warning, I'll be prepared. In exactly 1 month I'll be in the same place as you in the Jupiter Medical Center!
I hope you have a very speedy recovery! First 3/4 days will be the worst then it'll get better from there, hang in there and you'll get through it in no time! Since you did mandible and cheeks, at the same time there's definitely going to be lots of swelling Make sure you try to drink lots of water, try protein shakes with milk, and fruit juices. I know it can be difficult with the mouth stitches. Then you can switch to boiled eggs, And maybe sleeping pills can help with sleeping for the first few days, keep you morale up. And try to stay occupied (Netflix in bed helps speed time of recovery) :)
Jessie,
When I had my FFS a few months ago, I did not go to Jupiter Medical Center. I had my surgery in Dr Mardirosians office then I went to the hotel for recovery with a 24 hour companion. I had a check up at the office the next day and again 7 days later. My recovery was typical. I was walking about the next day and about 4 days later I was walking outside to the grocery store and on day 7, I was driving.
The only time Dr Mardirossian uses the local hospital is when he does tracheal or vocal chord surgery.
Quote from: Dani on June 04, 2017, 09:19:34 AM
Jessie,
When I had my FFS a few months ago, I did not go to Jupiter Medical Center. I had my surgery in Dr Mardirosians office then I went to the hotel for recovery with a 24 hour companion. I had a check up at the office the next day and again 7 days later. My recovery was typical. I was walking about the next day and about 4 days later I was walking outside to the grocery store and on day 7, I was driving.
The only time Dr Mardirossian uses the local hospital is when he does tracheal or vocal chord surgery.
Yeah...I can confirm this as well. It's specifically why he stated I went to JMC. Tracheal shave was needed as part of FFS in my case. I really understand why now too..you tend to hack up alot of fluids/mucus/junk following that procedure, could cause an airway obstruction. Still on painkillers and valium and eating rn is excessively difficult due to swelling, but at least I've regained control of mucus production in my mouth. My mother has been a wonderful surgery companion here. I haven't gone anywhere since I left the hospital but I can definitely walk ok on my own at this point throughout my grandma's house.
Quote from: Venusxoxo on June 04, 2017, 02:49:16 AM
I hope you have a very speedy recovery! First 3/4 days will be the worst then it'll get better from there, hang in there and you'll get through it in no time! Since you did mandible and cheeks, at the same time there's definitely going to be lots of swelling Make sure you try to drink lots of water, try protein shakes with milk, and fruit juices. I know it can be difficult with the mouth stitches. Then you can switch to boiled eggs, And maybe sleeping pills can help with sleeping for the first few days, keep you morale up. And try to stay occupied (Netflix in bed helps speed time of recovery) :)
Lol I really should try more Netflix/Hulu, I also brought a Nintendo switch with me for that reason...Smash Bros 3DS saved my sanity at the Gaia House in New Hope, PA...figured some Zelda would do nicely as well, albeit I've been a bit too weak to really play more than an hour at a time so far, plus grandma lacks a high def tv for me to use with the console so I have to use the portable screen. Hey, it's only day 3 tho. Take it easy they say (allegedly the swelling is finally supposed to go down tomorrow...I feel like a swollen tomato right now!).
Saw the Dr yesterday for an extra appt Galina scheduled and to clean up the head dressing/check healing, will also see him Wednesday and Sunday for stitch removal (Trachea first on wed, forehead later Sunday night). Appt went fine, healing is going well but I look like a swollen tomato. OMG tho, I look amazing as hell especially without the ace bandage on my head. Swollen, but the difference is astounding! I'm pretty sure my dysphoria is officially dead, unless I have voice issues long term. Pics will come when it starts to die down.
Also...I'm now off narcotic painkillers and bowel movements have fully resumed, but I still can barely chew and what not, only solid food I can really eat is oatmeal and scrambled eggs made with milk, along with ice cream. Doing alot of naked smoothies too ofc. Talking is also difficult due to mouth stitches.
Also, and fyi. Washing your hair after this procedure (you can after day 4) is kinda terrifying because the stitches in your hair/hairline for the forehead are fully exposed and the doctor says specifically not to pull on them (it can have a definite effect on scarring if you apply force too). I suspect it's going to remain a semi-matted mess until I get these stitches out and calm down about the hair washing and combing/brushing. At least my mom did it for me...but I kept telling her to take it easy even with the baby shampoo, (you know how it is when you go to a salon, they can really use ALOT of force when cleaning hair).
We also spoke again about the misgendering by people at JMC. He really was disgruntled about it, wanted any feedback I could give him so he can make a presentation to the hospital. Gonna be writing something up with my mom later too for his reference.
Another update 11 days out.
1. Had stitches and Staples removed yesterday, Sunday (Dr. M was nice enough to come in so I wouldn't have to rush my flight this morning, I'm waiting in the airport at). There were alot of them and it was a bit painful, wow. I can tell the scar is likely to heal well though.
2. I still have surgical glue on the incision site on my neck. It's going to take forever to come off. Can only use powdered concealer on it.
3. My jaw is still weak and feels funny, been massaging out fluid. Dr. M says I can't brush like another week :/. More peridex, woo! Jaw healing really takes a LONG time. Also definitely only doing soft foods for like the next few weeks. Don't know how long until I'll eat a jawbreaker candy again.
4. I have difficulty making facial expressions because of cheek implants. Muscles need to adjust.
5. Photos will come when I feel I look presentable for them. Going back to work tomorrow though. I think once this is healed I'm going to care alot more about my appearance because I'll have some pride in my face!
6. No ID issues at Palm Beach Airport TSA just now...the guy there was more interested in my flipside 2x wallet in my purse than my facial appearance, lol.
Here's some initial photos about 3 weeks out...so far so good for most of it imho
Again, procedures performed.
Mandible Contouring
Forehead Contouring/Brow Lift/Scalp Advance
Submalar Cheek Implants
Tracheal Shave
I really want to thread my brows but I'm scared of applying tension to the scalp wound :/. Needs more tensile strength first.
https://1drv.ms/a/s!AjGZdmPv49mZh60zZJUHzflKAZifSA
Before is HERE:
https://1drv.ms/a/s!AjGZdmPv49mZh6o5A3t67-JURK90kQ
Also, I still feel like my damn tracheal prominence is visible slightly. I mean it isn't horrible but blah. Dr. M said he did what he could, I believe him. I had a pretty big Adam's Apple.
In terms of pain, Chin still swollen and some of my facial muscles are still sore. The mouth stitches are all gone. I'm eating soft sandwiches at this point but still trying to take it easy with my diet. I was able to return to work about 12 days after surgery (office job) but I was TIRED.
Also I ordered some kelocote off amazon to take care of the scars, should arrive Monday.