I started with a Skype consultation with FT after purchasing a virtual FFS from Alexandra Hamer. Based on her analysis and the FT consultation, I sent in my deposit and locked in a surgery date. When I arrived in Marbella, I had a face-to-face consultation with Drs. Simon and Capitan to finalize the decision on what surgeries would be performed. There were no changes from the initial consultation (forehead reconstruction, rhinoplasty, lip lift, and trachea shave).
The VFFS was very helpful for me in making a decision on which surgeries to pursue. Other surgeons recommended things that might have made minor improvements, but were not deemed necessary by Ms. Hamer or FT. I'm very satisfied with their recommendations.
I must say, however, that you should not to take the VFFS simulations too literally. There's no way Ms. Hamer can anticipate some anatomical factors which can influence what can be actually be accomplished by the surgeon. In my case, the thickness of my skin limited how much my nose could be narrowed. If you compare the VFFS images with my actually results 3 months post-op, you can see the differences. Having said that, I'm glad that I had the VFFS done. It helped resolve the uncertainty that I was feeling about what to do.
BTW, several of the other surgeons that I consulted with barely looked at the VFFS images, and dismissed my concerns about doing forehead recontouring without a CT scan to determine the thickness of the bone covering the frontal sinus cavity. I did not want to risk perforation of the anterior wall of the sinus cavity, or have bone filler used to shape my forehead. That was a huge factor in my decision to choose FT over several surgeons here in the US.