Samantha,

I don't think you can really say for sure that Jenny would need reconstruction rather than a shave and fill technique. Her brow ridge looks quite minimal and for her, shave and fill would probably result in a perfectly feminine forehead.

This is a really good overview of male/female foreheads and the different FFS techniques: http://www.virtualffs.co.uk/Forehead.html

That list is pretty good as far as forehead reconstruction goes but I would probably add Dr. Bart in Belgium and the Facial Team in Spain.

And I don't think that 5% figure is accurate - plenty of trans women do not have a very prominent brow and a shave and fill technique is all that is necessary.


Edit:

Oh and Jenny, Dr. Z's claim that any forehead can be feminized with his technique is a bit of a stretch. For people like me who have very prominent brows Dr. Z's shave and fill technique would result in a flat forehead, but it would be quite bulbous because he wouldn't be able to shave down that much due to the sinus cavity. It would result in what is often referred to as the "dolphin" forehead and the VFFS site I linked goes into it in a bit more detail.

Thank you everyone for the words and encouragement

Quote from: Nicolette on November 17, 2013, 11:46:27 AM
You need an xray of your profile to determine the thickness of the bone covering the sinuses to know how much to take off. What I know is they can thin the bone out enough so it becomes pliable and then they can push it further back.

Zukowski can do it, but you'll know that endoscopic won't allow hairline lowering, if you require it. This would be best approach to prevent potential premature thinning of the hair, as this is less invasive.

Do you have larger frontal sinuses than what Maid had? You don't appear to.

Thanks, yeah I do wonder how big my frontal sinus is- I have a feeling it is on the large side extending far into my orbitals. 'Twould be great to know from an xray how much can be done with the shave alone. Honestly with the last version I posted, there is minimal shaving to the brow... Maybe a little bit over 1mm. Even if there is a slight ridge there after, I think ever so subtly changing the nose profile could help balance it.

Quote from: samantha55522 on November 17, 2013, 05:01:45 PM
Dear Jenny, be careful,...do not believe everything you read on the surgeon´s website, ....including the forums. Dr. Z is not the only one who do facial endoscopic surgery, there are many others. At the same time there is very little almost 5% of cases that can be improved with endoscopic technique. Your case needs a complete bone remodeling with osteotomy to get the result you want. Here a list of the best in the world. Find them and do your own analysis. Also go to FFS-support, yahoo foros, there are plenty of examples of all of them.
Dr. O.
Dr. Suporn
Dr. Spiegel
Dr Di Maggio

Mayer offers endoscopic, too, from what I can see. But yes I am well aware of the fact that endoscopic is not feasible for most. Mayer (as far as I know) only does the burring/shave method, because (like Dr. Z) he thinks it's a horrible idea to open and re-close the sinuses under any circumstance. I actually asked him about this while I was at Maid's consultation, and it went kind of like this:

(Me)
"What method of reshaping the bone do you use? Do you remove and reposition the bone or do you shave it?"

(Him)
"What do you think I do? *snarky face*"

long pause

(Me, blushing)
"You shave it and leave the sinuses intact?"

(Him)
"Yes, and I would never do it any other way"

He then went on to explain if there was an accidental perforation or hole, a small amount of bone filler would be used to plug it up. It's almost verbatim what's all over Zukowski's recontouring surgery page.

Quote from: abbyt89 on November 17, 2013, 05:46:29 PM
Oh and Jenny, Dr. Z's claim that any forehead can be feminized with his technique is a bit of a stretch. For people like me who have very prominent brows Dr. Z's shave and fill technique would result in a flat forehead, but it would be quite bulbous because he wouldn't be able to shave down that much due to the sinus cavity. It would result in what is often referred to as the "dolphin" forehead and the VFFS site I linked goes into it in a bit more detail.

I wasn't aware that Dr. Z uses filler if he can't shave enough. Even though my spirit animal is a dolphin and I would totally be one in a heartbeat, I don't want to have a dolphin head.

Quote from: Jennygirl on November 16, 2013, 09:09:35 PM
Yes but I want to avoid the "scoop" effect (something Dr. O is known for giving his patients) at all costs. I like the photo you cited, though. She is beautiful!

I added the slightest bit of concavity. Any more and it looks "done" / fake.



I'm starting to realize what an incredibly delicate procedure a nose job is. I mean I'm moving things around only by half a pixel and it makes a disproportionately huge difference.

Also, thank you for your feedback. This is really helpful to me!

I think you are already quite lovely
on your way to drop dead gorgeous

Thank you girls

Gabrielle, you do know that the photo you quoted is altered, right? Haha

Before / After

Quote from: Jennygirl on November 16, 2013, 07:14:40 PM
Thanks girls for the nice comments

Back when I had my trach shave with Dr. O in February, I asked him what else he would do to feminize my face. Here was his list:

• forehead recontouring
• nose
• jaw
• chin

I rolled my eyes at the jaw and chin, but did somewhat agree with him on the forehead and nose. Overall it seemed excessive then and it seems even more excessive now to me. Plus, he wanted $42K for everything. No thank you no thank you!

He also rec'd fat transfer to naso folds. I definitely do want to do something about that. Makeup seems to like to fall in the crack and enhance the look of the wrinkle. It looks masculine at times and I don't like it.

C'mon honey, you know this is Dr. O's bread and butter, so he'd love to do all that and probably more as long as your bank account can hold up. I think you look fabulous as is, so let's not get all crazy and carried away. It isn't going to add to your quality of life that much. Once you heal up and get the feeling back in your face you will still be you Jenny and any changes will be minimal and probably insignificant at best.

Quote from: Jennygirl on November 17, 2013, 07:53:22 PM
Thank you girls

Gabrielle, you do know that the photo you quoted is altered, right? Haha

Before / After

It was from google images.  I looked up "female rhinoplasty" to find an example of what I was thinking about.
My own would look something more like this:

Jenny, I would highly, highly recommend getting a virtual FFS assessment done. It costs $50 for a written assessment and then $50 each to have a photo of yourself feminized in photoshop, although you seem to do a good job of that already.

Anyway, the lady that does the assessments is incredibly knowledgeable about the differences between male and female faces and the types of procedures that can be done. And unlike surgeons, she is completely objective in her assessments. That for me was the big thing - it was hard for me to determine what I needed, and I also didn't want to rely on what the surgeons told me since as Shan pointed out they want to make as much money on each surgery as they can.

Quote from: Shantel on November 17, 2013, 08:13:51 PM
C'mon honey, you know this is Dr. O's bread and butter, so he'd love to do all that and probably more as long as your bank account can hold up. I think you look fabulous as is, so let's not get all crazy and carried away. It isn't going to add to your quality of life that much. Once you heal up and get the feeling back in your face you will still be you Jenny and any changes will be minimal and probably insignificant at best.

Me, get carried away? No way, no how!! Seriously thanks though, Shan. Really, I think just a little bit will go a long way and I don't want an aggressive surgeon to ever touch my face- if any at all. Personally I feel that most of the cranio maxillofacial surgeons are quite aggressive with the exception of Dr. Spiegel (from what I've read in the past).

Mayer is also known for taking the path of "less is more" and that's a big reason why I am excited to see him. The best reaction I could get from him is that he won't even offer me a brow procedure- rather opting for a slight change to nose profile instead. He is known for turning people away, and I've got my fingers crossed, but I'm sure my orbitals are a giveaway in most overhead lighting situations and without any eye makeup.

The consult is tomorrow so I'll know soon enough! If he turns me away I will be laying this to rest.. at least until the pangs of dysphoria inevitably return again. That's probably the biggest reason I think I may go for it, I'd love to clear my head of it once and for all.

Quote from: Jennygirl on November 17, 2013, 08:30:43 PM
Me, get carried away? No way, no how!! Seriously thanks though, Shan. Really, I think just a little bit will go a long way and I don't want an aggressive surgeon to ever touch my face- if any at all. Personally I feel that most of the cranio maxillofacial surgeons are quite aggressive with the exception of Dr. Spiegel (from what I've read in the past).

Good point, similar to the mentality regarding makeup use, a little is often better!

Quote from: Jennygirl on November 17, 2013, 08:30:43 PM
Mayer is also known for taking the path of "less is more" and that's a big reason why I am excited to see him. The best reaction I could get from him is that he won't even offer me a brow procedure- rather opting for a slight change to nose profile instead. He is known for turning people away, and I've got my fingers crossed, but I'm sure my orbitals are a giveaway in most overhead lighting situations and without any eye makeup.

Oh how I wish that when I had my upper blepharoplasty done years ago that I had known where I'd be now and had the foresight to get mine radiused.

Quote from: Jennygirl on November 17, 2013, 08:30:43 PM
The consult is tomorrow so I'll know soon enough! If he turns me away I will be laying this to rest.. at least until the pangs of dysphoria inevitably return again. That's probably the biggest reason I think I may go for it, I'd love to clear my head of it once and for all.

I'm not sure it ever really goes away for good, kind of like PTSD, you just learn to manage it by recognizing triggers and sidestep them.

I feel good about this surgeon! I'm now waiting to hear the price. We discussed:

• hairline/brow
• under eye bags
• naso folds

He offered to contour the transition between my brow and nose for free, which should let me avoid messing with the nose altogether and skip that surgery. There's no need to have it done at this point according to him.

For under eye bags, he recommended exactly what I thought- transconjunctival blepharoplasty with fat repositioning.

For nasolabial folds, he said he could use the excised forehead tissue as a graft and fill them in- which in his experience works better than fat as a filler which tends to reabsorb and/or migrate.

This is above and beyond what I expected coming here, and I am super impressed!

Now just waiting to hear the cost!

JennyGirl,

That is excellent news.  Confidence in the surgeon is a must; if you don't have it, things will go poorly.  I'm glad you took the time to talk about everything. 

Curious about the price as well.

Hugs,

Jen

I put my deposit down and I am officially scheduled for FFS with Dr. Mayer on Jan 8th!

The list of procedures and their costs-
Lower eyelid blaspheroplasty - $4,450
Hairline / brow lift & shave / radix graft above nose - $7,000 alone / $6,000 in package
Soft tissue to naso folds - $2,475 alone / $1,500 in package

Total: $11,950.

The excitement has barely surfaced, but it's eeking out little by little. What I do know is that I feel great about this doctor, and I can't even describe how relaxed I am about the whole thing. He is awesome. The price is sooo good too. I can hardly believe it.

Wow,

That's not bad considering all that he is doing.  Thinking....... 

Jen

Another item to check off your list!!! Congrats Jenny! That's a really good price too!

Quote from: Jennygirl on November 18, 2013, 05:58:29 PM
I feel good about this surgeon! I'm now waiting to hear the price. We discussed:

• hairline/brow
• under eye bags
• naso folds

He offered to contour the transition between my brow and nose for free, which should let me avoid messing with the nose altogether and skip that surgery. There's no need to have it done at this point according to him.

For under eye bags, he recommended exactly what I thought- transconjunctival blepharoplasty with fat repositioning.

For nasolabial folds, he said he could use the excised forehead tissue as a graft and fill them in- which in his experience works better than fat as a filler which tends to reabsorb and/or migrate.

This is above and beyond what I expected coming here, and I am super impressed!

Now just waiting to hear the cost!

I am going to have to break out my old copy of Grey's Anatomy to just understand what you are talking about! 

Thanks Sarah! I thought so, too!

Even with the anticipation I am suddenly very relaxed....breathing a huge sigh of relief deep down. The pressure I feel over makeup is numbered in days. I cannot even comprehend what that's going to be like! I haven't stepped foot out of my door without it in over a year.

Quote from: Gabrielle on November 18, 2013, 08:48:55 PM
I am going to have to break out my old copy of Grey's Anatomy to just understand what you are talking about! 

Lol, which part? I'm happy to explain

Congrats Jenny! That's coming up so soon and that's a really fantastic price - especially for a U.S. based surgeon.

Good luck with everything and keep us updated :0

Jenny, you do look great, but I can see what you're after with that photoshop example and I agree. That would make an already beautiful you into a complete knockout!

Good luck!

Thanks Abby and Liz!

I had my reconsultation today with Dr. Mayer. He drew on the photos we took Monday to describe exactly what is going to change. It seems like my initial assessment was pretty close- with the exception that I am not getting a nose job and there is only a slight modification to hairline (the shape rather than height) since I was pretty good to start off with. I am happy

This is what I will probably end up looking look like according to his drawings


I might end up doing a nose job at a later date, but as of now I don't want it! The only big issues I had were brows, nasolabial folds, and eye bags