Susan's Place Transgender Resources

Community Conversation => Transitioning => Voice Therapy and Surgery => Topic started by: staciM on May 17, 2017, 09:59:52 PM

Title: Current view and reliability of VFS??
Post by: staciM on May 17, 2017, 09:59:52 PM
Much of the transition literature that I've come across (some of which is quite dated) tends to frown upon VFS procedures.  In addition, some girls that I've spoken to that  have transitioned in the past usually have negative things to say when I mention that I'm considering VFS.

Have the VFS procedures been perfected or advanced recently to the point that they provide more reliable and safe results or have a few past bad examples merely fading from memory?  Is VFS now considered a viable and common transition surgery similar to FFS, GCS or is it still a fringe and "unnecessary" risky procedure?

Haben is who I am considering, but I don't want this to turn into a surgeon vs surgeon discussion.  I'm well aware of other well known surgeons but I simply don't wish to travel across the world. Has Haben's procedures become generally more reliable? 
Title: Re: Current view and reliability of VFS??
Post by: Dena on May 17, 2017, 10:37:15 PM
The older problem with the surgery was when the tie was more that 50%. In addition, a secondary problem was they would tie the cords but they didn't cause the unused portion to fuse. The end result was if the tie failed, the old voice returned. The surgery is better today but there are a few that fail because of healing issues. Last but not least, a surgical voice is 50% surgery and 50% therapy unless you have an extremely high starting point, you will still need use the head voice however you don't need to force the pitch in order to hit the feminine range.
Title: Re: Current view and reliability of VFS??
Post by: Doreen on May 17, 2017, 10:56:36 PM
I had CTA done (cricothyroid approximation) back in (I think) 1995 with Dr. Menard, when he was still working with Brassard in Montreal.  Honestly most of the people I had seen get the surgery never succeeded or sounded like mini mouse or w/e but here are the following reasons WHY most of theirs didn't work...

#1 - Smoking. Especially shortly afterwards.. very foolish.
#2 - Not waiting for it to heal, and 'revising' it.
#3 - Straining too fast and not letting your voice heal.  Its gonna be weeks to months for your voice to be fully operational.
#4 - Unrealistic Expectations.  In my particular case I've never fully regained my singing voice... but I'm working it up by practicing.
#5 - Bad juju - Or easier said... bad luck, or bad roll of the surgical dice.  Sometimes things just don't work out right.

In my case I avoided all 5, and my voice has never given me problems (well except really bad days) since. I get mammed on the phone all the time.  I also suspect having just recently had the voice 'drop' and freaking out & getting the surgery to fix it back to female norm might've helped too.. My voice hadn't been changed all that long, and it was DEEP at the time, and causing tons of problems mentally for me (I think it was 3 years).   So glad I ignored *EVERYONE* that was saying not to do it, it'll ruin me, etc.. the same dingbats that told me not to get GCS in Thailand with Kunaporn, and don't get FFS in mexico. 

Guess what naysayers?  It ALL turned out wonderfully. A pox on you and all your doubts lol.
Title: Re: Current view and reliability of VFS??
Post by: EmmaLoo on May 17, 2017, 11:59:10 PM

I've only known one person who's had VFS and it hasn't met their expectations. The surgery was done this year.

What worries me about it is when it does fail, you're not just stuck with an unsightly scar, but a very damaged voice which can be difficult to correct. Your voice is a key component of your personality and vocal folds are delicate. It's not something people won't notice if it's suddenly compromised.

I'm not suggesting that it's too risky for everyone, there are good results as Doreen mentioned. It would make me pretty anxious about the outcome.
Title: Re: Current view and reliability of VFS??
Post by: KatieByrne on May 18, 2017, 01:30:54 AM
I had VFS 2 months ago (Feminization Laryngoplasty) and I'm very happy with the results.

I wont go into detail here as i've put  up a whole thread about it here:
https://www.susans.org/forums/index.php/topic,223705.0.html

But yeah basically Dr. Ornouma at Yanhee Hospital in Bangkok did a good job with my VFS,
I know what you mean about most discussions simply writing off VFS and there are probably
multiple factors in that (the technique used, surgeon etc) and as a result its hard to gauge
reliability.

I will say though that most evidence is anecdotal and the plural of anecdote is not data.
Title: Re: Current view and reliability of VFS??
Post by: kwala on May 18, 2017, 02:43:30 AM
Quote from: staciM on May 17, 2017, 09:59:52 PM
Much of the transition literature that I've come across (some of which is quite dated) tends to frown upon VFS procedures.  In addition, some girls that I've spoken to that  have transitioned in the past usually have negative things to say when I mention that I'm considering VFS.

Have the VFS procedures been perfected or advanced recently to the point that they provide more reliable and safe results or have a few past bad examples merely fading from memory?  Is VFS now considered a viable and common transition surgery similar to FFS, GCS or is it still a fringe and "unnecessary" risky procedure?

Haben is who I am considering, but I don't want this to turn into a surgeon vs surgeon discussion.  I'm well aware of other well known surgeons but I simply don't wish to travel across the world. Has Haben's procedures become generally more reliable?

Hi, Staci. I feel obliged to tell you that I had surgery with Dr. Haben 2 and a half years ago and he nearly ruined my vocal cords.  Of course, he has had several successful stories and many of them have shared their stories here. In my case, he overestimated the suture site and gave me a huge web that was more like 75% instead of the desired 30-50% mark. After 6 months of barely being able to talk, he recommended to "downsize" it in a second surgery (not for free) and not knowing what else to do, I went back. He botched that one as well and the web grew even larger! I had to have it removed completely by a third party and while it's somewhat stable now, I've lost over an octave in range and I sound incredibly hoarse like a lifelong smoker even though I've never smoked.

I'd search this forum and other places and read some reviews before you decide. When he gets it right, it's amazing but just remember that if he doesn't (contrary to what he told me) the damage could be irreversible.

Sorry to scare you but I wish someone had scared me.
Title: Re: Current view and reliability of VFS??
Post by: Myself on May 18, 2017, 02:50:12 AM
Quote from: kwala on May 18, 2017, 02:43:30 AM
Hi, Staci. I feel obliged to tell you that I had surgery with Dr. Haben 2 and a half years ago and he nearly ruined my vocal cords.  Of course, he has had several successful stories and many of them have shared their stories here. In my case, he overestimated the suture site and gave me a huge web that was more like 75% instead of the desired 30-50% mark. After 6 months of barely being able to talk, he recommended to "downsize" it in a second surgery (not for free) and not knowing what else to do, I went back. He botched that one as well and the web grew even larger! I had to have it removed completely by a third party and while it's somewhat stable now, I've lost over an octave in range and I sound incredibly hoarse like a lifelong smoker even though I've never smoked.

I'd search this forum and other places and read some reviews before you decide. When he gets it right, it's amazing but just remember that if he doesn't (contrary to what he told me) the damage could be irreversible.

Sorry to scare you but I wish someone had scared me.

I am so sorry this happened to you! :( This does sound very scary and disheartening.
Title: Re: Current view and reliability of VFS??
Post by: Dena on May 18, 2017, 09:22:43 AM
Quote from: KatieByrne on May 18, 2017, 01:30:54 AM
I had VFS 2 months ago (Feminization Laryngoplasty) and I'm very happy with the results.

I wont go into detail here as i've put  up a whole thread about it here:
https://www.susans.org/forums/index.php/topic,223705.0.html

But yeah basically Dr. Ornouma at Yanhee Hospital in Bangkok did a good job with my VFS,
I know what you mean about most discussions simply writing off VFS and there are probably
multiple factors in that (the technique used, surgeon etc) and as a result its hard to gauge
reliability.

I will say though that most evidence is anecdotal and the plural of anecdote is not data.
I am not exactly sure which surgery you had but it wasn't VFS. Your larynx was reshaped and that goes beyond the normal procedure for VFS. Dr Thomas in the United States was preforming a procedure similar to what you describe but I don't know enough about either doctor to determine the differences in the procedures.
Title: Re: Current view and reliability of VFS??
Post by: KatieByrne on May 18, 2017, 05:42:50 PM
Quote from: Dena on May 18, 2017, 09:22:43 AM
I am not exactly sure which surgery you had but it wasn't VFS. Your larynx was reshaped and that goes beyond the normal procedure for VFS. Dr Thomas in the United States was preforming a procedure similar to what you describe but I don't know enough about either doctor to determine the differences in the procedures.

I'm sorry and please feel free to correct me here if i'm wrong as i'm certainly no authority on this subject but VFS just seems like a blanket term (Vocal Feminization Surgery) for ALL surgeries aimed at feminizing the voice to me. That was the assumption I was operating on anyway. Like for example people have mentioned Cricothyroid Approximation and That webbing procedure and the procedure i underwent was called a Feminization Laryngoplasty.

Again please feel free to correct me here but etymologically/semantically speaking that seems more of a generic term than something referring to a specific procedure
Title: Re: Current view and reliability of VFS??
Post by: kwala on May 18, 2017, 11:51:25 PM
Quote from: KatieByrne on May 18, 2017, 05:42:50 PM
I'm sorry and please feel free to correct me here if i'm wrong as i'm certainly no authority on this subject but VFS just seems like a blanket term (Vocal Feminization Surgery) for ALL surgeries aimed at feminizing the voice to me. That was the assumption I was operating on anyway. Like for example people have mentioned Cricothyroid Approximation and That webbing procedure and the procedure i underwent was called a Feminization Laryngoplasty.

Again please feel free to correct me here but etymologically/semantically speaking that seems more of a generic term than something referring to a specific procedure
I agree with you. Voice Feminization Surgery is a more general term that can be applied to any surgical alteration that attempts to feminize the voice. The more specific terms would be glottoplasty, cricho-thyroid approximation, etc (there are many!) and many doctors do a combination of these procedures.  Also not every doctor uses the same technique or the same instruments within those specific procedures.  Nevertheless, they all fall under that umbrella term of VFS.
Title: Re: Current view and reliability of VFS??
Post by: ainsley on May 24, 2017, 03:40:17 PM
I went to Haben in May of 2015.  What he did worked exactly as we expected.  My result is good.  I have had to have prolaryn plus injected into my false vocal folds (in April 2016) because I had a gap in my vocal cords that created a hoarse and breathy sound.  Not a result of Haben's surgery per se, but because I am old..lol (49), and because I smoked for 17 years, and because I was hoarse some prior to surgery.  He was up front with me and told me to only expect a B or B+ result because of my history. 

Shortening the vocal cords to raise the pitch made the gap (which causes hoarseness) a more pronounced area of my remaining cords.  The injections work for me.  My local otolaryngologist does the injections for me and she has been great to work with to avoid traveling to Rochester again and again. :)

I will say that VFS was the most impactful thing I did for my transition.  No one sees your vagina when you are out and about in public, but EVERYONE hears your voice.  I do not get misgendered on the phone, in drive thrus, or in person at all now.
Title: Re: Current view and reliability of VFS??
Post by: staciM on May 24, 2017, 04:13:17 PM
Thanks for the continued feedback girls.  It looks like VFS (in all forms) still has mixed results.  The girls with good results are VERY happy and the surgery can be life changing but there are still occasional bad results that are also very life impacting.  I was honestly hoping to hear that things are now more reliable and that surgeons would be able to tell well ahead of time the chances of success.