Hi! I have had FFS with Dr Spiegel and am very happy. I had just two procedures with him, but I think they were key. I also had FFS with Dr Leis at a latter date. The reason why I had them at different times and different doctors was finances. I submitted my photos to Dr. Spiegel, as well as to a number of other FFS surgeons in the US and abroad. Some recommended pretty much everything, others just certain procedures. Dr. Spiegel was one that recommended just what I needed, but gave me options. In my mind I already kind of knew the procedures I absolutely needed for my goal, which was to pass visually. I am of the average height and stature of other females, so at the beginning of my transition, after being on hormones for awhile, my first priority was ffs. And I did alot of research and contacted many ffs Doctors. I narrowed them down to the ones that didn't necessarily recommend rhinoplasy or jaw or chin work, to pass more as female. Everyone is different and requires what is right for them. To make it short, the procedures I absolutely required were upper face (brow bone/ orbital rim reduction, scalp advance and brow lift), the most important of them all, and an upper lip lift. Just those two procedures. I first had the upper lip lift, and cheek implants with Dr Spiegel. I didn't have the finances to do it all at once. And with those procedures, I chose to do them under local anesthesia, in Dr. Spiegels office, with no other sedation. I chose this to reduce costs, but am glad I did because I had no anesthesia sickness after and recovered quickly. But it all depends on you, and your tolerance. The most uncomfortable part was the initial injection of the local anesthesia, and after that I didn't have any pain while the surgery was done.
That alone was enough for me pass. I am very happy I also had the cheek implants, which is what moved me from "passable" to "pretty".
The procedure I had with Dr Leis (brow bone/scalp advance) was also critical. No one takes me as male anymore (that doesn't know I am trans). No one who sees me ever takes me as anything but female.
So yes, just do what you need. And not follow the "cookie cutter" approach.
I should be able to post photos here on site soon so you will be able to see.
Brenna