So as to my knowledge, the following differences are as below:

Dr. Haben/Remacle

1. Dissolvable suture
2. Laser involved
3. Less recovery time

Dr. Kim

1, Permanent suture
2. Microscapels
3. Longer recovery time

Can you guys tell me why you chose one over the other aside from transport/costs?

I feel a bit wary of having something permanent lodged in my throat after surgery - does it cause foreign bodily sensations?

At the same time, having lasers involved seem a bit damaging to sensitive skin tissues in the vocal cord area no?

So confused, but wish to make a confirmation soon.

Has anyone regretted surgery with either?

Thanks xxx

Hi.

I chose Dr Kim because
* at the time I did not know of Dr Haben or Prof Remarcle
* I heard several really good results
* I compared with German surgeons who basically do the procedure in a way that Dr Haben does (dissolving threads, laser scalpel, only 1-2 weeks of voice rest) - and found that their success rate was much lower. Also I thought that the technique of Dr Kim is much more convincing.
* Dr Kim places the stitches in a special way that creates a tapered shape of the new commissure and the threads go deep and not superficial. The tapering makes the voice less hoarse because there are less turbulences and the deep sutures do the same plus they give stability to the commissure. The permanent threads can be pulled together more tightly, making everything more stable, especially in the initial healing period.

I am not sure really how the Dr Haben procedure looks like in detail, but you listed some major differences - all three of them were in favour for Dr Kim in my mind. I do not like lasers because they take away tissue and create scars, they are also sometimes hard to control (I had a mishap happening with them during GRS). I would be afraid that the mucous skin would not grow back well enough if it was burned. I also like the permanent sutures, because they ensure that the healing can be complete without any strain pulling on the scar - creating a better V shape of the commissure.

The threads will grow in, they do not really stick out anymore after a while and you do not even see them after some months. So I doubt they cause any issue in the long run. CTA also uses permanent threads, and unlike the ones used in glottoplasty, those are actually under strain all the time, because they really have to hold the cartilage in place, it can never grow together permanently.



So, this is my personal opinion why I chose Dr Kim at Yeson in comparison to German surgeons, but I cannot really say much on Dr Haben - he seems to be a lot better than the Germans even though he uses similar techniques, so it seems a lot is in the skill and experience of the surgeon.

Here is a drawing about the differences regarding the tapering and deeper sutures. I am not sure what Dr Haben does in that respect, it would be nice if some of his patients could find out more details. Sorry, its an image from Germany with german text in it. top left is pre OP, bottom left is "traditional" glottoplasty, top right is Yesons glottoplasy (bottom right is still blank to insert how Dr Haben does it - lol )

Wow Anjaq thank you for your amazing response - that was very insightful, as I was trying to funnel all the important differences from articles and websites.

I've got a slot w Dr. Kim coming up actually but just pondering over it.

I picked Dr Haben because I knew him much better than I knew Dr Kim. Dr Haben's web page was very detailed and taught me pretty well everything I needed to know. Dr Haben does other voice surgery as well and I learned after I was there than people come from all over the world to see him. Even the locals are aware of his work, something I discovered while talking to my seat mate on the trip back. Ok, you caught me. I was writing and she was talking. 

I had an additional consideration as well. My male voice was so low I feared that VFS might not be enough by it's self to put my trained voice where it would sound feminine. I didn't want CTA if I didn't need it but I was ready to hand over the plastic should that be my only option.

I didn't write Dr Kim but I knew exactly what I had before I wrote Dr Haben so I didn't have to trust the Doctors judgment at the time of my appointment. I could tell him what he had to work with and he was able to tell me what he could do with it. My healing is slow compared to others but the surgery seems to be delivering the upper limit of what Dr Haben said I could get after the surgery. I am above the lower limit promised before surgery.

I know the sutures that Doctor Kim use are non reactive but I prefer the idea of sutures that dissolve. My father had a pin made of surgical steel in his leg that wasn't supposed to react with the body but it did. Thus I like the idea of not having foreign material in the body because it might cause long term issues and need a later surgery to remove.

My advice to you is have enough knowledge of your voice before going so the numbers the doctor gives you will make sense to you. After the doctor examined my voice and found I had different length cords, I had to make a spot decision if I wanted the surgery. I didn't have time to study the issue and learn more about my options.

I went to Dr. Haben because I heard great results here on Susans and really wanted to get the tracheal shave done at the same time. I also heard great results from Yeson, but they do not offer tracheal shave anymore and told me it could reverse the pitch increase if I get it done after their VFS. So I went with Dr. Haben's 'triple' procedure, which is glottoplasty, CTA and tracheal shave all in one surgery. With CTA, there is a scar, but the scar is on the crease of the neck and will eventually fade into a faint white line that people won't notice. 

If you get a scar on the neck, take care they show you exactly where it is placed. I personally have no folds or creases there, so a scar would always be visible in my case - but many people do have some features where they can hide the scar in. With CTA the scar AFAIK cannot be too far from the voice box though, with trach shave they can put the scar at the very top of your neck, which hides it better.

I went with Dr Kim because of proven results on YouTube and their website, as well as here. He also made his own micro scalpel and other instruments and his practice is very open about their results.

I didn't know much about Dr Haben and the one result he had on his website didn't impress me all that much.

I also figured traveling to a new country would be nice. No regrets.

In the end you have to weigh the options. Frankly, either one is good.

"Shorter rest period" is not really true for Haben. He prescribes a shorter rest period but I think Dr Kim's longer rest period provides a better result.

Dr Haben's results on his web site are typical results. Often he produces far better results but he is very careful about ver promising. Before surgery with my cord issues we talked about what was possible and he said I would get a 60hz improvement. After surgery he said I would get the 60 and might get as much as 80. It appears I am going to get the 80 Hz improvement. As I said, before any voice surgery, know what you need even if you need speech therapy to find out and know what the doctor can deliver. Do that an you won't be unhappy with the results.

Hi girls

Can someone explain to me what a cta is?



Can I ask what a CTA is?

  I am tired of having to strain my voice to pass on the phone (especially that I work in a call centre).

I lost high pitch after trachea shave a few years ago. My speaking voice has remained the same. In fact,  People haven't noticed any changes in my voice after I had trachea shave.  however, when I sing/ shout my pitch automatically drops. I cannot hit that higher note that I used to be able to hit.Thank you for your reply.

Also, does anyone know how much dr haben's surgery costs?

Thanks

Quote from: Ritana on November 16, 2015, 12:15:11 AM
Hi girls

Can someone explain to me what a cta is?



Can I ask what a CTA is?

  I am tired of having to strain my voice to pass on the phone (especially that I work in a call centre).

I lost high pitch after trachea shave a few years ago. My speaking voice has remained the same. In fact,  People haven't noticed any changes in my voice after I had trachea shave.  however, when I sing/ shout my pitch automatically drops. I cannot hit that higher note that I used to be able to hit.Thank you for your reply.

Also, does anyone know how much dr haben's surgery costs?

Thanks

CricoThyroid Approximation. Basically they stretch the vocal folds. However it is an "open" surgery rather than endoscopic so there is a scar.

Price is $5250 for the glottoplasty alone and $7000 for the triple which includes CTA and a trach shave.

Quote from: Dena on November 13, 2015, 04:47:08 PM
Dr Haben's results on his web site are typical results. Often he produces far better results but he is very careful about ver promising.

He probably has improved that but when I was looking at VFS options he only had the one result up in a heavy hispanic accent and I wasn't impressed much. I wanted to hear how a result would sound in American English with an American accent as overall perception of the voice was important to me.

Quote from: iKate on November 16, 2015, 09:06:35 AM
He probably has improved that but when I was looking at VFS options he only had the one result up in a heavy hispanic accent and I wasn't impressed much. I wanted to hear how a result would sound in American English with an American accent as overall perception of the voice was important to me.

Yeah, when I was originally looking into Dr. Haben that was the only example on his website but he did eventually update it to include two more.  I mostly relied on the information and examples posted here by people like warmbody to make my decision.  Hopefully as my voice improves I can continue that trend and post more examples here to help people make an educated decision

I am interested in dr Haben but the thought of having a scar is scary. Plus I've read about people whose voices got worse after cta procedure.

The scar is a thin white line. I have one that's 30 years old and nobody notices it unless I point it out. Without evaluating your current voice it's hard to tell if CTA will be needed. One of the things I liked about Dr Haben is I had the  option. I knew I needed a big pitch bump and with this in his toolbox, Dr Haben could give me more of a bump than Yeson should I need it. It appears I will have enough pitch without CTA but should I change my mind, I can go back for a revision.

You should already have a scar from your trachea shave. Dr Haven might be able to reuse it though it might be a bit longer.