I've been on HRT for one month shy of 2 years now, after starting it at age 32.  I'm fortunate in that I pass as female without makeup, but there are parts of my face which give me dysphoria, particularly when my hair isn't blocking some of my facial features from being seen (like when I'm at the salon, for instance).  Getting out of the shower also sucks, because then it's almost all visible facial features and scarcely any protective hair (because it's all wet).

I'll probably end up needing a hairline advancement and brow lift, rhinoplasty, and face lift (because I lost more than 100lbs and have had a good deal of excess skin on my neck for a while now, which bugs me).  Here's my face.  That picture is from last week, and a few days later I dyed my hair my natural color to get rid of some grays.

I guess that I should start with Virtual FFS, to have a clearer idea of what I should be looking to get done, before I set about doing consultations and getting prices.  I've heard people talk about this site for Virtual FFS.

For surgeons, I've been thinking about Dr. Cardenas, as well as Facial Team.  My understanding is that Dr. Spiegel does very good work, but that he is pricey.

If you already are decided you want FFS and already know which parts bother you the most, maybe you do not need the simulation. VFFS will give you an assessment that is not trying to sell you more than you need. It is a bit more conservative. It matches well with Facialteams philosophy. You will also be able to get picture simulations if you want to see what may change and if you really like it. Maybe you can also know then in which parts you actually want to ask for more or for less change. It is helpful, but if you are quite decided on procedures already you can live without it as well. I found it quite interesting to convince myself that it really is beneficial in some areas and that other areas would need more change than suggested for me to be seeing a difference. Compared to FFS the price of it is quite acceptable, I think

Quote from: anjaq on May 26, 2017, 05:35:42 AM
If you already are decided you want FFS and already know which parts bother you the most, maybe you do not need the simulation. VFFS will give you an assessment that is not trying to sell you more than you need. It is a bit more conservative. It matches well with Facialteams philosophy. You will also be able to get picture simulations if you want to see what may change and if you really like it. Maybe you can also know then in which parts you actually want to ask for more or for less change. It is helpful, but if you are quite decided on procedures already you can live without it as well. I found it quite interesting to convince myself that it really is beneficial in some areas and that other areas would need more change than suggested for me to be seeing a difference. Compared to FFS the price of it is quite acceptable, I think

I don't really know which parts are my exact trouble spots (and what exactly to have done), just going by what others have suggested in the past when they've looked at my pictures.  I guess the VFFS will do a good job of pinpointing that more precisely (and objectively).  It does seem like a wise purchase when looking at the overall cost of FFS.

Yes then go for it. It contains a several page long detailled assessment of your features and which one is worse and which one is ok and so on. And she is not getting money if you book more surgeries, so thats sometimes better than asking surgeons

Quote from: anjaq on May 26, 2017, 01:26:30 PM
Yes then go for it. It contains a several page long detailled assessment of your features and which one is worse and which one is ok and so on. And she is not getting money if you book more surgeries, so thats sometimes better than asking surgeons

Yeah it helped alot.  It's funny too that Spiegel (first consult, albeit I'm going with Mardirossian next week) gave basically the same conclusions as Alexandra Hamer, so I knew he wasn't crazy/upselling so much.  That also gave me an idea of what to push talking to other surgeons as well (including my chosen doc).  Avoids upselling if you're looking to avoid being upsold.  But just be aware, her recommendations aren't an end all, and after all there is some sort of intersectionality between beautification and Feminization in this surgical specialty, imho.

Quote from: JessieBirdie on May 26, 2017, 05:46:42 PM
But just be aware, her recommendations aren't an end all, and after all there is some sort of intersectionality between beautification and Feminization in this surgical specialty, imho.

Agreed.

Quote from: JessieBirdie on May 26, 2017, 05:46:42 PM
But just be aware, her recommendations aren't an end all, and after all there is some sort of intersectionality between beautification and Feminization in this surgical specialty, imho.

How does that affect the prior statement that Virtual FFS avoids upselling if you're looking to avoid being upsold? Does it imply that there may be some cases where being upsold is beneficial, because Virtual FFS can't predict everything?

Quote from: Anna Banana on May 26, 2017, 07:17:26 PM
How does that affect the prior statement that Virtual FFS avoids upselling if you're looking to avoid being upsold? Does it imply that there may be some cases where being upsold is beneficial, because Virtual FFS can't predict everything?

An example for ya, Hamer said zero needed about my nose (albeit she gave me a Sim of what it could do).  Spiegel also said zero needed about my nose, Facial team said zero needed, Mardirossian (who I chose in the end as he quite proficient enough and due to logistics issues, given my mother refused to come with me to Spain plus a shot at insurance isn't a bad thing...also facialteam's insurance in case shtf to cover complications is imho a joke) asked me about my nose....I knew given previous consults it wasn't necessary.  I told him flat out no, avoiding an upsell.  We basically went with Spiegel's suggestions following that, minus lip fillers.

Hamer/VFFS gave me an idea of what I'm looking for, more or less (forehead, thyroid, and jaw/mandible).  However, I actually disagreed with her on cheeks given Spiegel's and Mardirossian's recommendations...so really it's not an end all.

The consultation process needs to be an exploration of what's possible, and an unbiased opinion that isn't trying to sell you surgery can be beneficial in working through it.

Quote from: JessieBirdie on May 26, 2017, 08:16:46 PM
An example for ya, Hamer said zero needed about my nose (albeit she gave me a Sim of what it could do).  Spiegel also said zero needed about my nose, Facial team said zero needed, Mardirossian (who I chose in the end as he quite proficient enough and due to logistics issues, given my mother refused to come with me to Spain plus a shot at insurance isn't a bad thing...also facialteam's insurance in case shtf to cover complications is imho a joke) asked me about my nose....I knew given previous consults it wasn't necessary.  I told him flat out no, avoiding an upsell.  We basically went with Spiegel's suggestions following that, minus lip fillers.

Hamer/VFFS gave me an idea of what I'm looking for, more or less (forehead, thyroid, and jaw/mandible).  However, I actually disagreed with her on cheeks given Spiegel's and Mardirossian's recommendations...so really it's not an end all.

The consultation process needs to be an exploration of what's possible, and an unbiased opinion that isn't trying to sell you surgery can be beneficial in working through it.

Ahh, yeah, that makes sense.  So start with the feedback you get from VFFS as a foundation, but if you have multiple surgeons saying the same thing about something that you should deviate from the VFFS on, then you ought to do so.

Quote from: Anna Banana on May 26, 2017, 09:24:58 PM
Ahh, yeah, that makes sense.  So start with the feedback you get from VFFS as a foundation, but if you have multiple surgeons saying the same thing about something that you should deviate from the VFFS on, then you ought to do so.

I also like that approach and I plan on starting with a VFFS assessment as well. 

I'm curious, has anyone had a remote and a live consultation with the same surgeon and received revised feedback once they saw you in-person?

Alexandra is rather conservative in her suggestions. So its possible she will not suggest something that would be considered cosmetic but that you may like. Her focus is on pure feminization or rather on removing male characteristics. But maybe you want to be more feminine and would like fuller lips or a cuter nose anyways, even though there are many women with the lips and nose you have (just as a random example)

Quote from: JessieBirdie on May 26, 2017, 08:16:46 PM
also facialteam's insurance in case shtf to cover complications is imho a joke

What does it include and what not? Why is it not good? I know some surgeons do not even have such an insurance, which in one case I know ended in a patient being sent a 10k bill for emergency treatments... so I found it positive they do have it at all.

Quote from: staciM on May 26, 2017, 09:52:18 PM
I'm curious, has anyone had a remote and a live consultation with the same surgeon and received revised feedback once they saw you in-person?

Yes. I had this happen with Facialteam. I did send photos , they gave me a list of things I need and a quote - I went to a consultation later and was then told that I do not need FFS at all, but if I want, we can still do these procedures in the list, but the are all optional and I can pick and choose basically.

With another surgeon it was interesting as well. I did send pictures 2 years ago and got a list of procedures and a quote, then I did the same recently and the number of procedures doubled, as did the price. I feel he may be trying to "upsell" me?

Quote from: anjaq on May 27, 2017, 03:16:53 AM
What does it include and what not? Why is it not good? I know some surgeons do not even have such an insurance, which in one case I know ended in a patient being sent a 10k bill for emergency treatments... so I found it positive they do have it at all.

Facialteam sent me a Spanish document detailing the insurance when I inquired (given I had complications during my SRS, I did not want to be without a paddle if shtf in the OR or during recovery).  It had the following as far as I can tell:  €1,500 for medical complications, €1,000 for intensive care costs for each patient for a grand total of €2,500, insured by Previsión Mallorquina and paid for by their office (legally SICAP Healthcare S.L.P.).  This is a small amount, roughly $2,750 in today's dollars.  This...in comparison to an unlimited maximum so long as I hit my max out of pocket on US health insurance (as US Health insurance generally will cover complications for plastic surgery even if the original surgery is not covered).  Maybe it's me being more conservative, but I'd prefer the no lifetime limit of US health insurance given Obamacare, especially vs. <$3k.  If it were even $10-$20k I would've much more strongly considered FT.

If you're interested, I can send you the documentation.  PM me.

Wow - I did not expect the US health insurance system to be that superior in this department, but there always has to be a first. Here, private "cosmetic" surgeries are all up to the patient - none of the general health insurance pay for complications. If I just get a breast enlargement here, if something goes wrong I probably have to pay for it myself or get an extra insurance. At least this I was told. But covering ons 3000 or less is really nothing, considering complications can be easily several thousands if they need to keep you for a couple of days in the hospital, maybe even intensive care...

Quote from: anjaq on May 28, 2017, 09:47:07 AM
Wow - I did not expect the US health insurance system to be that superior in this department, but there always has to be a first. Here, private "cosmetic" surgeries are all up to the patient - none of the general health insurance pay for complications. If I just get a breast enlargement here, if something goes wrong I probably have to pay for it myself or get an extra insurance. At least this I was told. But covering ons 3000 or less is really nothing, considering complications can be easily several thousands if they need to keep you for a couple of days in the hospital, maybe even intensive care...

My point exactly.  Albeit I want to clarify something in your statement.  The definition of a "covered complication" in terms of US health insurance would be more or less something affecting daily function of the body in everyday context that isn't debatably trans or cosmetic related...for example.

A: A fistula following vaginoplasty that forces someone to use a colostomy bag.
B: Major sinus issues following FFS affecting breathing and requiring major surgery (forehead contouring opens up the frontal sinus...I could see this happening).
C: An inability to speak following VFS or a Tracheal Shave
D: A clot causing circulatory problems requiring emergency surgery in the OR
E: A major bacterial or viral infection following surgery that requires intensive care.
...etc

You probably wouldn't have the following covered if the original surgery wasn't covered (if it was though these may be a different story).
A: Breast implant rupture
B: Revisions for a rhinoplasty
C: Vaginal Deepening for inadequate depth following SRS.

I'd be shocked if any first world country didn't cover the first group honestly.  FYI: I had complications during my vaginoplasty (specifically a fistula scare due to an enterotomy in the OR), Mcginn took care of it very well and gave me extra care for free.  I also have a friend who is currently dealing with a Clostridium difficile infection right now after going to Bowers fairly recently.  Her hospital stay (separate from her treatment from Bowers as it occured after she got home) for that is covered here in the US.  If I got C. Diff out in Spain though post FFS...who knows how damn expensive that would be :/.  Heck, even my mom got C. Diff once after foot surgery just outside of NYC, which caused ischemic colitis and a 2 day hospital stay.

Complications, not just "botched results" happen, and I personally prefer to be in a position where they can be handled properly and I don't have to be concerned about money an ocean away from home, but that's just me.  In the US, with US health insurance and Obamacare, I can be certain I have that blanket of extra security.

Well I am not 100% sure about German health insurance. To a degree I think they would also cover long term consequences, possibly. What is pretty much excluded, especially ehen going abroad is immediate complications and I think this is all that is covered with FT insurance - like if you loose a lot of blood during surgery and need to be in intensive care for some days, or if you get an infection and need special care. Basically only stuff that occurs from the time of surgery until a few days later - by that time you should be home anyways...

Complication 1-A I had - but luckily it was covered because GRS was covered and even more luckily I only had this for half a year.

As far as I know in Germany people are often buying extra insurance if they do something like a breast implant for cosmetic reasons that covers issues like fibrosis or bad implant placement - not sure what it includes, really.

I think the long term complications are not really well covered if one does purely elective surgery. Basically a lot is "your own fault" then :\

HI Anna!!!... I used VFFS site early in transition... She sends well written recommendations along with the Photoshopping... Her recommendations were pretty much the same as the ones I received later from my surgeons (Ousterhout and Deschamps-Braly)... I went ahead with all that was recommended but looking back at her photoshopped pics.. I don't think they represented the final look of my face particularly well...

Onward we go

Ashley

Quote from: tgirlamc on May 28, 2017, 02:02:33 PM
I wasn't with all that was recommended but looking back at her photoshopped pics.. I don't think they represented the final look of my face particularly well...

This is interesting! I'm curious! May I ask you to share the photoshopped pics??? What are the main differences you noted between the final result and the photoshopped estimation??

Quote from: Wednesday on May 28, 2017, 02:20:40 PM
This is interesting! I'm curious! May I ask you to share the photoshopped pics??? What are the main differences you noted between the final result and the photoshopped estimation??

Hi Wednesday... I'm just heading out the door but will try to get them posted this evening... They are on an old laptop that barely works .. I've been having such issues trying to get photobucket to function lately too!... If you PM me your email it might be easier!!!

A:)

Quote from: tgirlamc on May 28, 2017, 02:27:48 PM
Hi Wednesday... I'm just heading out the door but will try to get them posted this evening... They are on an old laptop that barely works .. I've been having such issues trying to get photobucket to function lately too!... If you PM me your email it might be easier!!!

A:)

Roger that! Thank you very much!!!!

Hi Ashley - can you say something about what was different? I had the VFFS pictures with me when I asked Facialteam and they said that they should be pretty accurate...