Hi everybody,

I am much older than many of you on here but luckily like a lot of us girls, look years younger than our actual years ...
 
I transitioned in the late 80's had SRS in 1991 and various procedures ever since including FFS in 2004 !!!!

I have often considered Vocal Chord Surgery even though I have a very good phone voice ( it's a confidence thing because people cannot see me ) but have problems at times in keeping the female pitch when talking to people face to face, especially genetic women which is again another confidence issue, I know.

Also in noisy places like clubs, when I shout to make myself heard, my voice deepens too much.

I have seen people talking about vocal chord surgery with Dr Haben.

Is his method the very latest and best?

A lady that lives in the USA had it done and I believe the surgery was performed in Oregon. I met her before and after her procedure and the result was excellent. Who is this surgeon?

I considered this surgery a few years ago on the UK's NHS but I was told that it was a lousy and outdated method.

Look forward to hearing from you.

Happy 2016

Hugs

Paula

I think the doctor in Oregon was Dr Thomas and when I researched him, he was doing a larynx reconstruction and the sample voices on the web site made me decide if that was my only option, I would stick with what I had. Now if I had a badly damaged larynx, he would be high on my list of doctors I would consider. I also heard he has switched to VFS and if so, he might be a good option.

I went to Dr Haben because he was the only doctor who offered the triple and I felt I might need the extra pitch that it offered. It turned out VFS was all I needed but I was ready to run the plastic for the triple if needed. Dr Haben is well known for doing surgeries other than feminization and people come from all over the world for the other surgeries.

Yeson has turned out some very good voices as well as long as you only need VFS. There are several very good voice on the site and I am sure others who know his work can tell you more than I can.

The important thing is to know how much improvement you need in your voice before you contact the doctors. Then they will be able to tell you if they can provide what you need. If you need any help determining this, let us know and we will tell you what you need to know.

Personally I went to Dr.Kim at YESON for the various reasons:

1. Uses micro scalpel instead of laser which could burn and hurt neighboring tissues
2. He called the "web" that other doctors create a "disease" when I asked him bluntly why his procedure was differentiating - and I agree. Dr. Kim is not simply creating a web between your vocal cords where the "suturing site" is basically scar tissue - he is suturing your old vocal cords to give you a completely new, healthy vocal cords.

I am not a doctor and obviously this is what I was told, so you are entitled to form your own opinions: but, this is how I feel I had confidence more so in him than the other doctors here mentioned on this site.

3. YESON is very professional in the way they handle the entire procedure

I am just a week over recovery and cannot speak in terms of results, but would be more than happy to after the 2 months mark

Hope you found my post useful!

When I did the numbers there were 4 surgeons that I considered. Thomas, Remacle, Kim and Haben. All 4 are experienced surgeons and most are mentioned with case histories on this thread. If money is no object, then Kim at Yeson should be the choice. If location is an issue, then either Thomas in the US or Remacle in Europe. Haben has also very good write ups  but I would be wary of anybody offering a CTA and Glottoplasty in the same procedure. Most importantly, I also look at aftercare. Do they take your money and run? I have been in contact will all of those mentioned, but will leave it up to you to decide. If pushed, I will recommend one, but only by PM. Hope that helps.

What is the approximate cost of the VFS surgery?

I'm sure their is a range based upon the surgeons, their reputations and techniques, but I am just curious about the expense.

Thanks!

5 to 6000 USD plus expenses.
GB

Hiya,

Thank you for your reply.

PM sent

Hugs

Paula

Quote from: gentlebreeze on December 30, 2015, 12:25:29 AM
When I did the numbers there were 4 surgeons that I considered. Thomas, Remacle, Kim and Haben. All 4 are experienced surgeons and most are mentioned with case histories on this thread. If money is no object, then Kim at Yeson should be the choice. If location is an issue, then either Thomas in the US or Remacle in Europe. Haben has also very good write ups  but I would be wary of anybody offering a CTA and Glottoplasty in the same procedure. Most importantly, I also look at aftercare. Do they take your money and run? I have been in contact will all of those mentioned, but will leave it up to you to decide. If pushed, I will recommend one, but only by PM. Hope that helps.

Hi Dena,

Many thanks for your reply .. 

Yes I would like help in determining this, can you kindly tell me what I need to know.

Happy New Year

Paula

Quote from: Dena on December 29, 2015, 11:43:17 PM

The important thing is to know how much improvement you need in your voice before you contact the doctors. Then they will be able to tell you if they can provide what you need. If you need any help determining this, let us know and we will tell you what you need to know.

Thank you kindly for your answer, I have heard some great things about Dr Kim.

Happy healing and would love to chat when you are feeling up to it.

Have a great 2016.

Hugs

Paula

Quote from: divineintervention on December 29, 2015, 11:57:53 PM

I am just a week over recovery and cannot speak in terms of results, but would be more than happy to after the 2 months mark

Hope you found my post useful!

That's very good = £3300 to £4000 Sterling

Quote from: gentlebreeze on December 30, 2015, 12:47:09 AM
5 to 6000 USD plus expenses.
GB

I wonder if you can still sing after this surgery?

Dr Kim (Yeson) charges a little over $7k for his surgery plus you have to factor in travel and lodging costs to Korea.

I went to Dr Kim and if I had to go again I would go to him.

I did not need the triple and my adam's apple is naturally not visible (I have to feel around for it).  So I just needed to shorten the vocal folds. I figured that a trip to Korea would bring some new experiences too so that swayed my decision.

Hi "Kate"

Did you stay in Korea for your recovery?  If so how long?

Thnks!

Joi

Quote from: Paula1 on December 30, 2015, 06:11:21 AM
Hi Dena,

Many thanks for your reply .. 

Yes I would like help in determining this, can you kindly tell me what I need to know.

Happy New Year

Paula

If you don't have it already, you need tool(s) to understand your voice. For a PC, there is praatt which you will find on the top of the voice section. If you have a mobile device, a useful tool is PitchLab.

There are six things you're interested in. For both you normal male voice and your trained voice, you should find out the lower end of your range, your normal speaking range and the upper end of your range. Don't push you voice to the point where it becomes uncomfortable as that can damage a voice and we are only interested in useful range.

Now you have the numbers, surgery can add as little as 60Hz to as much as 100Hz depending on several factors you won't know until you see the doctor. Figure you could get as much as 70-80 Hz improvement. Looking at the table will in the link will tell you where your voice will fall.

I had speech therapy many years ago but I could only hit 130-140 Hz with my trained voice. Post surgical, my untrained voice would be about 140Hz so to hit the feminine range, I need to used a trained voice which pushes me to about 205Hz. I knew this was going to be the case before surgery so there were no surprises other than the surgery left my voice higher than Dr Haben or I expected it to be.

There are several people who have very good post surgical voice from the start. Often the case with these voice is while the starting voice sounded male, it wasn't that low so the surgery pushed it into the feminine range with room to spare. Others like me require the combination of surgery and trained voice.

When you talk to the doctor, make sure you agree on the goal of the surgery. If the doctor feels you don't need to move that much, you will have a lesser tie. Dissatisfaction comes because one may not be able to drop out of their trained voice and end up with a lesser tie than the need or because they don't understand that a trained voice will be required after surgery.

Figure you only get one shot at this so you want to do it right the first time. The only revision surgery I know of is getting CTA after VFS. Keep asking questions of us and the doctors so you have all the answers before surgery.

http://www.nyspeechandvoicelab.net/transgender/voice-feminization/

Hi Dena,

Thank you so much for your reply.

I have lots to do and study before I go away on Saturday for a fortnight as I will not have computer access.

No rest for the wicked eh? ..

Excuse my ignorance but what is CTA?

Ta

Paula

Quote from: Dena on December 30, 2015, 02:38:16 PM
If you don't have it already, you need tool(s) to understand your voice. For a PC, there is praatt which you will find on the top of the voice section. If you have a mobile device, a useful tool is PitchLab.

There are six things you're interested in. For both you normal male voice and your trained voice, you should find out the lower end of your range, your normal speaking range and the upper end of your range. Don't push you voice to the point where it becomes uncomfortable as that can damage a voice and we are only interested in useful range.

Now you have the numbers, surgery can add as little as 60Hz to as much as 100Hz depending on several factors you won't know until you see the doctor. Figure you could get as much as 70-80 Hz improvement. Looking at the table will in the link will tell you where your voice will fall.

I had speech therapy many years ago but I could only hit 130-140 Hz with my trained voice. Post surgical, my untrained voice would be about 140Hz so to hit the feminine range, I need to used a trained voice which pushes me to about 205Hz. I knew this was going to be the case before surgery so there were no surprises other than the surgery left my voice higher than Dr Haben or I expected it to be.

There are several people who have very good post surgical voice from the start. Often the case with these voice is while the starting voice sounded male, it wasn't that low so the surgery pushed it into the feminine range with room to spare. Others like me require the combination of surgery and trained voice.

When you talk to the doctor, make sure you agree on the goal of the surgery. If the doctor feels you don't need to move that much, you will have a lesser tie. Dissatisfaction comes because one may not be able to drop out of their trained voice and end up with a lesser tie than the need or because they don't understand that a trained voice will be required after surgery.

Figure you only get one shot at this so you want to do it right the first time. The only revision surgery I know of is getting CTA after VFS. Keep asking questions of us and the doctors so you have all the answers before surgery.

http://www.nyspeechandvoicelab.net/transgender/voice-feminization/

Quote from: Paula1 on December 30, 2015, 04:13:41 PM
Hi Dena,

Thank you so much for your reply.

I have lots to do and study before I go away on Saturday for a fortnight as I will not have computer access.

No rest for the wicked eh? ..

Excuse my ignorance but what is CTA?

Ta

Paula

Crico-Thyroid Approximation "CTA". I am providing a link to Dr Haben's site because even if you don't  use him, the information on the site applies to some degree to all of the voice surgeries.
http://www.professionalvoice.org/feminization.aspx

Paula, its nice to meet someone who has transitioned that long ago and I can feel with you to want more done as the time passes. I did transition in the 1990ies and did not dare to do voice surgery at that time because the surgeons seemed to have bad techniques or not enough experiences to produce good results. This seems to have changed now.
I also know those 4 names - Drs Thomas, Kim, Haben and Remarcle. They all have different techniques to a degree. Dr Thomas in Portland has a very invasive surgery that can, if luck and healing are good, create a good voice because it also changes resonance. Dr Kim has a special refined version of the glottoplasty (or "vocal fold shortening" = VFS) technique and he has a lot of experience. Remarcle does glottoplasty, but uses a different technique than Dr Kim (laser instead of microscalpels, dissolving threads instead of permanent ones, he creates more scar tissue at the web than Dr Kim does). Dr Haben does the glottoplasty similar to Remarcle, but adds a trach shave and a CTA to it to maximize the changes. CTA is probably what was offered in the UK in the 1990ies... it has a couple of disadvantages (Dr Kim/Yeson Website lists a comparison of the available methods).

Now since you say you have a good voice already, I would assume you have good resonance and your pitch is not abysmal. So I would not risk Dr Thomas, because your voice is already well enough in terms of resonance. I also would not go for the "triple" of Dr Haben, because that makes mostly sense if your pitch would be very very low. So I would think that glottoplasty would be the best choice for you and for that you have still three options - Remarcle and Haben seem to be similarly good. There is apparently also a Doctor in the UK who does something similar, but I do not know name or reputation. Dr Kim does his modification of the glottopplasty, which I personally favoured after comparing the techniques. The main reason was that the "web" is not really a web but a very clean and tight suture. The new commissure (the V shaped part where the vocal chords meet) is very much V-shaped and scar free with his method, other surgeons (particularly I compared this to surgeons doing glottoplasty in Germany) may create more of a U shape and sometimes scar tissue is exposed  which both causes some hoarseness and loss of volume. Also the complication rate with Dr Kim at Yeson seems to be rather low. There have recently been a few patients of Dr Haben who had complications with sutures and the web not holding. I did not hear something like this from Remarcle yet, but the reports from patients of his are not so numerous.

Hi Dena,

I am slowly beginning to understand all this.

I now remember that CTA was the procedure used by London's NHS Charing Cross Hospital a few years back and I did not like what they were telling me.

I did have speech therapy in the late 80's although the speech therapist said I did not really need it !!!

In 1989, I had my Adams Apple done privately by Tony Cheesman at the Royal, Nose, Ear & Throat Hospital in Grays Inn Road, London. He said at the time that he removed as much as he could because of the calcification.

When I had my FFS in 2004, the surgeon in Illinois wanted to perform a second tracheal shave if and when I had a neck lift with him but when I mentioned this to Facial Team in November, they said even with a full face/neck lift, it was not necessary !!

So I assume that a CTA is not for me or am I wrong?

I am getting there, albeit slowly.

Many thanks for all your advice.

Paula

Quote from: Dena on December 30, 2015, 04:39:31 PM
Crico-Thyroid Approximation "CTA". I am providing a link to Dr Haben's site because even if you don't  use him, the information on the site applies to some degree to all of the voice surgeries.
http://www.professionalvoice.org/feminization.aspx

CTA should be used if you need the maximum amount of improvement. Dr Haben's triple combines all three surgeries because when you do the CTA, you will need another tracheal shave.

In your case, you may not need as much of a bump so the triple may not be required. If that is the case, you have a wider choice of surgeons to chose from.

It's hard to say exactly what you need without numbers so this is a bit guess work and mostly general information.

Hiya,

Lovely to meet you ... 

And thank you for your advice.

Looks like a trip to Korea then but will be expensive although I have had NHS funded surgery done in Canada (long story). But still would have to pay air fares, accommodation and return for check-ups.

But I have held off on this for a long time because this procedure scares me more than even the face as you only have one voice.

And we probably all know what happened to my face ... 

So there is hope here and I have a brilliantly supportive GP and access now to a gender councellor who only recommends the best for me, so maybe I could secure funding for non EU surgery.

I believe that the best vocal chord surgeon in the UK is based in Newcastle and operates within the NHS.

Take care and Happy New Year.

Hugs

Paula

Quote from: anjaq on December 30, 2015, 05:08:47 PM
Paula, its nice to meet someone who has transitioned that long ago and I can feel with you to want more done as the time passes. I did transition in the 1990ies and did not dare to do voice surgery at that time because the surgeons seemed to have bad techniques or not enough experiences to produce good results. This seems to have changed now.
I also know those 4 names - Drs Thomas, Kim, Haben and Remarcle. They all have different techniques to a degree. Dr Thomas in Portland has a very invasive surgery that can, if luck and healing are good, create a good voice because it also changes resonance. Dr Kim has a special refined version of the glottoplasty (or "vocal fold shortening" = VFS) technique and he has a lot of experience. Remarcle does glottoplasty, but uses a different technique than Dr Kim (laser instead of microscalpels, dissolving threads instead of permanent ones, he creates more scar tissue at the web than Dr Kim does). Dr Haben does the glottoplasty similar to Remarcle, but adds a trach shave and a CTA to it to maximize the changes. CTA is probably what was offered in the UK in the 1990ies... it has a couple of disadvantages (Dr Kim/Yeson Website lists a comparison of the available methods).

Now since you say you have a good voice already, I would assume you have good resonance and your pitch is not abysmal. So I would not risk Dr Thomas, because your voice is already well enough in terms of resonance. I also would not go for the "triple" of Dr Haben, because that makes mostly sense if your pitch would be very very low. So I would think that glottoplasty would be the best choice for you and for that you have still three options - Remarcle and Haben seem to be similarly good. There is apparently also a Doctor in the UK who does something similar, but I do not know name or reputation. Dr Kim does his modification of the glottopplasty, which I personally favoured after comparing the techniques. The main reason was that the "web" is not really a web but a very clean and tight suture. The new commissure (the V shaped part where the vocal chords meet) is very much V-shaped and scar free with his method, other surgeons (particularly I compared this to surgeons doing glottoplasty in Germany) may create more of a U shape and sometimes scar tissue is exposed  which both causes some hoarseness and loss of volume. Also the complication rate with Dr Kim at Yeson seems to be rather low. There have recently been a few patients of Dr Haben who had complications with sutures and the web not holding. I did not hear something like this from Remarcle yet, but the reports from patients of his are not so numerous.