Hi, I've had type 3 forehead reconstruction & a lip lift, but not with Dr. Z or Spiegel. Forehead remodeling makes a lot of difference, as the forehead is a major gender cue; I saw one of the pictures you posted with a side view, and I think that you may benefit a lot from this procedure. The lip lift helps to feminize the lower face, and even though it's not a major procedure, it has a significant impact.