Susan's Place Transgender Resources

Community Conversation => Transitioning => Facial feminization surgery => Topic started by: josie76 on July 08, 2018, 10:53:47 AM

Title: choosing FFS, sugestions
Post by: josie76 on July 08, 2018, 10:53:47 AM
I might be able to have the funds become available in the coming months for FFS. I know some areas I definitely want work done on. Opinions are appreciated. I want to go into this process with goals in mind.

I know I want my nose done. I want my chin projection reduced and the height cut slightly tapered narrower. Mt spouse thinks I'm fine with my supraorbital arches. I don't have a large brow ridge but when the light is right I notice a shadow above them. I don't like that. Wish it was ground down.

(https://farm2.staticflickr.com/1807/43230137382_ecc2ffb887_b.jpg) (https://flic.kr/p/28S6KJf)IMG_20180620_152107_037 (https://flic.kr/p/28S6KJf) by Josie H (https://www.flickr.com/photos/149006210@N03/), on Flickr

(https://farm1.staticflickr.com/916/43230136622_5061e2f82e_b.jpg) (https://flic.kr/p/28S6Kv9)IMG_20180620_152953_419 (https://flic.kr/p/28S6Kv9) by Josie H (https://www.flickr.com/photos/149006210@N03/), on Flickr

(https://farm2.staticflickr.com/1823/43230136792_e53d3f7f85_b.jpg) (https://flic.kr/p/28S6Ky5)IMG_20180620_152922_268 (https://flic.kr/p/28S6Ky5) by Josie H (https://www.flickr.com/photos/149006210@N03/), on Flickr

(https://farm2.staticflickr.com/1821/43230137012_4019b9e7e7_b.jpg) (https://flic.kr/p/28S6KBS)IMG_20180620_152919_209 (https://flic.kr/p/28S6KBS) by Josie H (https://www.flickr.com/photos/149006210@N03/), on Flickr

(https://farm1.staticflickr.com/843/43230137242_23545df01d_b.jpg) (https://flic.kr/p/28S6KFQ)IMG_20180620_152114_261 (https://flic.kr/p/28S6KFQ) by Josie H (https://www.flickr.com/photos/149006210@N03/), on Flickr

(https://farm2.staticflickr.com/1769/43230136432_98ab4fe8ed_b.jpg) (https://flic.kr/p/28S6KrS)IMG_20180620_153014_618 (https://flic.kr/p/28S6KrS) by Josie H (https://www.flickr.com/photos/149006210@N03/), on Flickr

(https://farm1.staticflickr.com/915/43230136122_2619a84031_b.jpg) (https://flic.kr/p/28S6Kmw)IMG_20180620_153031_431 (https://flic.kr/p/28S6Kmw) by Josie H (https://www.flickr.com/photos/149006210@N03/), on Flickr

(https://farm2.staticflickr.com/1762/43230135972_0402213dcf_b.jpg) (https://flic.kr/p/28S6KiW)IMG_20180622_161606_933 (https://flic.kr/p/28S6KiW) by Josie H (https://www.flickr.com/photos/149006210@N03/), on Flickr


I kinda lean towards Dr. Zukowski partly because he is close by. My one concern is a few girls I have seen he goes pretty far on their noses. I might consider a more local maxillofacial surgeon for the chin and nose job. Also since I have an underbite that such a surgeon could correct. I have never heard of Dr. Z correcting teeth alignment. One St. Louis maxillofacial surgeon I emailed with said he would have no trouble with the chin / underbite and nose job, but has not done brow work and so would suggest finding someone else for that job. I might also get a consult with the craniofacial surgeons that work from Wash U medical school. They have a plastic surgery practice and are both professors of craniofacial and maxillofacial surgery at Wash U. IDK yet.  :-\ :P ??? ???
Title: Re: choosing FFS, sugestions
Post by: Allison S on July 08, 2018, 11:25:10 AM
You have very pretty eyes! I want most of the same surgeries myself... Only thing else I would maybe do is upper lip lift. Very minor lift though. Good luck

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Title: Re: choosing FFS, sugestions
Post by: reborn on July 08, 2018, 12:28:37 PM
I agree about Dr Z noses. I think that you need type 3 forehead reconstruction together with the orbital rims. Nose job, chin and a lip lift. I would go with an experienced doctor. Try using your insurance, some pay for FFS nowadays
Title: Re: choosing FFS, sugestions
Post by: josie76 on July 08, 2018, 01:46:01 PM
Quote from: reborn on July 08, 2018, 12:28:37 PM
I agree about Dr Z noses. I think that you need type 3 forehead reconstruction together with the orbital rims. Nose job, chin and a lip lift. I would go with an experienced doctor. Try using your insurance, some pay for FFS nowadays

I guess I thought a type3 was where the sinus cavity was close to the surface and a type1 was when the bone over the sinus was thick enough that just grinding it was enough without cutting and replacing bone? My understanding was that was something a X-ray or CT was needed to find out?
I pretty much agree with your observations. My outer orbital rims are not very high but with the raised arches it pushes the fleshy area above the eyelids down some. I remember 10-15 years ago my upper lip didn't cover my teeth as much as it does now. I think it dropped as my nose got longer. I also need a significant septoplasty done. I didn't add the upshot of my nose but it's pretty bad.

I'm unemployed due to injury. I do have a COBRA policy but it's from Mississippi and won't cover anything trans related. I also have a state medical card with exclusions for surgical coverage.

Quote from: Allison S on July 08, 2018, 11:25:10 AM
You have very pretty eyes! I want most of the same surgeries myself... Only thing else I would maybe do is upper lip lift. Very minor lift though. Good luck

Thanks girl!  :D
Title: Re: choosing FFS, sugestions
Post by: reborn on July 09, 2018, 04:56:15 PM
Quote from: josie76 on July 08, 2018, 01:46:01 PM
I guess I thought a type3 was where the sinus cavity was close to the surface and a type1 was when the bone over the sinus was thick enough that just grinding it was enough without cutting and replacing bone? My understanding was that was something a X-ray or CT was needed to find out?
I pretty much agree with your observations. My outer orbital rims are not very high but with the raised arches it pushes the fleshy area above the eyelids down some. I remember 10-15 years ago my upper lip didn't cover my teeth as much as it does now. I think it dropped as my nose got longer. I also need a significant septoplasty done. I didn't add the upshot of my nose but it's pretty bad.

I'm unemployed due to injury. I do have a COBRA policy but it's from Mississippi and won't cover anything trans related. I also have a state medical card with exclusions for surgical coverage.

Thanks girl!  :D

In my opinion you need to set your forehead back about 1cm in order to achieve an optimal result. In order to achieve this you need type 3 forehead reconstruction.
Title: Re: choosing FFS, sugestions
Post by: TaylorLeigh on July 09, 2018, 09:37:34 PM
Hi Josie -

I'm reposting my comments below from a related thread. Maybe you'll find them useful :)...

Last year, I was able to attend  a WPATH conference in LA where I was fortunate enough to get in-person consultations with Dr. Simon (Facial Team - Spain) and Dr. DiMaggio (MDM Surgery - Argentina). In addition, I had 2 visits with Dr. Zukowski (in Chicagoland).

As I needed a Type 3 forehead reconstruction, Dr. Z was out (although he had been my first choice due to his great reputation for soft tissue work and proximity to home). Facial Team was booked 8 months months out at the time of my consultation, so a longer wait. Dr. DiMaggio, requires a 1-month stay in Buenos Aires, which I couldn't manage because of work commitments. Finally, based on recommendations from others on this forum, I decided to check out Dr. Rossi (another Buenos Aires-based surgeon) who replaced Dr. DiMaggio at the T-Change practice. My consultation with Dr. Rossi was via Skype. Also, Dr. Rossi, like DiMaggio, had a reputation for aggressive work - which I felt I needed.

Regarding quotes, Drs. Rossi and DiMaggio were about half of Dr. Z, and maybe 25% less than Facial Team. There are more risks when you go abroad, as it may be tougher to get any legal remedies, should something bad happen. There are also travel and living costs which eat into the savings over, say, using a US-based surgeon. However many non-US surgeons are still American Board Certifed, so you may have some leverage if there is a problem. Plus most good surgeons stand behind their work, and so often cover revisions (but not the travel and hospital costs).

I, myself, used frequent flyer miles to get a free ticket to Buenos Aires which otherwise would have cost $1800. If you know someone with lots of miles, perhaps they could help you with a ticket. Also I paid $50/night for a nice apartment, so over my 14 day stay was $700, plus maybe $250 for meals (mostly cooked for myself).

Here is the link to a review of my FFS experience with Dr. Rossi on RealSelf (including before & after pics). https://www.realself.com/review/argentina-great-experience-dr-rossi

Hope all of this is helpful. :)

-Taylor
Title: Re: choosing FFS, sugestions
Post by: josie76 on July 10, 2018, 10:07:52 AM
Quote from: reborn on July 09, 2018, 04:56:15 PM
In my opinion you need to set your forehead back about 1cm in order to achieve an optimal result. In order to achieve this you need type 3 forehead reconstruction.

A whole cm huh? Something to think about. I had thought if I could get the arches flattened to even with my nose root (nasion) so I had a flat glabella area I'd be happy with it. The partly turned pictures capture the bump formed by my outer supraorbital arches. They drop away just before the corner of the tempral bone. So if my head was turned just a bit more toward straight ahead the ridge falls away. I don't have much of a raise in the outer orbital margins. If I do the brow I'd have them knocked down also but as they are there is little there. I think in that area I'm about even with a lot of cis women. Usually when that grows it also lowers the outer eyebrows down over the eye and drops the outer eye canthus. I suppose it comes down to can I afford to pass as cis female or can I afford to be pretty?  :D
Title: Re: choosing FFS, sugestions
Post by: josie76 on July 10, 2018, 10:10:37 AM
TaylorLeigh
WOW you look great! I don't think I can make that kind of trip work for me but he did an amazing job for you! I am very impressed.
Title: Re: choosing FFS, sugestions
Post by: reborn on July 11, 2018, 05:08:52 AM
Quote from: josie76 on July 10, 2018, 10:07:52 AM
A whole cm huh? Something to think about. I had thought if I could get the arches flattened to even with my nose root (nasion) so I had a flat glabella area I'd be happy with it. The partly turned pictures capture the bump formed by my outer supraorbital arches. They drop away just before the corner of the tempral bone. So if my head was turned just a bit more toward straight ahead the ridge falls away. I don't have much of a raise in the outer orbital margins. If I do the brow I'd have them knocked down also but as they are there is little there. I think in that area I'm about even with a lot of cis women. Usually when that grows it also lowers the outer eyebrows down over the eye and drops the outer eye canthus. I suppose it comes down to can I afford to pass as cis female or can I afford to be pretty?  :D

When it comes to passing I think that you already pass well. I thought you were after some feminizing beautification. Don't get me wrong but I think you need a very aggressive forehead/ nose/ chin work. Try to change insurance if you can. It would be very handy not to pay out of pocket for FFS. Nowadays it is possible.
Title: Re: choosing FFS, sugestions
Post by: Colleen_definitely on July 11, 2018, 07:37:24 AM
I like Dr. Z as a person but I wouldn't have him work on my nose.  He just gets a little wild for my taste.

Dr. Crane in Austin is who I am working with now to take a grinder to my skull, I got a really good feeling from him during my consult.  Dr. Raphael in Plano does good work as well, but doesn't take insurance for FFS any more (problem for me, but not for you).

Just eyeballing things I think a brow ridge and orbit reduction would be great for you, trimming the nose wouldn't hurt, and a lip lift would do wonders.  If your chin bothers you, might as well work on that while they're in there.
Title: Re: choosing FFS, sugestions
Post by: josie76 on July 11, 2018, 09:13:36 AM
Thanks both of you.

Reborn, I would love to have beautification done. Not sure what I can afford. I can't work now. Not sure if that will change. I have nerve damage from a back injury that has been pretty limiting on my activity. After a couple of hours of standing or sitting I have to lie down to reduce the pressure and the pain level. At this point I'm kind of counting on the settlement from work comp to pay for this when I get it. The attorney likes my case because I used to make a decent salary before I was hurt. Been nearly a year now. Anyway, I don't take it the wrong way. I appreciate the opinion. I know a girl who had Dr Z recently do her. Her forehead turned out really good and I think she had more than me there to get removed. His nose work is the one thing really I don't like. Also the way she described her recovery. I know that is totally an individual thing but then reading about how quickly Kendra was doing better it makes me wonder how rough Dr Z is with his angle grinder? Lol

Yeh I think I do need chin work. I think it projects too far and is too long height wise. If the chin section can be sliced down and the front cut down with it I think it'll be good then. I know what a doctor does depends on the nerve position and all that. I have a couple mm underbite that also makes my chin seem worse to me anyway. That's why I was contacting a maxial facial plastic surgeon more locally. This doctor does tons of nose jobs and jaw bone work with teeth alignment. He also is one of the go to doctors with the Children's Hospital for kids with palet defects and does accident reconstruction work. He just said he has never done brow reduction so he would not be the guy for that.

Everything depends on how much I end up having available. I know if I don't do my brow I will always regret it. So somehow I want to work that in.

I do kind of pass. I think wearing glasses makes some features less obvious. I am by no means a pretty woman though.
Title: Re: choosing FFS, sugestions
Post by: reborn on July 11, 2018, 03:11:10 PM
Well, you are pretty and you look very intelligent. I guess you are which is good. You can always become more beautiful. I wouldn't do the nose and the forehead in separate procedure especially not the nose first. Local maxillofacial surgeon is a good option for the chin and the nose perhaps. Do the forehead first elsewhere. There are several very good type 3 forehead doctors in the USA.