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looks like Dr. Spiegel is now offering glottoplasty

Started by kwala, December 06, 2015, 01:12:58 AM

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kwala

Lagertha, I think you're oversimplifying things a bit.  This procedure may have been around for a long time, but it was by no means routine or common.  Secondly, the person in 1996 was smart to do her homework but she was also going in totally blind as she probably had no examples on which to base her decision.  Many of us are not comfortable risking something as important as our voice without some idea of the final product.  Obviously, somebody had to take the plunge and be first, but many of us are just not ready to commit without some evidence.  Thirdly, no one is under the assumption that surgeons like Dr. Kim, Dr. Haben, or Dr. Remacle, etc are doing this for purely altruistic reasons.  Yes, they help people but they DO run a business.  Running a business is not necessarily a bad thing.  Just like any other business, to keep going you have to have a high satisfaction rate.  If you do low quality work, you lose your customer base.  Also,  I don't know what the girl paid in 1996 but with inflation, that price wouldn't really be comparable to a surgery cost 20 years later anyhow.  For now, I personally am glad that I went in knowing that my surgeon was able to achieve success with many, many others at a price I could afford.  After much online research and direct contact with the surgeon himself, I felt very comfortable taking the risk. So I feel like a very smart patient, lol.
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Myca

Quote from: Lagertha on December 06, 2015, 08:59:39 PM
Widespread use is because one surgeon and his office decided to advertise themselves online and use youtube to their advantage. If not for them 99% of trans women probably wouldnt know about this "voice feminization surgery" for another decade, or until someone else would decide to advertise it and put information out there.

I would not disagree that there has been a viral effect of sorts via those YouTube videos from that clinic.  (And my congratulations to all here who have benefited from their expertise.)  My point on the "widespread use" term was what the peer-reviewed research papers advocated starting around the late 2000s, i.e., the use of Wendler glottoplasty in the transgendered population to raise vocal pitch.  This was certainly way before these high profile videos came online.

Why this wasn't a position taken earlier given the void of suitable procedures in the 2000s for VFS is beyond me.  But just speaking for myself, I'm not the type to try a surgical procedure until I have some assurance of past history of success.  But certainly kudos to the person who took the initiative back in 1996 to get a Wendler glottoplasty on her own.

Anyway, I believe that there actually was a clinic in Bangkok that predated Yeson/Kim by several years (in the mid or even early 2000s) with web glottoplasty as a voice option, but outcomes seemed murky.  Apparently too high of a pitch was actually one of the problems.


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Lyndsey

Hi sweetie you are right I have been struggling for a long time with my voice. I will try to record it for you later. I'm told it passes but I don't think it's good. And yes I'm and old fart at 58 Lol. But I'm happy with how I look and feel and I also believe that being confident like I feel helps a lot. I have never been called out even with my voice.

Hugs Lyndsey


Sent from my iPad using Tapatalk
Lyndsey Marie Burke- Started my journey February 2011 Full time on May 5th 2014 HRT June 6th 2014 Name change and on all records and court documents June 20th 2014 SCS October 20th 2015 with Doctor Marci Bowers in Burlingame California I'm a very Happy women and finally living what I should have been living my whole life. Expect the unexpected. I feel Blessed. Love, Live, Be Happy. Be safe.
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Lyndsey

As for SRS I had Dr. Marci Bowers and I'm very happy all around I feel and know that I'm a women and I'm very comfortable were Im at. Just the voice is my problem. My Brest have developed to large C cup and I'm very happy there and I'm not Heavy. So there is good and bad with anyone's transition.

Hugs Lyndsey 


Sent from my iPad using Tapatalk
Lyndsey Marie Burke- Started my journey February 2011 Full time on May 5th 2014 HRT June 6th 2014 Name change and on all records and court documents June 20th 2014 SCS October 20th 2015 with Doctor Marci Bowers in Burlingame California I'm a very Happy women and finally living what I should have been living my whole life. Expect the unexpected. I feel Blessed. Love, Live, Be Happy. Be safe.
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Lagertha

#24
Quote from: kwala on December 06, 2015, 09:37:23 PM
So I feel like a very smart patient, lol.

Not in my eyes... You deserve to pay the premium. Im happy for dr. Haben and dr. Kim. They are doing good job. Good business! The fact that they started advertising is good for everybody. So many trans women had lived in the past with their terribly male voices. Now thanks to the internet and advertising glottoplasty as voice feminization, they can have this fixed (they could have it fixed 15 or 20 years ago, if they were smart enough to go out and ask if there is any phonosurgeon around)
You people here are making it seem like they are doing something extraordinary and different than anybody else, and there is no way any other phonosurgeon is capable of understanding how to raise a pitch and fix androphonia... and they surely are the best in the world because they published 15 before after results online. What logical reason makes one phonosurgeon better than others because they happen to be "appreciated" on trans forum?
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Lagertha

Quote from: Myca on December 06, 2015, 10:38:10 PM
But just speaking for myself, I'm not the type to try a surgical procedure until I have some assurance of past history of success.  But certainly kudos to the person who took the initiative back in 1996 to get a Wendler glottoplasty on her own.

She wasnt the test bunny. Her surgeon had done the same surgery for many patients with androphonia before her. Its no different. I also need to have some assurance of past successful results. But its not like that youtube is the only way of assurance, and not every ENT doctor needs to be approved by susan.org before they can be consider competent.  :)
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iKate

It's like LASIK or similar eye surgery. Tons of surgeons do it but if it's my eyes I don't want to risk a bad outcome and side effects like haloes, dry eyes and similar. This is why there are $2000 surgeons and $5000 surgeons for that surgery and why it similarly varies for MTF procedures like FFS, glottoplasty and FFS.

In the end though it's your body and nobody can decide what to do with it other than you.
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kittenpower

Quote from: Lagertha on December 07, 2015, 06:42:38 AM
She wasnt the test bunny. Her surgeon had done the same surgery for many patients with androphonia before her. Its no different. I also need to have some assurance of past successful results. But its not like that youtube is the only way of assurance, and not every ENT doctor needs to be approved by susan.org before they can be consider competent.  :)
Ok, but what are your credentials; you seem to be very direct with your medical critiques, but we know nothing about you. If you are not a licensed medical professional, then it's probably not a good idea for you to be so authoritative when you advise people about surgery. I am only saying this because your opinions are very absolute, and someone might follow your advice, so I hope you have the proper training.
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kwala

Quote from: Lagertha on December 07, 2015, 06:42:38 AM
She wasnt the test bunny. Her surgeon had done the same surgery for many patients with androphonia before her. Its no different. I also need to have some assurance of past successful results. But its not like that youtube is the only way of assurance, and not every ENT doctor needs to be approved by susan.org before they can be consider competent.  :)

You mean examples of the surgery performed on cis-women with androphonia?  It's VERY different.  In addition to the size of the vocal folds, there are many, many, MANY differences in the anatomical structures that create sound in males and females.   So far, we have a mysterious trans woman who supposedly went to a phonosurgeon who had never performed the surgery on anyone other than cis-women.  She supposedly saved a bunch of money (how much? we don't know...and this was 20 years ago).  And we are hearing this information second-hand from you.  But those of us who have gone with the practices who actually publish results and have a long list of examples to review made a poor choice? 

I live in a major metropolitan city and the three ENT's I talked to about a stroboscopy following my surgery had never heard of this operation. 
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Lagertha

Quote from: kittenpower on December 07, 2015, 10:44:52 AM
That's true, but what are your credentials; you seem to be very direct with your medical critiques, but we know nothing about you. If you are not a licensed medical professional, then it's probably not a good idea for you to be so authoritative when you advise people about surgery. I am only saying this because your opinions are very absolute, and someone might follow your advice, so I hope you have the proper training.

No, I'm not MD. I have a lot very direct insight on glottoplasty, because I personally know a phonosurgeon, who has done around 400 glottoplasty surgeries in the past 7-8 years. I have had a few very informative consultations so far, during which I have also gotten some information on how these procedures are carried out elsewhere around Europe and US. I have had a chance to listen to about 40 before/after recordings (not rainbow passages but real logopedie analysis) from their patients, and I could listen to many more androphonia treatment results if there was a point of doing so. I suggest to anyone who is interested in glottoplasty to do the same, and get the first hand information from phonosurgeon who is willing to give you some of their time. 
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Myca

Quote from: Lagertha on December 07, 2015, 06:42:38 AM
She wasnt the test bunny. Her surgeon had done the same surgery for many patients with androphonia before her. Its no different. I also need to have some assurance of past successful results. But its not like that youtube is the only way of assurance, and not every ENT doctor needs to be approved by susan.org before they can be consider competent.  :)

So please illuminate me.  Was this smart person the only TG way back then?  Or were there other TGs who also did the research and had this done 15-20 years ago?

As for my looking for past results before committing to surgery, guess again, Sherlock.  It ain't based on YouTube or this forum.
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anjaq

Quote from: Lagertha on December 06, 2015, 06:28:08 PM
I found it really funny that people think that there's really just two surgeons in the world who do this. Or that people are willing to fly to Korea from US to have this done, while there are probably at least ten phonosurgical specialists in New York area alone who do it on a regular basis.
For me it was a matter of quality rather than of availability. I know there are at least 2, more likely 4 or 5 surgeons in Germany who do this. Some did a lot of it and for years, but still they claimed a 30% success rate only...
THATS why I took the flight to Korea instead, because I would not want anyone who can put some threads into vocal chords and sew them together in some way to ruin my voice.

Quote from: Myca on December 06, 2015, 07:54:22 PM
That the Wendler glottoplasty has been around for a few decades is not the point; it has only recently been considered for widespread use in the TG population (less than the last 10 years).  If you follow the research papers (Remacle has a lot of them), this is relatively new for us as a viable option.
Well "widespread" is relative. I know a paper from Berlin in 1999 that compared the one year post op results of a couple of transwomen who had the procedure done there and it describes the procedure as a viable option for trans women. So thats about 17 years ago, the paper was probably written a year earlier and the surgeries were certainly done in the mid 1990ies...

Quote from: Lagertha on December 07, 2015, 06:33:15 AM
You people here are making it seem like they are doing something extraordinary and different than anybody else, and there is no way any other phonosurgeon is capable of understanding how to raise a pitch and fix androphonia... and they surely are the best in the world because they published 15 before after results online. What logical reason makes one phonosurgeon better than others because they happen to be "appreciated" on trans forum?
You cannot possibly believe that all phonosurgeons are offering similar quality of results, do you? You are welcome to get a voice surgery in Berlin. You will get operated upon by a Professor of phonosurgery who has done the procedure for almost 20 years and if you are German you can even get it on NHS payment - and most certainly the pitch will go up from it - but then you have to live with a 30% success rate (judged by the patients) and he will tell you before that you will never be able to sing or shout again, that there will be hoarseness remaining and so on. Oh and I know that he took a look at Amys vocal chords after the Dr Kim VFS and he was baffled how this can be looking so good and the voice sounding so good.
So no, I certainly do not think that just because someone does practically the same procedure, he can be considered equal.

The tricky thing about this surgery is not to sew the vocal folds together with an endoscopic equipment and raise pitch - many surgeons are doing this procedure. The trick is to do it in a way that makes the voice sound natural, with little hoarseness, with good voice control possible, with little scarring etc. I know a bunch of trans women who had phonosurgery and say they are happy, the pitch went up, they are recognized as female also on the phone, but they sound like they did 20 years of drinking whisky and smoking cigars! If all you want is a higher pitch and a voice that is recognized as female you can go to any of these surgeons , I guess, but some people have a bit higher goals.

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iKate

Quote from: anjaq on December 08, 2015, 06:05:02 AM
The tricky thing about this surgery is not to sew the vocal folds together with an endoscopic equipment and raise pitch - many surgeons are doing this procedure. The trick is to do it in a way that makes the voice sound natural, with little hoarseness, with good voice control possible, with little scarring etc. I know a bunch of trans women who had phonosurgery and say they are happy, the pitch went up, they are recognized as female also on the phone, but they sound like they did 20 years of drinking whisky and smoking cigars! If all you want is a higher pitch and a voice that is recognized as female you can go to any of these surgeons , I guess, but some people have a bit higher goals.

I quoted this because it is key.

Other surgeons will laser the vocal folds to create the web. Dr Kim uses a special microscalpel he designed himself. I believe this affects the scar tissue and healing.
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anjaq

And it's not that easy to tell - all surgeons have good and bad results - there are great voices coming from lasering the vocal chords before suturing them together, so it's not that this is generally a bad idea.
But one has to recognize that the chances and risks are different with different surgeons. Its like with GRS - if you go for Suporn or some of the Top surgeons in the USA you likely will get a functional and aesthetically pleasing vulva and vagina - but there are some surgeons that have been threatened with lawsuits from patients groups because they did so many "mistakes" that it just is horrible to think about it. Like people having to live with an iliostoma forever because of the surgery, or with loss of feeling or with a one inch vagina. But of course these surgeons also do GRS and they also perform a vaginoplasty and all of this - but obviously there are differences in the details and the skills...

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Lagertha

Quote from: anjaq on December 08, 2015, 06:05:02 AM
You cannot possibly believe that all phonosurgeons are offering similar quality of results, do you?

I didn't say that. This is why its essential to hear the results and judge the quality for yourself. Either on youtube, or while consulting a local phonosurgeon.
For example for me the usual VFS results don't give the most ideal comparison. My speaking frequency is around 180Hz, normal untrained voice. I never used male resonance, so I didnt have to train my voice. We will be looking at max 20% length reduction, and it was a lot more useful to listen to cis-female results with androphonia treatment than it would be to listen to average mtf results, which often aim at one third length reduction, or 40%, or sometimes even 50%. We are not looking for increase of 70Hz or anything like that.
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anjaq

Well if your voice is at 180 Hz with female resonance, then your case is clearly different from the majority of those doing feminizing voice surgery. 180 Hz is still in the female range, I guess at least here this would not even be considered androphonia at all. I think I would not take the risk to change that. But of course thats an individual decision - for me, I went from 110-120 Hz to 170-180 Hz with the surgery, so my final point is where you are starting...

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Lagertha

I'm not decided yet. Its obviously not problematic... so I have plenty time to think about. But I am little bothered by my voice, it doesnt exactly fit with the rest of my appearance. 210-220Hz probably would.
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anjaq

Quote from: Lagertha on December 08, 2015, 04:31:14 PM
I'm not decided yet. Its obviously not problematic... so I have plenty time to think about. But I am little bothered by my voice, it doesnt exactly fit with the rest of my appearance. 210-220Hz probably would.
Do you really thing that this makes such a difference? I think I would not have chosen to go for VFS if I had a 180 Hz voice already. Any surgery carries risks, VFS definitely also does change some aspects of the voice that are not always great. Soem people reported some decrease in volume, some hoarseness that comes easier post VFS, some loss in upper range... not sure if those are worth going from 180 to 220 Hz.

Are you a petite feminine person that you say a 180 Hz voice would not fit to you?

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Lagertha

My morning voice bothers me.. and when I get a cold I get really uncomfortable with my voice. Otherwise in normal daily life I get by with my voice more or less fine. Its not ultra feminine, but its OK enough, I guess.
I wouldnt say Im petite looking person at 5-11, more or less about average female built... I just think my voice is still in somewhat androgynous range, while my appearance isnt. I think of it more as an added benefit to resolving my morning voice and cold voice issue. It is worth taking the risk of less than ideal result... is why Im not decided yet.
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iKate


Quote from: Lagertha on December 09, 2015, 07:00:45 AM
My morning voice bothers me.. and when I get a cold I get really uncomfortable with my voice. Otherwise in normal daily life I get by with my voice more or less fine. Its not ultra feminine, but its OK enough, I guess.
I wouldnt say Im petite looking person at 5-11, more or less about average female built... I just think my voice is still in somewhat androgynous range, while my appearance isnt. I think of it more as an added benefit to resolving my morning voice and cold voice issue. It is worth taking the risk of less than ideal result... is why Im not decided yet.

I still have somewhat of a lower morning voice but it's feminine without any doubt. I've had to make phone calls and was addressed as ma'am instantly.

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