Ok,
I have a huge range in my voice.. if I could sing I would be great but I don't have the gift.
Anyway, I am on the higher side of pitch but not to female level..
I am in sales and my voice is driving me crazy and I have tried.. I want something done so that I can more easily get to the female range without as much effort..  Some say I sound female.. but on the phone I am sired every time.
So I am chosen a CTA surgeon in Bangkok because I can get done while I am there.  She is good from what I know..
Advise?? 
I know there are risks but havent they become much less with the more experienced procedures these days?
Keri

You really should check out carefully the surgeon who does that.
The reason why voice surgery is just gradually and in some cases becoming an option these days is not that overall the techniques have improved that much - they are still essentially very similar to the old ones, but because SOME surgeons now have more skill and can do better surgeries. They also may apply some newer techniques to get this done. But by no means this translates into ALL surgeons now being better or having access or interest in those techniques - and by no means it translates into all surgeons having the skill.

I could have gotten my voice surgery on NHS for basically free , but I decided against it because the surgeons in Germany doing either CTA or glottoplasty often produce extremely hoarse or fake sounding voices. And this is a very highly industrialized country.

So I think you really should check to get the best surgeon to do this and not out of convenience choose someone who happens to be close by, cheaper or covered by insurance unless he also happens to be one of the worlds best

Also I hope you have compared and considered the different types of voice surgery. CTA will for sure minimize your big vocal range that you seem to be a bit proud of (can I ask what your range is?). Is that ok for you? Is there an advantage CTA has for you over glottoplasty or a combination or other methods?

Greetings

Quote from: anjaq on November 09, 2015, 11:47:06 AM
You really should check out carefully the surgeon who does that.
The reason why voice surgery is just gradually and in some cases becoming an option these days is not that overall the techniques have improved that much - they are still essentially very similar to the old ones, but because SOME surgeons now have more skill and can do better surgeries. They also may apply some newer techniques to get this done. But by no means this translates into ALL surgeons now being better or having access or interest in those techniques - and by no means it translates into all surgeons having the skill.

I could have gotten my voice surgery on NHS for basically free , but I decided against it because the surgeons in Germany doing either CTA or glottoplasty often produce extremely hoarse or fake sounding voices. And this is a very highly industrialized country.

So I think you really should check to get the best surgeon to do this and not out of convenience choose someone who happens to be close by, cheaper or covered by insurance unless he also happens to be one of the worlds best

Also I hope you have compared and considered the different types of voice surgery. CTA will for sure minimize your big vocal range that you seem to be a bit proud of (can I ask what your range is?). Is that ok for you? Is there an advantage CTA has for you over glottoplasty or a combination or other methods?

Greetings

The voice surgery costs 140,000 Thai Baht which if you exchange the money in Thailand is currently about US$4000. I have to ask Naeree to book this for me due to there being a 10,000 baht deposit and until I can go to Bangkok I don't have a Thai Bank account. The remaining 130,000 baht is paid locally when you arrive at Yanhee Hospital in Bangkok on the day of Surgery. The surgery requires a 2 night stay in hospital, 7 days without talking and a 2 week stay in Thailand in total, Your fee of 140,000 baht will include transportation from your hotel to the hospital before the surgery and back to your hotel after surgery, Also transportation to and from your post op consultation in the 2nd week of recovery.

This is the Dr. I would be using.. see below..
Keri

Dr. Ornouma, an otorhinolaryngologist, and a Fellow in the College of Otolaryngology, Head and Neck Surgery in Thailand, a graduate of the College of Medicine in Mahidol University, who has completed her Fellowship in Laryngology at Portland Oregon, USA,  heads  the ENT (Ears, Nose, Throat) Department of Yanhee International Hospital, where she has been performing her specialty surgeries for 10 years now, 500 of which are voice change surgeries, 300 "anti- snore" surgeries, 200 sinus surgeries, and other surgeries involving the ears, nose, and throat.

As far as range I don't mind losing some range especially the lower range.. 

Sounds like she's quite experienced!

Before the surgery, I was concerned about having extreme hoarseness and a minnie mouse voice if I have the surgery, and thankfully I have none of those after the surgery. 

Why not glottoplasty? Dr Haben can do both Glottoplasty and CTA and he's located in the USA and a lot of girls get good results from him.

You're looking at around $7000 for both and a bit over $5000 just for the glottoplasty.

Those of us who go to Yeson in Korea only get glottoplasty because that's all they really offer for trans patients. But that involves travel to Korea.

The nice thing about glottoplasty is that there is no scar and you still have control of your pitch better than a CTA. With the CTA you get a scar on your neck.

Quote from: iKate on November 09, 2015, 02:22:04 PM
Why not glottoplasty? Dr Haben can do both Glottoplasty and CTA and he's located in the USA and a lot of girls get good results from him.

You're looking at around $7000 for both and a bit over $5000 just for the glottoplasty.

Those of us who go to Yeson in Korea only get glottoplasty because that's all they really offer for trans patients. But that involves travel to Korea.

The nice thing about glottoplasty is that there is no scar and you still have control of your pitch better than a CTA. With the CTA you get a scar on your neck.

Thanks Icate.. I will look into Haben.. more money by quite a bit but sounds like he is popular on Susans.
Keri

Quote from: Keri - formerly known as Dodie on November 09, 2015, 12:22:18 PM
The voice surgery costs ......

Forget costs - this is your voice, your life, something to keep for many decades to come - don't think about money when it comes to this. Its not a new car or smartphone!

QuoteThe surgery requires a 2 night stay in hospital

That sounds too long. There is no need to stay in hospital more than a night and that is only because you have that cut at the throat that needs to be properly stitched up and desinfected, IMO
In Germany they keep you in for a week! just to make more money...

QuoteDr. Ornouma, an otorhinolaryngologist, and a Fellow in the College of Otolaryngology, Head and Neck Surgery in Thailand, a graduate of the College of Medicine in Mahidol University, who has completed her Fellowship in Laryngology at Portland Oregon, USA,  heads  the ENT (Ears, Nose, Throat) Department of Yanhee International Hospital, where she has been performing her specialty surgeries for 10 years now, 500 of which are voice change surgeries

That does not sound too bad regarding the data. 500 CTA surgeries is quite good, but this surgery is in some ways "easy" - the obstacles seem to be to make it in a way that it lasts and the voice does not come down after some months or years and to make it symmetric, so there is no dysphonia and to hide the scar well. Sadly a scar directly at the larynx as from some adams apple removal surgeries has become a "tell" for trans women since people are aware of this sort of surgeries.
It would be interesting to know if that Dr has anything to do with Dr Thomas who is also in Portland and one of the world class voice surgeons. If so, she may have learned a lot of good things there and Dr Thomas may be able to comment on the quality of her work.

In any case, credentials are not everything - it is vital to speak with - or read reports from people who had the surgery there and listen to audio samples. I would never have such a surgery based on money and credentials of a surgeon alone. Prof Nawka in Berlin is  a Professor in this field, he did several hundred of voice surgeries already but still he has only a 30% success rate going by the judgement of the patients. So credentials are not everyting...

QuoteAs far as range I don't mind losing some range especially the lower range..

With CTA you will definitely loose at both ends. Consider this - now you have two muscles that can create pitch change in your voice - after CTA you have only one of them left. The vocal range thus is limited - its like the mobility of your arm would be lessened significantly if one was to fuse the ellbow.

Quote from: iKate on November 09, 2015, 02:22:04 PM
Why not glottoplasty? Dr Haben can do both Glottoplasty and CTA and he's located in the USA and a lot of girls get good results from him.

You're looking at around $7000 for both and a bit over $5000 just for the glottoplasty.

Well of course glottoplasty has its own drawbacks. Intubation in further surgeries and emergencies are a problem, if glottoplasty is done without extreme precision and care, it can easily lead to hoarseness and a bad voice, sometimes the increase in pitch is not enough, the rest period is longer than with CTA, the voice break is not gone. So one really has to consider all the pros and cons of these surgeries.

QuoteThose of us who go to Yeson in Korea only get glottoplasty because that's all they really offer for trans patients. But that involves travel to Korea.

I think that is partly true. But in part it is also that Dr Kim thinks CTA is a bad idea - thats why he does not do it even if I am sure he could do that well, too. And many of those going there think the same , that is why they go there and not get CTA or a combination elsewhere.

Here is Dr Kims comparison table of the voice surgery techniques available:
http://www.yesonvc.net/disease/feminization_surgery_04.asp

Omg.. Anjaq,
I want to say thanks but the way you describe this is almost as if there is no benefit to the surgery.. If I went by what you have said alone.. I would never do it.
You do have good info, however you make the surgery seem unlikely to help.  At least I read it that it is unlikely to help..

The truth is.. I need all the extra help I can get.. I am surprised you even had the surgery.
I want a higher pitch.. so that the rest will be easier.. I don't need much..

What I am doing is talking to Haben and Thomas.
I did not need a trach shave.. no visible adams apple.. I know.. its weird...

You make it seem even scarier because I have no scar at the adams apple so should I not do CTA..

As for money, I do my research as I am now.. and I went with Dr. Zukowski which was 30,000 less for FFS than Spiegle and well you see my results.. stunning..   so money is important but also I agree the procedure is most important.
Keri

Quote from: anjaq on November 10, 2015, 03:06:45 AM
Forget costs - this is your voice, your life, something to keep for many decades to come - don't think about money when it comes to this. Its not a new car or smartphone!
That sounds too long. There is no need to stay in hospital more than a night and that is only because you have that cut at the throat that needs to be properly stitched up and desinfected, IMO
In Germany they keep you in for a week! just to make more money...
That does not sound too bad regarding the data. 500 CTA surgeries is quite good, but this surgery is in some ways "easy" - the obstacles seem to be to make it in a way that it lasts and the voice does not come down after some months or years and to make it symmetric, so there is no dysphonia and to hide the scar well. Sadly a scar directly at the larynx as from some adams apple removal surgeries has become a "tell" for trans women since people are aware of this sort of surgeries.
It would be interesting to know if that Dr has anything to do with Dr Thomas who is also in Portland and one of the world class voice surgeons. If so, she may have learned a lot of good things there and Dr Thomas may be able to comment on the quality of her work.

In any case, credentials are not everything - it is vital to speak with - or read reports from people who had the surgery there and listen to audio samples. I would never have such a surgery based on money and credentials of a surgeon alone. Prof Nawka in Berlin is  a Professor in this field, he did several hundred of voice surgeries already but still he has only a 30% success rate going by the judgement of the patients. So credentials are not everyting...
With CTA you will definitely loose at both ends. Consider this - now you have two muscles that can create pitch change in your voice - after CTA you have only one of them left. The vocal range thus is limited - its like the mobility of your arm would be lessened significantly if one was to fuse the ellbow.

Well of course glottoplasty has its own drawbacks. Intubation in further surgeries and emergencies are a problem, if glottoplasty is done without extreme precision and care, it can easily lead to hoarseness and a bad voice, sometimes the increase in pitch is not enough, the rest period is longer than with CTA, the voice break is not gone. So one really has to consider all the pros and cons of these surgeries.
I think that is partly true. But in part it is also that Dr Kim thinks CTA is a bad idea - thats why he does not do it even if I am sure he could do that well, too. And many of those going there think the same , that is why they go there and not get CTA or a combination elsewhere.

Here is Dr Kims comparison table of the voice surgery techniques available:
http://www.yesonvc.net/disease/feminization_surgery_04.asp

Quote from: Keri - formerly known as Dodie on November 10, 2015, 01:34:14 PM
Omg.. Anjaq,
I want to say thanks but the way you describe this is almost as if there is no benefit to the surgery.. If I went by what you have said alone.. I would never do it.
You do have good info, however you make the surgery seem unlikely to help.  At least I read it that it is unlikely to help..

The truth is.. I need all the extra help I can get.. I am surprised you even had the surgery.
I want a higher pitch.. so that the rest will be easier.. I don't need much..

What I am doing is talking to Haben and Thomas.
I did not need a trach shave.. no visible adams apple.. I know.. its weird...

You make it seem even scarier because I have no scar at the adams apple so should I not do CTA..

As for money, I do my research as I am now.. and I went with Dr. Zukowski which was 30,000 less for FFS than Spiegle and well you see my results.. stunning..   so money is important but also I agree the procedure is most important.
Keri

I had people discouraging me from getting the surgery. Anja actually encouraged me a bit.

I didn't listen to the naysayers, and I did it anyway.

Now my voice is more feminine than a lot of cis women. I am almost completely happy with it. I say almost because I want to sing like Mariah Carey...

Nobody - and I mean nobody - clocks me by my voice now. In fact I can't remember the last time I've been clocked for any reason.

Even when I make phone calls and use my male name to fix stuff and change my name, I get "miss" and "ma'am" right off the bat.

On conference calls I have to tell people stop interrupting me because they talk over me.

Even the judge when I went to change my name could not believe I was trans. He was pretty much surprised.

If you think it will make you happy, do it.

Besides, don't wait too long because the older you get the less effective it is.

I am a bit skeptical about Dr Thomas' procedure. He doesn't seem to have as consistent results as Yeson or Dr Haben.

About pitch - don't think that pitch is everything. I have heard women who have had the surgery and they have a really high pitch and sound awful. I have heard those with lower pitch and they sound absolutely fantastic. It is really a hit or miss but no real risk other than minimal change.

The surgery alters more than just pitch. Think of it as a high pass filter. Your lower ranges will be attenuated and your voice will sit at a higher pitch. Ideally your voice will simply shift upwards. A human voice is not a single tone. It is complex and made up of a lot of different sounds. The mix of those determine the color of the voice, whether it is feminine or masculine.

I also do not have a visible adam's apple.

It's also not magic. Some people still need to work at it. I am lucky in that I don't, but I am the exception rather than the rule.

I wish you luck on your decision.

Hi ICate,
Well I am leaning to Dr Thomas now.. only because he will fine tune it later if we do not get the result we want.. which is very exciting.
Also, I like his procedure..
He is the most expensive.. but I do like the idea of no scar.. and he wont do CTA..
So decision made.. think I will send a check and just get it paid and scheduled.
Meantime.. I will work on my voice..
So by next summer.. newer voice GRS done.. Im done.. Yea..
Time to have fun..
I have my first Date in Chicago this month.. I am so excited. and he does not care about the voice issue...
Life is good.. no pain no gain.. I will be so happy to get voice and GRS behind me.. ugh.
Keri

Quote from: Keri - formerly known as Dodie on November 10, 2015, 01:34:14 PM
Omg.. Anjaq,
I want to say thanks but the way you describe this is almost as if there is no benefit to the surgery.. If I went by what you have said alone.. I would never do it.
You do have good info, however you make the surgery seem unlikely to help.  At least I read it that it is unlikely to help..

Haha, I am sorry to be like that, but I want people to go there with realistic expectations. Some people go there and expect a lot of the surgery, but then the surgery cannot provide all that and they are angry, disappointed or frustrated about the procedure, the surgeons,...etc - and that is not really always fair. These procedures do change the voice and if they are done in a good way they can be life changing, or very helpful. But its not magic. One will have to do some things to make use of what was changed.

I had the Yeson surgery over half a year ago and while people tell me that my voice did not change that much compared to my trained voice before - I can now speak the same without using a trained voice, without having to think about it, and I feel the sound is different. And others seem to hear it too, just not people who know me from before - but I was not misgendered because of my voice since the surgery, so it clearly must have changed something significantly. One reason people do not realize the change is probably that I had a rather good female trained voice before - which now has become my normal voice - Lots of things changed for me with that surgery. I feel a big lot more free now and much less scared of being "clocked" or misgendered or asked stupid things - so I have a ton more self confidence thanks to the surgery. So it definitely was a big positive thing for me (y)

And yes -if feminine pitch is a given thanks to surgery, you can concentrate on the other things more easily.

Does Dr Thomas also do glottoplasty alone? I was not sure if he did that or if he usually does his fullscale laryngoplasty

QuoteI did not need a trach shave.. no visible adams apple.. I know.. its weird...

Its not that weird. I never had one either - which is why I liked the glottoplasty because it does not give me a scar that will look as if I had one

CTA is out for me now.. for sure because of scar..
I am going with Dr. Thomas.. I think I can trust he will do the best he can..  The wonderful thing is if we have an issue and not high enough pitch he can do laser at no charge to change that.
So, I will do a lot of documentation for other girls.. videos and all I can to see what happens.
I am all in with Thomas.. in April.. wish me luck..
Keri

Good luck. Thomas is not a popular option here. It would be nice to have a data point.

Thats interesting. Dr Thomas seems to be a really good surgeon.

Just one confusion is happening now IMO: Dr Thomas IMO favours his feminization laryngoplasty which sounds like a risky procedure but an interesting appraoch as it remodels the larynx completely. If this is what you are getting, the scar will be larger than with a CTA for sure. But I guess Dr Thomas also does glottoplasty? Maybe you should explain which option you are taking

When I first started checking out voice surgery about 6 months ago, I looked at Dr Thomas first. The procedure on his web site at the time was a complete reconstruction of the larynx and the voice samples on the his site were mostly so bad that I felt my voice would be better off left alone if that were my only option. I continued looking finding Yeson which I wasn't comfortable with because of the small amount of information on the web site (hadn't looked at youtube) and in the quest for another option, I found Dr Haben and Susan's all in one place. Dr Haben's web site taught me everything I wanted to know about his procedure and the samples on Susan's told me he could deliver. Cost didn't enter into it because I figured I only had one shot at this and it was a question of who I trusted to do the job right. The fact I could get the surgery in this country was somewhat of a consideration because other than short trips to Mexico, I really haven't had much experience as a world traveler.

If Thomas is doing VFS, then he may have changed his procedure in the last few months and that would be interesting to learn about. If I had a badly damaged larynx I would have considered Thomas for reconstruction but I felt reconstruction of the larynx just to bump the pitch might be a bit of overkill. I also didn't contact him for additional information so there is a possibility that some of the information I gathered might be in error.

Well Girls,
You are right.. will have a large scar.. not for me.. I don't need that much pitch help and the examples did not impress me either.. so back to square one.

I am going to find a speech therapist and work on my voice.. and if that does not work by end of next year will look into surgery.. 

I can now see why some go to Yesson.. since the surgery does not create a scar...
So much appreciate your help..
Keri

Dr Haben can do it without a scar too, if he does no CTA. Dr Thomas also does some sort of Laser tuning, which can be good if you do not need much pitch change, just want a little bump. Prof Remarcle in Luxembourg also does a glottoplasty without leaving a scar, similar to Dr Haben. He also does a more effective version of the laser tuning, giving you a bit of a bigger bump with that (also no visible scar). And of coourse there is always Dr Kim at Yeson who does it without scar and with using a slightly modified procedure and permanent threads to give more stability.

I agree it's best not to have the scar but I had my adams apple shaved 35 years go and nobody notices the scar as it's only a faint white line. I could cover it with makeup but there is no need to do so. Modern surgery has ended the big ugly scars of the past. As for my surgery, Dr Haben gave me a huge boost in pitch and did it all through the mouth. No new cuts on my neck.

Quote from: Keri - formerly known as Dodie on November 12, 2015, 02:18:29 PM

I can now see why some go to Yesson.. since the surgery does not create a scar...
So much appreciate your help..
Keri

That's only one of the things. We went because the surgery is proven to work. Same with Dr Haben and Prof Marc Remacle.

To get invisible scars takes several things: luck, a body that scars without ugliness, a skilled surgeon and great aftercare. I have seen people having had a trach shave in the past couple of years and that scar is a bigger mark than the adams apple before, IMO. I personally would not want to risk it, as I can see with other scars on my body, that this is not pretty. the only scars that are really nice are from GRS, but that is a part of the body that always heals more nicely.