Hi my lovelies,

Okay, stage 1 of my SRS has gone well (the bilateral orchiectomy) and I'm now planning stage 2 which is my FFS in October / November.

I had a good consultation with Dr Sutin at PAI where we discussed options. Realistically, for financial reasons, I can't do everything in one go but I'm not sure that's a bad thing anyway.

I'm new to the whole FFS area though and know little about it. So any help would be massively appreciated. This is what we're thinking:

1. Lower hairline and brow lift (probably not orbital rim this time as Dr Sutin didn't really think I needed it with my eyes - lucky). I don't need any forehead reconstruction apparently either.

2. Full Facial Lift FFL

3. Tipplasty and Arrplasty (but not full rhinoplasty)

To which I may add a chin shave. I'm just checking the price on that.

The reason for 2. is partly cost but also because I don't want to have a very thin nose that is out of keeping with my face shape.

Another question I have. My hair is all mine and quite full: you probably can't see it on my avatar as it's been 'rebonded' and styled since, and it's longer. So will 1 and 2 leave my own hair in place?

There's so much to find out! Heeeelp?!!

Rachel Richenda x

Have you received multiple consults from other surgeons ?

I wouldnt trust one doctor's opinion frankly. I also don't trust when a doctor says any of us don't need some kind of forehead reconstruction. MOST trans women require some sort of reconstruction (usually Type III).....unless a very unique situation and/or started hormones in your teens.

Can you give scientific backing for the forehead statement Debra?

Quote from: Richenda on September 01, 2016, 04:31:47 PM
Can you give scientific backing for the forehead statement Debra?

The only good data available is in Dr. Ousterhout's book on FFS.   Probably worth a Kindle download and read.   I think he says that something like 85% of all of his patients had protruding frontal sinus that required a Type III forehead surgery with set back of the frontal sinus wall.   

Quote from: oneoftwo on September 01, 2016, 07:07:05 PM
The only good data available is in Dr. Ousterhout's book on FFS.   Probably worth a Kindle download and read.   I think he says that something like 85% of all of his patients had protruding frontal sinus that required a Type III forehead surgery with set back of the frontal sinus wall.   

I had read the entire book before my FFS consult... So much good info!!!... I took it with me and Dr O autographed it ...LoL!!!!

Ashley

Quote from: oneoftwo on September 01, 2016, 07:07:05 PM
The only good data available is in Dr. Ousterhout's book on FFS.   Probably worth a Kindle download and read.   I think he says that something like 85% of all of his patients had protruding frontal sinus that required a Type III forehead surgery with set back of the frontal sinus wall.   

I meant peer-reviewed academic statistical data rather than a ffs craniofacial surgeon's personal viewpoint. I'd like to see proper hard evidence for his claim that 85% of cis males have significant medial brow ridging requiring reconstruction. I don't mean to appear overly sceptical but it's clearly in the interests of someone getting paid for forehead reconstruction to promote that idea. So proper scientific backing is required.

Anyway, luckily I appear to be in his 15%. I also don't have prominent orbital rims, amongst some other female skeletal features like very thin ankles (as you can probably see from my avatar).

One of the things I admired about my consultation at PAI was telling me what I don't need as well as what I do, even though financially the former isn't in their interests. Hmmm ... did someone mention the word 'trust'?

Quote from: Richenda on September 01, 2016, 11:12:29 PM
I meant peer-reviewed academic statistical data rather than a ffs craniofacial surgeon's personal viewpoint. I'd like to see proper hard evidence for his claim that 85% of cis males have significant medial brow ridging requiring reconstruction. I don't mean to appear overly sceptical but it's clearly in the interests of someone getting paid for forehead reconstruction to promote that idea. So proper scientific backing is required.

Anyway, luckily I appear to be in his 15%. I also don't have prominent orbital rims, amongst some other female skeletal features like very thin ankles (as you can probably see from my avatar).

One of the things I admired about my consultation at PAI was telling me what I don't need as well as what I do, even though financially the former isn't in their interests. Hmmm ... did someone mention the word 'trust'?

Good for you then! I know some other girls on here didnt need it either supposedly. My suggestion wasn't that you necessarily need it....just that it's good to get multiple consults / opinions (if you haven't already)

Ah okay, sorry for misinterpreting. I think you're right about the wisdom of getting some other opinions actually. I will do so.

It is very difficult to say what you need based on your avatar picture. I can hardly see your face there. Perhaps sharing a few photos can give us a chance to evaluate your face

Yes indeed, and I'd love to, but it seems nigh impossible to post pics on here? As far as I can see only photobucket does the trick and that seems the most unwieldy site in history. Would love to be corrected and directed.

I could change my avatar to a close up of my face for a day?!

Or just add a few photos on photobucket. It is the best if you can add front side and 45% pictures so that we can give you a honest opinion

Quote from: Richenda on August 25, 2016, 04:15:01 AM
Hi my lovelies,

Okay, stage 1 of my SRS has gone well (the bilateral orchiectomy) and I'm now planning stage 2 which is my FFS in October / November.

I had a good consultation with Dr Sutin at PAI where we discussed options. Realistically, for financial reasons, I can't do everything in one go but I'm not sure that's a bad thing anyway.

I'm new to the whole FFS area though and know little about it. So any help would be massively appreciated. This is what we're thinking:

1. Lower hairline and brow lift (probably not orbital rim this time as Dr Sutin didn't really think I needed it with my eyes - lucky). I don't need any forehead reconstruction apparently either.

2. Full Facial Lift FFL

3. Tipplasty and Arrplasty (but not full rhinoplasty)

To which I may add a chin shave. I'm just checking the price on that.

The reason for 2. is partly cost but also because I don't want to have a very thin nose that is out of keeping with my face shape.

Another question I have. My hair is all mine and quite full: you probably can't see it on my avatar as it's been 'rebonded' and styled since, and it's longer. So will 1 and 2 leave my own hair in place?

There's so much to find out! Heeeelp?!!

Rachel Richenda x

Use Imgur.com when you get on the screen there will be a green button to upload your picture. After the picture uploads. copy the URL and paste the web number to your PM or web comment. I didn't have to sign in the first time I used it. Make sure to set the privacy setting to personal. This will allow you to view and send your photo without public display on Imgur but anyone who has the URL can access it.

Ooooh like it

Okay, here we go:

http://imgur.com/a/KP4T2

I would love love love love love love love any thoughts or comments These are non-professional and non-photoshopped snaps using a phone, so be gentle-ish

x

I have read that the sinus plate is 1.5 mm on 95% of males and thicker on 5%. If you need more than burring of at most 1mm then the plate needs to be removed and re-contoured in order to get the desired effect. The thickness can be determined with an x-ray.

I needed more than 1mm of shaving so I am going with the recontouring. When Dr. McGinn looked at my forehead she said If I wanted it flat then I would need recontouring and recommended a surgeon. That surgeon recommended recontouring, which I will be doing soon.

I'm really not keen on any forehead rebossing etc. I've read too many dodgy things about it and I don't consider it that vital tbh. Maybe my view will change but I'm just not convinced it is a major gender marker. I'd place more store on the eyes i.e. orbital rims as an issue and forehead size which is corrected by lowering hairline and eyebrow lift. Just my take.

Ok my honest opinion
Hairline lowering is very much needed in your case as it will make your head smaller and more feminine. eyebrow lift as well. You don't have a prominent frontal sinus and I think that type 2 forehead work will be enough. I would suggest orbital rims burring as it will open your eyes and make them more feminine even though you can do without it. Face lift will make you look younger so you will benefit from that. I am not sure about your nose because you may need full nose job or perhaps just the tip. It will depend on the forehead work you get. Your chin looks okay to me so i wouldn't touch it.

Wow Reborn.

That is exactly, almost word for word, what Dr Sutin said to me. I mean, seriously, every detail is precisely his opinion too. Which is very very encouraging.

I'm going to try for the orbital rims as I think I may as well whilst I'm there. He also said the same about my chin by the way.

Thank you

x

Yeah your eyes are not very shadowed at all so the need for forehead reconstruction not so bad as most of us. Easier to see with a side profile shot though. But from the front, that's my thought.

This is sooooooooo encouraging. Thank you xx

I think I 'will' go ahead with the orbital rim work. Dr Sutin said it's more of a toss up: there's a little protusion. If so then with your comments above on board it looks like this:

1. Lower hairline and brow lift plus orbital rim shave

2. Full Facial Lift FFL

3. Tipplasty and Alarplasty

Total cost $14,900. Ouch. Surgery requested for December 2nd.