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My FFS experience with Dr. Spiegel

Started by Venusxoxo, February 11, 2017, 02:39:09 PM

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Venusxoxo

Dr. J. Spiegel FFS Review.

Hey everyone! Here is my rather long, yet detailed account of my Facial Feminisation Surgery experience. :)

I've started my transition in early January 2016 (at age 23) the same week of my Boston consultation trip, surprisingly. During my last months I was researching and trying to decide an FFS surgeon - I've read through many forums, FFS surgery videos and looked through RealSelf. I felt that I definitely needed surgery to restore my confidence and be complete from within, as I knew hormones (HRT) would have its limitations into facial bone structure as far as it goes. So, I've researched numerous doctors specialised in FFS around the world and finally came to a conclusion that Dr. Spiegel was the right surgeon for me.

I arrived at Boston in January 2016 to meet for a consultation with Dr. Spiegel vis-a-vis. The consultation as far as I remember was about an hour long all together. I was really excited to go through my thoughts and feelings of what I really wanted done and the ideal image of that woman I ought to have been born. Although, I never had difficulty passing as a female even without any application of makeup sometimes, I still felt insecure about some of my masculine facial features and this is the reason why I've decided to do FFS. Luckily, I was blessed to be femininely androgynous to begin with, and didn't need significantly/overdone major work. I was still really unhappy with my chin and jaw-line mostly. The rest of my facial features were okay, not very masculine anyhow, but still definitely needed refinement here and there. I needed a surgeon with artistic talent and natural looking results, hence Dr. Spiegel was the choice for me.

I thought about whether I should do the surgery all in 1 round or in 2 rounds. But, I've decided to opt to do it in 2 rounds for faster recovery and less discomfort from all the swelling I would be experiencing - perhaps I just wanted to see the changes slowly... and I knew that doing all the procedures would be far too much burden on my body. I was definitely excited for my surgery, and willing to travel back again for my round 2 during the same year.

After months of waiting and considering my options and which procedures I wanted to do. I booked my first surgery date for 5th January 2017 for round 1 (this will also be my 1 year post HRT). I'll be going into surgery to do: Trachea shave, Mandible contouring (jaw & chin), Lip lift, Lip augmentation (using my own dermal tissue) and Cheek augmentation. I was very excited at the time! Although I was worried what the swelling and pain would be like short-term, but I knew it would be worth it for a lifetime of happiness!

Then I booked my second surgery shortly afterwards, which was scheduled for 4th May 2017 (4 months after my first round of procedures) for just the Forehead contouring (removal of bony ridge) & Brow-lift, I didn't feel that I needed to include a rhinoplasty (in my case, this would be a revision rhinoplasty) as it was only a minor difference in tip work. Well, I was still kind of still happy with my primary rhinoplasty I did several years ago. Also, I knew that a forehead surgery would definitely open up my eyes, making a nice change to complete my profile.

Day before surgery, At pre-op appointment my surgeon went over what we were doing, and what needed to be changed and his further remarks and recommendations, we opted to include lip augmentation and go for large implants size in the end, pre-op lasted about 2 hours. And all aftercare instructions for each procedure and date/time of surgery is included.

Day of surgery, Day 1, the big day was finally here! The hard part was I wasn't able to eat or drink anything after midnight, and my surgery was until later around noon, but I managed it! :) I met all the staff, nurses, and Dr's for the operating room; they were all lovely and caring. Finally I met Dr. Spiegel, and we went over what we were having done. My time for surgery came, and I was given a medication where I completely passed out. From this point I don't remember anything! Until waking up all swollen & happy! :) The swelling wasn't as bad when I woke up. Day 2, the swelling increased and some bruising around my eyes, my lips were very very swollen, but I still liked how my face turned out even beyond all the swelling. I tried to manage to gather some sleep, and had applesauce in the morning which was really soothing, I really wanted to go back to the apartment and rest there. Start of Day 3! And the swelling is definitely at the highest peak point (eek) I'm trying to keep the liquids up drinking yoghurt and protein shakes to stay energised and drinking lots of water, I slept okay yesturday too, I don't feel much pain but from now on (2 painkillers & sleeping pills before bed usually help getting some rest) now it can only get better after today. At Day 5, I noticed the bruising increasing as it started to heal up fast and the swelling was going to eventually come down. I continued to drink lots of water (4 litres per day) take my medications, drink my protein shakes. Day 6, my lip sutures were removed, and I can see my profile much clearly, I loved the lip lift! :) By Day 7, most of the swelling around the eyes was completely gone, and I felt I've regained most of my strength back. I continued drinking at least 4 litres of water a day, and kept well fed, lots of soft food like boiled eggs and soup. By Day 14, majority of the swelling subsided but my left cheek, lips and neck area was still swollen. It's was differently getting better each day. I felt it was necessary to extended my stay further 11 days due to the excessive swelling. By around Day 21, I had seen Dr. Spiegel for my last visit before my flight back, he assured me everything was fine and OK - everything looked and felt so much better at this stage. By Week 6, I regained mostly all of my energy finally back and began to see my results! At this point the major part of the swelling was gone, I really liked how everything turned out.. :)

I'll try keep everyone updated on my FFS journey and my recovery. I'll post some pictures from the time to time, so that everyone considering FFS can make informed decisions on whether what they decide to do, and something they can be sure of that is definitely worth. Beyond the short-term minor pain, swellings and discomforts it's very rewarding in the long-term.

My advice is to take Vitamin-C (500mg), Arnica Montana, Bromelain (500mg) at at least 2-6 week after surgery. And, Icing for the first 3 days as much as possible. These help the swelling and bruising. Don't feel stressed or depressed with the swelling as it's definitely not the final result. I was freaking out from the swelling the first 2 weeks, it's norm to feel this way, so try not to fixate on this. It'll get better! I also recommend booking maybe an Airbnb if you're an outpatient.

With hindsight, I'd also advise to split you're procedures in two if you plan for full FFS: Upper-face (forehead), mid-face (cheeks/lips/nose) with lower-face (mandible/trachea), if you can. There'd be lot less discomfort from the swellings & recovery would also be quicker! (I'm glad I did it this way).

In conclusion, I'd definitely recommend Dr. Spiegel for he's knowledge, experience, natural and artistic looking results. Also, I would like to add that the staff there are very friendly and welcoming, and everything happened ever so smoothly. Thanks Dr. Spiegel for helping me feel a million times better, confident and happier with myself!

I hope I've covered everything. Feel free to DM, or reply if you've got any questions. Best Regards, Jacq. xoxo :)

Photos, I didn't know how to upload other than Imgur. Images are from Pre op day to about 6 weeks post op:
https://imgur.com/gallery/tJGDE

*I've left out the pictures of post-op days 1-7 because it was very graphic; this is the scary phase of recovery*
  •  

Denise

Wow - The straight-on picture of your lips and the lower part of your nose is remarkable. 
1st Person out: 16-Oct-2015
Restarted Spironolactone 26-Aug-2016
Restarted Estradiol Valerate: 02-Nov-2016
Full time: 02-Mar-2017
Breast Augmentation (Schechter): 31-Oct-2017
FFS (Walton in Chicago): 25-Sep-2018
Vaginoplasty (Schechter): 13-Dec-2018









A haiku in honor of my grandmother who loved them.
The Voices are Gone
Living Life to the Fullest
I am just Denise
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kittenpower

You look great; very pretty, and I can see a big difference between your before and after. I hope you took those negative comments on your page with a grain of salt, because they don't know what they're talking about, and must be blinded by jealousy.
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Venusxoxo

I'm super really happy with the results. Its so natural and feminine. I've never been misgendered since and I get a lot more attention from guys now  :)
Thanks! Honestly yes some of those comments are really negative, because of jealousy people can say bad things about others. Forehead surgery left to do in May ill definitely post pictures in 3rd and 6th month marks :)
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yuna

Thank you for sharing, you look very pretty! GL with the rest of your surgery!
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anjaq

The change of the chin is obvious, not sure why the people commenting on imgur do not see that. The change in the lip is more subtle but the goal was not to have balloon lips anyways. What other things did you change? I think those other changes are a bit more subtle too. But you said you split FFS in two parts, so some things will come later anyways?

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anjaq

Who did the rhinoplasty - not Dr Spiegel, I suppose, but it was done before? I wonder if it is better to get Rhinoplasty done elsewhere. I have the feeling FFS surgeons do rhinoplasty less good than specialists?

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Venusxoxo

Thanks Yuna :)

Quote from: anjaq on February 16, 2017, 09:46:21 PM
The change of the chin is obvious, not sure why the people commenting on imgur do not see that. The change in the lip is more subtle but the goal was not to have balloon lips anyways. What other things did you change? I think those other changes are a bit more subtle too. But you said you split FFS in two parts, so some things will come later anyways?

Hey Anjaq, yes Dr Spiegel was aggressive on my chin, and my lips look super feminine and natural now. To recap; the first round (5th Jan) I had done cheek augmentation (CBSM-L), lip lift, lip augmentation, mandible contouring & trachea shave. The second round in a few months on (4th may) ill be doing the forehead contouring with brow lift, I'll make an update on that too :)

I've had a primary rhinoplasty ages ago about 3/4 years ago, by a plastic surgeon in London. Indeed, I believe FFS surgeons are not very good with rhinoplasty. I may be (considering) having a secondary rhinoplasty to do a little tip work after the forehead contouring with rhinoplasty specialist in London :)
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Venusxoxo

Here's an update on my FFS.
This is 44 days (@6weeks) post-op:
https://imgur.com/a/v1IeD

It's definitely a major mark for major swelling to subside. Also, I'm not wearing any makeup in the photos.
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MeghanMe



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Ellement_of_Freedom

Hey Venus! You look stunning. I think I might follow that advice and have rhinoplasty done by a specialist, separate to FFS.

How are you finding the scarring from your lip lift?


FFS: Dr Noorman van der Dussen, August 2018 (Belgium)
SRS: Dr Suporn, January 2019 (Thailand)
VFS: Dr Thomas, May 2019 (USA)
  •  

Venusxoxo

Thanks!

Quote from: Ellement_of_Freedom on February 19, 2017, 01:25:14 AM
Hey Venus! You look stunning. I think I might follow that advice and have rhinoplasty done by a specialist, separate to FFS.

How are you finding the scarring from your lip lift?

Yep, it'll definitely work out better I'm sure! As for the lip-lift, it's faded to pink now tending towards white now. After the sutures were removed, I've been applying scar gel recover by 'SkinMedica' as recommended by Dr Spiegel's twice daily (midday and midnight) on the lip-lift & trachea shave incisions. Its definitely helps fade out the redness to white. I sometimes put powered foundation when going out sometimes too. It's definitely not as bad as it seems to be now, I'd definitely recommend this procedure, it's very feminising :)
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anjaq

Does it make sense to do the lip lift with the same surgeon doing the rhinoplasty?

I asked around and a lot of people told me to not do rhinoplasty and forehead together would compromise an optimal result because one cannot be done as radical as it can be if the surgeon has to assume that the other remains unchanged and they cannot really preemtively change one part more than the other because it would look disfigured until the other step is done :(

  •  

Ellement_of_Freedom

Quote from: anjaq on February 21, 2017, 05:27:09 PM
Does it make sense to do the lip lift with the same surgeon doing the rhinoplasty?

I asked around and a lot of people told me to not do rhinoplasty and forehead together would compromise an optimal result because one cannot be done as radical as it can be if the surgeon has to assume that the other remains unchanged and they cannot really preemtively change one part more than the other because it would look disfigured until the other step is done :(
Oh Anja.. we are always thinking the same things!


FFS: Dr Noorman van der Dussen, August 2018 (Belgium)
SRS: Dr Suporn, January 2019 (Thailand)
VFS: Dr Thomas, May 2019 (USA)
  •  

Venusxoxo

Quote from: anjaq on February 21, 2017, 05:27:09 PM
Does it make sense to do the lip lift with the same surgeon doing the rhinoplasty?

I asked around and a lot of people told me to not do rhinoplasty and forehead together would compromise an optimal result because one cannot be done as radical as it can be if the surgeon has to assume that the other remains unchanged and they cannot really preemtively change one part more than the other because it would look disfigured until the other step is done :(

Hey Anjaq, yes its better to do rhinoplasty and lip lift together. Due to the incision in base of the nose. But I would recommmend to do lip lift first, then the rhinoplasty, because it kind of changes the shape of the nostrils. I would agree on that too, (mandible, trachea, cheeks, lips, all done initially), forehead first then rhinoplasty second (to complete everything). But I'd also recommend if you're doing mandible contouring (chin + jaw shave) doing lip lift together also. It's definitely all about proportions, and the surgeon can make better results from this, and taking it slowly with informed decisions, and as not to rush everything. :)
  •  

Ellement_of_Freedom

Quote from: Venusxoxo on February 22, 2017, 03:18:21 AM
Hey Anjaq, yes its better to do rhinoplasty and lip lift together. Due to the incision in base of the nose. But I would recommmend to do lip lift first, then the rhinoplasty, because it kind of changes the shape of the nostrils. I would agree on that too, (mandible, trachea, cheeks, lips, all done initially), forehead first then rhinoplasty second (to complete everything). But I'd also recommend if you're doing mandible contouring (chin + jaw shave) doing lip lift together also. It's definitely all about proportions, and the surgeon can make better results from this, and taking it slowly with informed decisions, and as not to rush everything. :)
Didn't you do rhinoplasty first? Why should rhinoplasty be done second?


FFS: Dr Noorman van der Dussen, August 2018 (Belgium)
SRS: Dr Suporn, January 2019 (Thailand)
VFS: Dr Thomas, May 2019 (USA)
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Venusxoxo

#16
Quote from: Ellement_of_Freedom on February 22, 2017, 04:09:08 AM
Didn't you do rhinoplasty first? Why should rhinoplasty be done second?

Yes, my first surgery was a primary rhinoplasty, and my last surgery would also (hopefully) be a secondary rhinoplasty to reduce the size of my tip by a few mm, that's why I'm doing it again. Either way, but that's how I would do it. :)
  •  

anjaq

Quote from: Venusxoxo on February 22, 2017, 03:18:21 AM
Hey Anjaq, yes its better to do rhinoplasty and lip lift together.

I'd also recommend if you're doing mandible contouring (chin + jaw shave) doing lip lift together also.

It's definitely all about proportions, and the surgeon can make better results from this, and taking it slowly with informed decisions, and as not to rush everything. :)
I am confused now - it sounds a bit like the best would be to do it all together to minimize scarring and because then each part goes better together, but then you say it should be done slowly, which sort of implies doing it step by step? Which makes more sense? I was always favouring a "all in one" approach to only have one surgery and one surgeon planning it all in the same aesthetics. I only questioned this now as I felt that a lot of people say they are unhappy with rhinoplasty by FFS surgeons, so I consider now to do that separately, although I'd rather not like to do that if it can be avoided.
Interestingly Facialteam, as I understand it, call in a rhinoplasty surgeon for the FFS, letting him do the nose instead of the same surgeon doing the rest also doing the nose. So in a way this makes sense in that context, but then again I am not sure - people complained about rhinoplasty with them as well, so maybe it is not really the problem of having someone else do it but maybe the problems are really from doing it both in one surgery?

  •  

Venusxoxo

Quote from: anjaq on February 23, 2017, 06:56:16 AM
I am confused now - it sounds a bit like the best would be to do it all together to minimize scarring and because then each part goes better together, but then you say it should be done slowly, which sort of implies doing it step by step? Which makes more sense? I was always favouring a "all in one" approach to only have one surgery and one surgeon planning it all in the same aesthetics. I only questioned this now as I felt that a lot of people say they are unhappy with rhinoplasty by FFS surgeons, so I consider now to do that separately, although I'd rather not like to do that if it can be avoided.
Interestingly Facialteam, as I understand it, call in a rhinoplasty surgeon for the FFS, letting him do the nose instead of the same surgeon doing the rest also doing the nose. So in a way this makes sense in that context, but then again I am not sure - people complained about rhinoplasty with them as well, so maybe it is not really the problem of having someone else do it but maybe the problems are really from doing it both in one surgery?

Hey Anjaq, honestly it definitely might be better to do all/as much as procedures in 1 go for faster recovery times in long term. But it's definitely down to the person, I prefer doing it in stages.
  •  

Venusxoxo

Here's some tips, that I made note when helping me to recover faster, i thought to include it as it might be helpful to anyone going for FFS...  :)

🌹Recovery & Routines for FFS🌹

  • Medication:
    - Arnica Montana* (2 week before & 6 weeks after)
    - Bromelain - 500mg* (6 weeks after)
    - Vitamin C - 500mg* (2 week before & 6 weeks after)
    - Resume HRT* (after 7th day)
    - Antibiotics* (1 every 12 hours)
    - Painkillers* (1 every 4 hours)

  • Daily routines:
    - Neosporin* (keep incisions moist for stitches for forehead)
    - Hydrogen peroxide (or pads) diluted in water* dipped in Q-tips to clean stitches around forehead
    - Ace bandage (keep wrapped around neck and face) change daily, keep on for 2 weeks.
    - Daily washing of hair w/ John's baby shampoo* (in forward motion)
    - Resume normal shampoo & conditioner after 3 weeks.
    - Towel dry hair & wash hair from behind. Then air dry, don't use blow drier.
    - Vaseline (for dry lips caused by the lip lift)

  • Recovery #1: Food, etc.
    - Water (500ml bottles) 7p/day
    - Protein shakes
    - Fruit juices
    - Raspberries, banana, blackberries
    - Milk
    - Eggs 4-6p/day
    - Soup (chicken, pumpkin, sweet potato)
    - Chicken & mince meat
    - Oats porridge
    - Flexible straws
    - Gentle face cleaners
    - Kleenex
    - Kitchen towels
    - Q-tips
    - Frozen peas (used as icing) as much as possible until post-op 4th day (every 2 hours)

  • Recovery #2: Resting
    - Bring warm comfy clothes; scarfs, loose shirt, sweatpants, sweat shirt, zip-ups
    - *Sleep at a 70 (degrees) angle (2 pillows - head above heart, no side sleeping, no face gestures, no talking, don't bend face down instead bend knees)*🌹
    - Chill with Netflix, books, iPad, iPhone & movies!
    - 3rd/4th day swealling peaks. So ice as much as possible.
    - Keep head elevated for 6 weeks after surgery (x2 pillows)
    - Intense exercise resumed 4/6 weeks after
    - Allow 6 weeks for major/significant swelling to reside and see the new outlook :)
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