Hi all!  I'm hoping y'all can give me some advice.  I'm scheduled with Dr. Mayer in a couple weeks.  As part of the pre-op tests, I had a lateral skull x-ray today.  I was given a disc with the image on it, and of course I had to take a peek!  My stomach dropped when I saw how gargantuan my frontal sinus cavity is...and how thin the frontal bone is.   My understanding is that Mayer doesn't perform type three reconstruction.  I'm thinking that if I want the least embossed, most natural brow possible, I'd need a type 3?  That the Mayer type won't cut it(no pun intended!)?  I'd love to hear your opinions.  I'm considering canceling with Mayer and going with Spiegel, since I've heard he does type 3 and he accepts Carecredit(which is part of my funds for this venture).  I know I could probably ask for a "dolphin forehead", but I want to get rid of the overhang as much as possible.  Thank y'all in advance!

In your shoes I would have a talk with Dr Mayer and Dr Spiegel to see what both would do given that information. You may need to switch doctors to get what you are after but with the images in hand, both should be able to tell you what they would do with your face.

Mayer isn't able to look at the x-ray until after the holiday weekend.

Spiegel, on the other hand, spoke with me on the phone today!  XD  I was blown away by the service - I sent the request for a consult with my xray attached, and his office called within half an hour!  And they put me on the phone with him!!  He said 95-97% of cases require type III reconstruction over the frontal sinus. :/  He also mentioned it would be dangerous for me to undergo burring - obviously, due to the how thin my bone appears and how that contributes to the risk of a break through.  When I measured the bone thickness using the software tool on the CD given to me by the imaging tech, it came out to .2 CM.  There's only 2mm to work with there...and that is likely at it's THICKEST. :/

With how quickly Spiegel, himself, got me on the phone and with what he said, I have decided to cancel with Mayer.  I am waiting to see the quote from Spiegel.  I hope I have enough to cover the forehead, hairline, nose, and lipo under my neck/jawline.  Those are the things that cause me the most grief when I look at my face.  My chin would be nice to contour a bit, and adding some volume to my upper lip would be great, but I consider those vanity mods.

Thank you for sharing your opinion, Dena!  Btw, I like your new profile pic.

I have extensively researched ffs
I hope you have not paid yet
Those two are great for girls who started early
Like early adult or late teens amd dont have type 3

They do a shave and fill amd that can make you even
Worse
Think about it
Shave it thin but build back up with concrete

Imo if you have that much to spend look
At facial team or t-change

You qant it done right once
Not in the end spending 40k when
Spend half once

Read the virtual ffs web site to confirm
My input 

Quote from: Cadence Jean on September 04, 2015, 11:09:53 AM
Thank you for sharing your opinion, Dena!  Btw, I like your new profile pic.

Your welcome. As for my picture, I didn't realize how good I looked 30 years ago. I have been good with sun block so my skin hasn't aged much but there are a few more wrinkles and the hormones caused my cheek bones to develop a bit. I am in the process of growing a new hair cut and will take another picture in a few months that won't be quite so hot but it will be a more up to date.

Also the only work I had done was the nose, adams apple, SRS and naturally the voice.

If I was you I would not go to Mayer for forehead work simply because you are right in thinking that your sinus is large.. and thin.  So you should go to a surgeon who can set it back through reconstruction rather than simply shaving.

I've come around to the idea there is no one "best" overall surgeon, it just comes down to each one's particular aesthetic sense and skillset being best suited for patients' within a particular range of needs.

Mayer is incredible with soft tissue and does amazing suture work, and he's also very good at not going overboard and keeping a face within a harmonious and natural range. But he doesn't do type 3, so he isn't the best choice for people needing that or super aggressive work in general. If you need at most a moderate amount of work, I think he's a great choice. For serious work, you may want to go to someone more aggressive on the bone work.

Looking at that xray I'd say ya, you def need a type 3 surgeon as that's pretty dramatic. I probably technically needed one, but I decided I didn't want one and was happy with what he was able to do for me with a type 1 as my sinus was much smaller and thicker.

Modest suggestion:  Consider that only a formally trained cranio-facial surgeon has the proper training and experience to deal with that unusual bone structure shown in the x-ray you posted up. 

The other surgeons that claim to do that type of work - - sometimes really do not,  when all is said and done.  And if they do,  they are doing that work without the formal training and supervision that is required to be a cranio-facial surgeon. 

Also,  if there is a complication during your surgery - - a surgeon - - other than a cranio-facial surgeon - - will likely have to stop and find one to help deal with the problem. 

Thank you all! I have decided to go with Dr. Javier Rossi at Tchange. His pricing is incredible right now, pictures on his site and here have been stellar, and Amanda has been simply incredible and accommodating to work with over email. I have been own away by Amanda's customer service! It will also be nice to take a few week vacation in South America. I have never been out of North America before, so this should be exciting!

Great choice Cadence!

Maybe you've seen my thread below on Dr. Rossi. I went to him and Amanda for the same reason: Great customer service, price, and amazing before/afters. I hope I'm not being redundant but your x-ray picture made me want to compare mine with yours. Basically, I think you're forehead is going be very different and flat. However, I do want to say that you look great already, especially from the front.

X-ray just like yours (had some trouble posting the picture directly):

http://postimg.org/image/fvblgpc0z

New and most recent before/afters

http://postimg.org/image/zeg6q2asj

He's real good. However I do just want to mention that Dr. Mayer is a fantastic surgeon and has been crucial in the field of plastic surgery/ffs. He's the surgeon who developed the trychophytic incision method that Dr. Rossi also uses so hair can grow through the coronal incision. Considering your hairline is nice and low already, I'm sure he'll do that and the scar will be practically invisible like mine.

There's no way his prices will be this cheap in the future. He's a good as any other surgeon pretty much. Also I hope you enjoy Buenos Aires. I fell in love with the city and decided to rent an apartment for an entire month so I could heal and have an adventure

Best of luck with everything,

- Ruby

Thanks, Ruby! Our x-ray sinus cavities could be twins! Lol Your after profile looks great. I hope my results are just as good. Have you noticed a change in your vocal resonance with the smaller sinus cavity? Or any changes with allergies or congestion?

I'm going with the hair transplant option. Amanda said that he would not be able to completely feminize my hairline due to how he'd make the incision to hide a lot of it behind the hair in front, etc. I figured the transplants will guarantee no scar, which is great because I plan on wearing my hair combed back for a while.

Cadence-

That's what I did, get hair transplants probably from the same doctor you will get them from, Dr. Bruno Szyferman. I got 1400 grafts, most with 2-3 hairs. I'm extremely happy with how he recreated a new feminine hairline. It's really starting to grow in at 3 months. You're going to love it, I promise. The price is amazing as well.

As for a difference in resonance because of a smaller sinus cavity, well no unfortunately. But I did notice that I have fewer issues with my sinuses for some reason, maybe less room for the bacteria to grow, I don't know. Something changed and I don't have nearly as much problem with sinus pressure like I used to.

If you have any questions, please don't hesitate to pm me. Again congrats on finalizing a doctor.

- Ruby

Quote from: Cadence Jean on September 10, 2015, 02:23:41 PM
Thanks, Ruby! Our x-ray sinus cavities could be twins! Lol Your after profile looks great. I hope my results are just as good. Have you noticed a change in your vocal resonance with the smaller sinus cavity? Or any changes with allergies or congestion?

Y'all are Xray twins.  In several weeks we will find out if there are triplets.  :-)
I asked several FFS surgeons about effect on sinus issues, they indicated there is no direct improvement.  Amanda did state you have to be clear of any sinus infections, or the surgery would be postponed.

Quote from: Cadence Jean on September 10, 2015, 02:23:41 PM
I'm going with the hair transplant option. Amanda said that he would not be able to completely feminize my hairline due to how he'd make the incision to hide a lot of it behind the hair in front, etc. I figured the transplants will guarantee no scar, which is great because I plan on wearing my hair combed back for a while.

Are you going with the hair transplant at time of FFS surgery?  Amanda said that was an option they are looking into.  Because of the number of procedures I'm having, bone and soft tissue work, that option is not available to me.  I've planned an extended stay in BA, to let the swelling subside enough to get FUE with Dr. Bruno Szyferman.

Yep, I'm going with the hair transplants. I'm taking the option where they cut the strip off. No way will I let someone shave the back of my head to the skin! Amanda said that the hair transplant will happen at a different time, at Dr.Szyferman 's office. Probably two or three days after my ffs with Rossi.

Did I mention that I am now booked for October 28th? XD

Hi Cadence,

     Congrats on the date, coming up soon! How long are you staying in Buenos Aires? I'm asking because 2-3 days after the FFS seems a bit too soon in my opinion because of forehead swelling. I waited two weeks to get mine and there was a tiny section where there was more swelling and I lost some transplants because of it. Just a thought. Dr. Syzferman will have the last word on this.

     Another issue is that you're might want to wait for the coronal incision to fuse better before doing an FUT incision in the back. That might create extra unwanted scalp tension. Dr. Rossi will remove the staples in your head 10-14 days and after that would be a better time. Finally, I went with the FUT incision. Bruno is amazing with the incision, it will invisible, but the first few days after it will be very bothersome, painful, inchy, and sensitive. FFS is already painful enough, adding that would be enough to drive someone crazy Just my two cents for what it's worth.

     I'm going to update my thread on my transplants. I wasn't terribly happy with my hairline after ffs and being unhappy, I made the quick to get transplants 5 days before I left Buenos Aires. I made the decision and only two days later I was under the knife again lol Bruno was so talented and sweet as a person that I basically told Amanda he would be a perfect fit for t-change. (since the team is already talented). Not only that but his prices are the most competitive I've even seen. I guess my good experience/results were persuasive enough to convince Amanda to make him part of the team For many of us, hair transplants are indispensable part of facial feminization. I don't think a hairline incision could create the precise, customizable, and natural-looking hairline made possible by transplants. And no scar!

    Congrats again and well wishes to deeiche who will be leaving in a few short weeks! Here's to the sinus triplets

- Ruby

   

Ruby

I am going with FUE ( follicular unit extraction) method as I don't want another incision, and don't mind close cropped (fuzzy :-) )hair.   

deeiche,

   Oh yes, my mistake, I fixed that. Got them confused Both of you say hi to Amanda for me!

Certainly will! I'll be staying in Buenos Aires for twenty days. Amanda suggested waiting until the last week to go to Dr. Zsyferman (sp) for the transplants. Is Bruno the doctor she mentioned? I'll be staying at Leandro's apartment. Five hundred for twenty days, with a full kitchen, seemed like a good deal to me. what's been on my mind lately is more about my safety. I brought it up to Amanda, and she mentioned that I don't have to worry about violence, but I should be careful about pick pockets. I guess I'll be buying a fanny pack! Lol any suggestions on how to carry money? I've heard cash is best, and yet that scares me to be walking around with that much money, or even leaving cash in the apartment.

Quote from: Cadence Jean on September 14, 2015, 06:43:47 PM
Certainly will! I'll be staying in Buenos Aires for twenty days. Amanda suggested waiting until the last week to go to Dr. Zsyferman (sp) for the transplants. Is Bruno the doctor she mentioned? I'll be staying at Leandro's apartment. Five hundred for twenty days, with a full kitchen, seemed like a good deal to me. what's been on my mind lately is more about my safety. I brought it up to Amanda, and she mentioned that I don't have to worry about violence, but I should be careful about pick pockets. I guess I'll be buying a fanny pack! Lol any suggestions on how to carry money? I've heard cash is best, and yet that scares me to be walking around with that much money, or even leaving cash in the apartment.

Yes, Dr.Bruno Szyferman, you can find his website by google searrch for "dr bruno szyferman buenos aires hair transplants".  It is in Spanish, but Google Translate is your friend.

Well, I'm writing this at the dining room table in Leandro's apartment, it is nice.  I reserved it for almost 4 weeks, though I hope to move my return flight up.  The neighborhood is older, we walked around a bit this afternoon.  There are lots of cafe / restaurants.  We also went to a mall ( door man opening up the entrance door), stores seem upscale.  I'm not a mally so I don't have much to compare to.  Amanda mentioned pickpockets too, I purchased a money belt you wear around your wait under your clothes, it kind of gives you a poochy belly look.  But I'll take safety with my cash over looks any day.