I had heard somewhere that Dr. Spiegel has experience with some of the techniques used for "tiny face surgery" practiced in Korea. I'm seeing some of these before and afters on these South Korean websites and....holy hell I am impressed. Like, far more impressed than I am seeing any FFS outcomes. (and I've been seeing a few trans patients on their before and afters too and they look just as good) Yes, obviously I'd rather go to an american surgeon like Spiegel because I don't want to get facial surgery with surgeons who are usually only familiar with working on strictly their nationality. But some of the reduction I'm seeing the face size and shape...it's completely radical and while I certainly do not need to have a teeny tiny petite heart shaped anime head (which would look ridiculous on my body anyhow) it certainly shows that a big manly box head outside female ranges could potentially become a slightly bigger looking but still normal sized cis female looking face/head shape, which is what realistically I am aiming for. (I feel to do anything smaller would get pretty risky and dangerous, so I'm trying to be realistic with what I'm working with)

I'm wondering this because I know with having FFS with Spiegel you can be very specific about what you want and he'll do it if it's within his skill set. (he does subtle changes on average for example, but if you say you want him to be more aggressive he will...this is what I've heard)

Quote from: lemons on September 15, 2015, 07:43:51 PM
I had heard somewhere that Dr. Spiegel has experience with some of the techniques used for "tiny face surgery" practiced in Korea. I'm seeing some of these before and afters on these South Korean websites and....holy hell I am impressed. Like, far more impressed than I am seeing any FFS outcomes. (and I've been seeing a few trans patients on their before and afters too and they look just as good) Yes, obviously I'd rather go to an american surgeon like Spiegel because I don't want to get facial surgery with surgeons who are usually only familiar with working on strictly their nationality. But some of the reduction I'm seeing the face size and shape...it's completely radical and while I certainly do not need to have a teeny tiny petite heart shaped anime head (which would look ridiculous on my body anyhow) it certainly shows that a big manly box head outside female ranges could potentially become a slightly bigger looking but still normal sized cis female looking face/head shape, which is what realistically I am aiming for. (I feel to do anything smaller would get pretty risky and dangerous, so I'm trying to be realistic with what I'm working with)

I'm wondering this because I know with having FFS with Spiegel you can be very specific about what you want and he'll do it if it's within his skill set. (he does subtle changes on average for example, but if you say you want him to be more aggressive he will...this is what I've heard)

Be very very careful - - - .   This "Korean Face Surgery" subject keeps bubbling to the surface from time to time. 

To be blunt: most or nearly all of the public "Korean"  face surgery before/after pictures I have seen have been heavily photoshopped.   There was one set posted up in another thread here some time back, and when you looked at those side by side pictures carefully using even crude software measuring tools  - -  the facial landmarks did not even match in the before and after pictures.  You cannot change some of those facial landmarks with surgery!   Thus, it is hard to avoid the conclusion that those pictures were photoshopped.

There is nothing secret or magic about the "techniques" claimed to be used in Korea.  Just a huge amount of marketing hysteria in their local market.  You can find some of those same B/A pictures posted up as giant posters in rail or subway stations in Korea!

Suggestion,  if you want extensive facial work done that involves ANY bone work,  then take your time and do your homework.

Find a craniofacial surgeon.  A real and formally trained craniofacial surgeon (i.e., a  real post-residency training program for a year at a nationally recognized surgical training program - -  not some 30 day or 90 day stop-look-listen program).  Several of the "popular" or often mentioned surgeons around the various TG boards suggest, infer, or claim to be trained as craniofacial surgeons, but were really not, or in some cases, they may have spent 30 or 90 days as a guest in a cranifoacial training program.  Typically that often means they spent their time there standing around in the back of an operating room trying to see what was going on under the lights.

And then find one of those who is also a member of one of the recognized boards of the American Board of Medical Specialties.    The easiest way to check is to go to  www.CertificationMatters.org.   That should let you verify the surgeon  you find is a real board certified plastic surgeon or maybe a head and neck surgeon.  One of those two specialties. 

Then search through your list of those real craniofacial surgeons who are board certified and find one who is also formally trained in jaw surgery  (max/fac or orthognathic training) . 

If you put all three of those critical training and skill sets together in one surgeon - -  then you have someone who has all of the skills required to do the kind of comprehensive facial make-over that you appear to want.

[ From searching around on the net and drilling down very carefully in order to avoid lots of hype and "vanity" "board" certification claims - -  there really are not any of the surgeons in Korea that have an equivalent training level that can be verified. ]

In the western world, there are only a few  surgeons who are verifiably and properly trained  cranifofacial //orthognathic - max-fac // board certified plastic surgeons.  There not many, but there are a few.  When he was active, Dr. Ousterhout was one of them.   In his FFS book, he states that about 1 in 11 of his patients came to him after they had a failed surgery and asked him to attempt to  correct what was done improperly the first time by an inadequately trained  surgeon.   That observation in his book should be a clear caution for everyone to pick our facial surgeons carefully.

So that all being said, would Spiegel still be a good choice to go with?

I can tell which are photoshopped in the pictures but some look great and unphotoshopped so it's hard to tell....

He did come up on that Board Certified list (which I figured he would) under Otolaryngology.

Like, obviously i don't need my head to be a tiny tiny little anime Korean face.  Fine.  But...my head and face are pretty harsh looking and super bony and masculine, so I worry if the FFs done on me would even be enough.  Because looking at other FFS results, I really don't think it would...

How photoshopped do you think these are?

Quote from: myfairlady49 on September 15, 2015, 09:47:46 PM
Be very very careful - - - .   This "Korean Face Surgery" subject keeps bubbling to the surface from time to time. 

To be blunt: most or nearly all of the public "Korean"  face surgery before/after pictures I have seen have been heavily photoshopped.   There was one set posted up in another thread here some time back, and when you looked at those side by side pictures carefully using even crude software measuring tools  - -  the facial landmarks did not even match in the before and after pictures.  You cannot change some of those facial landmarks with surgery!   Thus, it is hard to avoid the conclusion that those pictures were photoshopped.

There is nothing secret or magic about the "techniques" claimed to be used in Korea.  Just a huge amount of marketing hysteria in their local market.  You can find some of those same B/A pictures posted up as giant posters in rail or subway stations in Korea!

Suggestion,  if you want extensive facial work done that involves ANY bone work,  then take your time and do your homework.

Find a craniofacial surgeon.  A real and formally trained craniofacial surgeon (i.e., a  real post-residency training program for a year at a nationally recognized surgical training program - -  not some 30 day or 90 day stop-look-listen program).  Several of the "popular" or often mentioned surgeons around the various TG boards suggest, infer, or claim to be trained as craniofacial surgeons, but were really not, or in some cases, they may have spent 30 or 90 days as a guest in a cranifoacial training program.  Typically that often means they spent their time there standing around in the back of an operating room trying to see what was going on under the lights.

And then find one of those who is also a member of one of the recognized boards of the American Board of Medical Specialties.    The easiest way to check is to go to  www.CertificationMatters.org.   That should let you verify the surgeon  you find is a real board certified plastic surgeon or maybe a head and neck surgeon.  One of those two specialties. 

Then search through your list of those real craniofacial surgeons who are board certified and find one who is also formally trained in jaw surgery  (max/fac or orthognathic training) . 

If you put all three of those critical training and skill sets together in one surgeon - -  then you have someone who has all of the skills required to do the kind of comprehensive facial make-over that you appear to want.

[ From searching around on the net and drilling down very carefully in order to avoid lots of hype and "vanity" "board" certification claims - -  there really are not any of the surgeons in Korea that have an equivalent training level that can be verified. ]

In the western world, there are only a few  surgeons who are verifiably and properly trained  cranifofacial //orthognathic - max-fac // board certified plastic surgeons.  There not many, but there are a few.  When he was active, Dr. Ousterhout was one of them.   In his FFS book, he states that about 1 in 11 of his patients came to him after they had a failed surgery and asked him to attempt to  correct what was done improperly the first time by an inadequately trained  surgeon.   That observation in his book should be a clear caution for everyone to pick our facial surgeons carefully.

Don't really see anyone that is formally trained in those two areas, craniofacially and orthognathic.... ya technically Dechamps-braly but theres no way to determine if his credentials are just those "stop and see" kind, and they most likely are because the places he received such "training" were in other countries so hed have to jump through a bunch of hoops to even touch a patient there (like national board regulations and exams), rather than just watch.

So there isn't anyone who does FFS who is FORMALLY trained in those areas.  If you know some why be vague about it... just write their names.  Is this some forum quirk here where no one mentions anyone's names even though that is the most important piece of information...?

That's what I'd like to know.  Obviously feel free to PM if you want information to be private.

Any experienced FFS-surgeon including Dr.Spiegel can do the bonework as in the pictures. It all depends on how much you have to work with and how agressive you instruct the surgeon to be. However I think you have a higher risk on having nerve damage if you remove as much bone as in these examples.

Quote from: SamSparks on September 16, 2015, 08:31:45 PM

So there isn't anyone who does FFS who is FORMALLY trained in those areas.  If you know some why be vague about it... just write their names.  Is this some forum quirk here where no one mentions anyone's names even though that is the most important piece of information...?

Well, with the internet, and a little effort, everyone can be their own judge of the training and background.   From his book, Dr. O was formally trained in max/fac/orthognathic, and then went to Paris and trained in craniofacial surgery under the guy who invented craniofacial surgery.  That appears to have worked out pretty well,  since Dr. O  ended up as the chairman of the department of plastic and craniofacial surgery at UC San Francisco. 

So, a few  decades later, Dr. O decides to find a successor for his practice.   What does he do?  He finds a younger guy to take over his FFS practice.  From a quick look at the web site, that younger guy was formally trained for a year in craniofacial surgery at one of the few academically accredited programs here in the U.S. (Children's hospital in Wisconsin)  But that guy also then went back to Paris for still more craniofacial training and then to Zurich for orthognathic jaw surgery training at the hospital where most of that was invented. He is also board certified by the real plastic surgery board.

So I think those are pretty much facts.  I guess it could all be smoke and mirrors.  But it looks pretty solid.

There are a few others similarly trained.  In an earlier thread on this board, someone found one or two others.  And there are also,  from the reports,  still other surgeons with only part of that training that get pretty good results.

But the OP asked for help.   What is the alternative to suggesting to her that she try to find surgeons well trained in the relevant skill areas - - ?  Is the alternative to suggest to her that she try to find a surgeon who is  not ?   That does not sound like a good alternative to recommend.

Quote from: myfairlady49 on September 17, 2015, 10:01:27 AM
Well, with the internet, and a little effort, everyone can be their own judge of the training and background.   From his book, Dr. O was formally trained in max/fac/orthognathic, and then went to Paris and trained in craniofacial surgery under the guy who invented craniofacial surgery.  That appears to have worked out pretty well,  since Dr. O  ended up as the chairman of the department of plastic and craniofacial surgery at UC San Francisco. 

So, a few  decades later, Dr. O decides to find a successor for his practice.   What does he do?  He finds a younger guy to take over his FFS practice.  From a quick look at the web site, that younger guy was formally trained for a year in craniofacial surgery at one of the few academically accredited programs here in the U.S. (Children's hospital in Wisconsin)  But that guy also then went back to Paris for still more craniofacial training and then to Zurich for orthognathic jaw surgery training at the hospital where most of that was invented. He is also board certified by the real plastic surgery board.

So I think those are pretty much facts.  I guess it could all be smoke and mirrors.  But it looks pretty solid.

There are a few others similarly trained.  In an earlier thread on this board, someone found one or two others.  And there are also,  from the reports,  still other surgeons with only part of that training that get pretty good results.

But the OP asked for help.   What is the alternative to suggesting to her that she try to find surgeons well trained in the relevant skill areas - - ?  Is the alternative to suggest to her that she try to find a surgeon who is  not ?   That does not sound like a good alternative to recommend.

What I was alluding to in my post was that his training in Zurich and Europe in general was most likely observational in nature only.  He were to practice in Europe he would have to be certified as a surgeon in those countries.  They don't just let random American doctors come over to for example Switzerland and start performing or assisting in surgeries in Switzerland unless said American went through formal channels to be certified as a surgeon in those countries.  Same would apply for a European wanting to practice in the U.S.

I totally agree those skill sets are the best for what ts people need, I just don't think anyone really has FORMAL training in those two areas, as in full separate specialty residencies with craniofacial and maxillofacial surgeries.  Like for example it seems Dr. O took a while to get his craniofacial skills really down but was always strong in the mandible department, which makes sense considering that he was primarily maxillofacial specialist before adding on craniofacial knowledge.  However there are many formally trained craniofacial ffs surgeons, however their mandible training seems to be a more informal practice as you go approach, which is disappointing.  The problem with DechampsBraly is that for one, hes young therefore by definition has less experience than most other surgeons right now, and number two, his fancy pedigree, while impressive, is hard to verify because of point number one and the lack of before and afters.  Yes its nice that he has all 3 pieces of notary but without results how can you know how much those are worth?  I suppose you could ask him in the consultation about his background, I wonder how that would go.

I could be wrong, if anything Iv written here is wrong please correct me I wouldn't want to give out bad information.

Rossi in Buenos Aires seems to be a specialist in the mandible. Only problem is we don't have a lot of patient pictures to judge.