Susan's Place Transgender Resources

Community Conversation => Transitioning => Voice Therapy and Surgery => Topic started by: kwala on April 10, 2018, 07:55:35 PM

Title: Third time is the charm? Surgery with Dr. Thomas
Post by: kwala on April 10, 2018, 07:55:35 PM
Greetings. I know many of you have followed my posts over the last three years but I'll give a brief overview for any newcomers. In 2015, I had a glottoplasty with Dr. Haben in Rochester.  He somehow created a web that was way beyond the size of what we had discussed, leaving me with an almost nonfunctional voice box. I could not speak above a whisper and even the whisper sounded like I was gravely ill. I returned to Dr. Haben to have the web decreased but this failed as well and actually made things a little worse (which I did not think was possible). The definition of insanity is trying the same thing over and over and expecting a different result, so I consulted a local ent who was successfully able to divide the web. This gave me enough volume back to communicate as long as I wasn't in a really noisy place, but still I sounded like a chain smoker, and I don't smoke.

Not willing to settle with this broken voice I traveled to Korea to see Dr. Kim. I was hoping that his glottoplasty procedure may be able to create a stronger web out of the now scarred anterior portion of my cords.  After examining me, he decided that a web was too risky at this point because there would still be too much scarred tissue and it created a large gap that would be even more problematic with a web. He did, however offer a pulse-dye laser treatment to soften the scar tissue, but informed me that this would be a mild improvement at best. He was right, and there was a bit more clarity to my voice, but I still sounded hoarse in most registers.

Always researching and seeking out opinions, I watched James Thomas' YouTube video on his FemLar procedure. He stated in the video that it could be used to correct webbing procedures because he essentially removes the webbed portion altogether. I wasn't sure if this would apply to me because my web was so large and the scarring was so significant that I had my doubts. I went to see him in January to discuss. I told him that my current goals were less about pitch and more about voice quality/decreasing the hoarseness. We came up with a plan to remove the bottom third of my vocal cords, and additionally he would reposition them closer together since the scarring had left my cords bowed and stiff. This would enable them to meet and attain a more complete closure, or at the very least decrease the space of the gap. He was very honest about my chances, noting that scarring is unpredictable but I told him if there was even a decent chance, I was all in. So, I had the surgery exactly two weeks ago and today is my first day off of voice rest.

I have linked two vocaroo examples: the night before surgery, and today. Currently I am blown away. My volume is still low but I have not been able to make a sound this clear in three years. I have faith that more volume will come (its only day 1!) but so far I am cautiously optimistic. My pitch is quite high, it may settle a bit lower but honestly I just want to sound like a regular person and not be constantly asked if I'm sick. I have to continue to take it easy, minimal talking for the next 2 weeks, but I'll be sure to let you all know how it turns out down the road. My only questions now are whether I will continue to gain volume and after a month I will test out singing. I may die on the spot from happiness if I'm able to sing again.

To anyone who is looking into VSF, especially those who have had botched attempts, this surgery may be worth investigating, and I have nothing but positive things to say about Dr. Thomas and his practice.  Like I said, it's early and the jury is still out, but I am very pleasantly surprised in only my first day!


Night before FemLar:
https://vocaroo.com/i/s1Fl2DIS5d2U

Day 1 of talking after FemLar:
https://vocaroo.com/i/s1B2eJll0JRj
Title: Re: Third time is the charm? Surgery with Dr. Thomas
Post by: Dena on April 10, 2018, 10:28:46 PM
When I was first researching voice surgery I encountered Dr Thomas and wasn't very impressed by the voice samples on his web site. I haven't heard anything more recent as the members here tend to use other surgeons. These results are very good and if there are more examples, we may have another voice surgeon.

As for volume, if your anything like me it may take months to a year before your voice returns to full strength. Remember that you have gone 2 weeks without using a muscle and that muscle can atrophy. In my case my voice was weak for the first 6 months and after about a year my volume greatly improved.
Title: Re: Third time is the charm? Surgery with Dr. Thomas
Post by: kwala on April 10, 2018, 10:44:21 PM
Quote from: Dena on April 10, 2018, 10:28:46 PM
When I was first researching voice surgery I encountered Dr Thomas and wasn't very impressed by the voice samples on his web site. I haven't heard anything more recent as the members here tend to use other surgeons. These results are very good and if there are more examples, we may have another voice surgeon.

As for volume, if your anything like me it may take months to a year before your voice returns to full strength. Remember that you have gone 2 weeks without using a muscle and that muscle can atrophy. In my case my voice was weak for the first 6 months and after about a year my volume greatly improved.

As you know, this isn't my first go around with VFS, so I am well aware of how things take time to heal. However, in my initial case neither volume nor clarity returned even after a full year.

Voicedoctor.net has at least fifty (probably more, I didn't count) before and after videos that offer a wide range of results. On the main page there is a click down icon you can use to scroll down to "audio examples" and you can fine tune the examples to "feminization laryngoplasty" and "thyrohyoid elevation" to hear those results and not those of other procedures. Each example lists the age, any prior surgeries, as well as any complications or revisions that were done. Dr. Thomas says he has continued to fine tune the process since the early 2000's and I didn't ask specifically what he has changed but I definitely think the results are consistently better at 2008 and onward. Like most surgeries, younger patients tend to fair better than older but that's not a hard rule. I still don't know to what extent this will be a success. I don't know how much of my range will return and I don't know how it will hold up in loud places but I am thrilled that there is a big improvement in clarity.
Title: Re: Third time is the charm? Surgery with Dr. Thomas
Post by: KayXo on April 11, 2018, 10:36:24 AM
Yes indeed, there are many, many samples (66+) of his work and personally, I'm most impressed with his results. If there were one voice surgeon to go to, this would be my pick but to each their own. :) Keep us posted Kwala and thanks for sharing.
Title: Re: Third time is the charm? Surgery with Dr. Thomas
Post by: Rachel on April 11, 2018, 05:54:19 PM
Good luck Kwala. You have very informative posts and I learn so much from you.
Title: Re: Third time is the charm? Surgery with Dr. Thomas
Post by: kwala on April 12, 2018, 05:40:11 AM
Thank you, Rachel!
Title: Re: Third time is the charm? Surgery with Dr. Thomas
Post by: kwala on April 28, 2018, 12:13:18 AM
Just thought I would post another update since it has been over a month. My voice is very much improved. I can speak comfortably in public as long as it isn't too noisy and my voice still sounds clear. Everyone has commented on how much better I sound. I am still hopeful that more volume and more range will come in time but just to be able to speak clearly and not sound like a smoker and not constantly be asked if I have a cold is life changing. I would highly, HIGHLY recommend seeing Dr. Thomas if you are someone interested in pitch elevation and especially if you've had a past attempt that left you damaged. My voice still isn't perfect by a long shot, but I had nearly given up hope that I could ever even sound as good as I do right now and I owe that to Dr. Thomas.

4.5 weeks: https://vocaroo.com/i/s0vPoF87GDbv
Title: Re: Third time is the charm? Surgery with Dr. Thomas
Post by: Ellement_of_Freedom on April 28, 2018, 03:57:10 AM
Quote from: kwala on April 28, 2018, 12:13:18 AM
Just thought I would post another update since it has been over a month. My voice is very much improved. I can speak comfortably in public as long as it isn't too noisy and my voice still sounds clear. Everyone has commented on how much better I sound. I am still hopeful that more volume and more range will come in time but just to be able to speak clearly and not sound like a smoker and not constantly be asked if I have a cold is life changing. I would highly, HIGHLY recommend seeing Dr. Thomas if you are someone interested in pitch elevation and especially if you've had a past attempt that left you damaged. My voice still isn't perfect by a long shot, but I had nearly given up hope that I could ever even sound as good as I do right now and I owe that to Dr. Thomas.

4.5 weeks: https://vocaroo.com/i/s0vPoF87GDbv

WOW! You sound AMAZING! I'm sooo happy for you kwala, I know you've been through a struggle and this makes me smile to see you coming out the other end with success. :)
Title: Re: Third time is the charm? Surgery with Dr. Thomas
Post by: Rachel on April 28, 2018, 08:07:25 PM
Kwala, I am happy for you.
Title: Re: Third time is the charm? Surgery with Dr. Thomas
Post by: Lynne on May 01, 2018, 06:52:53 PM
Kwala, first of all, thank you very much for sharing your experience, from what I've read it wasn't easy for you. It's important to hear about the more challenging situations to get a complete picture, we cannot ignore the dangers associated with any of the surgeries.

Your latest recording sounds so much better than the earlier ones, I hope your voice will improve even further as you heal!