I just finished speaking with Dr. Z. It was a short call because I didn't really have any questions prepared for him.

Yeah, he told me tattooing and hair removal is fine at 6 weeks. He said exercise is also okay at 6 weeks. He said I basically finished the first stage post op but that I still got ways to go. My tissue is apparently thick so I need to massage aggressively still, 3 times a day. He said I could go down to 2 times a day at 6 weeks. He also told me to wear the garment only around the house. One last thing he said was to continue to take Ibuprofen for another two weeks.

I'm upset at myself because Monday and yesterday I only massaged once. Today I haven't done a massage yet. I'll try to get at least 2 in before bed. I know it's important so I need to do it.

Quote from: JenJen2011 on February 08, 2012, 12:04:50 PM
I just finished speaking with Dr. Z. It was a short call because I didn't really have any questions prepared for him.

Yeah, he told me tattooing and hair removal is fine at 6 weeks. He said exercise is also okay at 6 weeks. He said I basically finished the first stage post op but that I still got ways to go. My tissue is apparently thick so I need to massage aggressively still, 3 times a day. He said I could go down to 2 times a day at 6 weeks. He also told me to wear the garment only around the house. One last thing he said was to continue to take Ibuprofen for another two weeks.

I'm upset at myself because Monday and yesterday I only massaged once. Today I haven't done a massage yet. I'll try to get at least 2 in before bed. I know it's important so I need to do it.

Jen is antiscar gel O.K. on forehead?

Do you feel a bunch of little bumps inside neck scar?  I do.  Just under middle of chin I feel bump size of "pea".  I think that would be too small for a lymph node.  Neck is looking better.  I still massage about twice a day.  My nose I probably do three times a day.  My forehead I massage but it still looks yucky.  Eye areas are nice and just give quick massage..

Quote from: wendy on February 08, 2012, 12:17:20 PMJen is antiscar gel O.K. on forehead?

Each case is different but yes, he did give me the okay so I suppose it is for you too. I'm at 4 1/2 weeks post op.

QuoteDo you feel a bunch of little bumps inside neck scar?  I do.  Just under middle of chin I feel bump size of "pea".  I think that would be too small for a lymph node.  Neck is looking better.  I still massage about twice a day.  My nose I probably do three times a day.  My forehead I massage but it still looks yucky.  Eye areas are nice and just give quick massage..

I feel small bumps along my jaw when I'm doing the massages. Don't know what that is. My jaw, chin, and massator area looks quite swollen but normal according to Dr. Z. I just got to do my massages religiously. I think my forehead scar looks quite good. Very neat and I haven't had any issues that I can tell anyways. I don't massage any of my scars though. I'm mainly focusing on my jaw/chin/massator area.

Quote from: wendy on February 08, 2012, 12:17:20 PM
Do you feel a bunch of little bumps inside neck scar?  I do.  Just under middle of chin I feel bump size of "pea".  I think that would be too small for a lymph node.  Neck is looking better.  I still massage about twice a day.  My nose I probably do three times a day.  My forehead I massage but it still looks yucky.  Eye areas are nice and just give quick massage..

Lymph nodes can be ultra tiny.  It is only when they are irritated that they swell big.

Quote from: JenJen2011 on February 08, 2012, 12:52:30 PM
Each case is different but yes, he did give me the okay so I suppose it is for you too. I'm at 4 1/2 weeks post op.

I feel small bumps along my jaw when I'm doing the massages. Don't know what that is. My jaw, chin, and massator area looks quite swollen but normal according to Dr. Z. I just got to do my massages religiously. I think my forehead scar looks quite good. Very neat and I haven't had any issues that I can tell anyways. I don't massage any of my scars though. I'm mainly focusing on my jaw/chin/massator area.

Dr. Z told me he thought I would look better without jaw and muscle reduction so that I feel no bumps along jaw.  I will guess he works from incision under chin.  My scar is less than 2.5 inches.  It has small bumps under scar area and I think peas size bump under chin is only bump that is large.  I think after three months skin is starting to loosen up.

Quote from: Jeneva on February 08, 2012, 01:14:21 PM
Lymph nodes can be ultra tiny.  It is only when they are irritated that they swell big.

O.K. chin one might be lymph node and I should not keep massaging it.

How does it feel when you pull out a suture with tweezers? I found a stiff, plastic-like suture last night and I'm scared to pull it out myself.

Quote from: JenJen2011 on February 09, 2012, 02:10:32 PM
How does it feel when you pull out a suture with tweezers? I found a stiff, plastic-like suture last night and I'm scared to pull it out myself.

With the exception of 1 suture that was just hideous, none of mine have hurt too badly.  If it is just a loose string then it doesn't really hurt at all, but usually there is a knot just under the skin so it hurts a bit as you pull it through.

But even then this is no where near hair plucking pain levels.  Most are around the level of picking at a scab.

Quote from: JenJen2011 on February 09, 2012, 02:10:32 PM
How does it feel when you pull out a suture with tweezers? I found a stiff, plastic-like suture last night and I'm scared to pull it out myself.

Jen feel like a teenager with acne with my forehead.  Just pull suture out with reasonable tug and clip it.  I like to use a sterile nail clipper cleaned with rubbing alcohol to clip suture.  Then try to leave things alone.  Mine continue to spit dissolved whitish material.  Maybe threads are starting to dissolve?  Maybe this isn't fishing line?  I am self conscious of forehead blemishes.

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Bottom back of each ear leaks out clear fluid.  Must be lymph node drain at bottom back of each ear.  You might feel some stitches behind ears.  These stitches were black when they come out.  Still have few bumps back there.

Ok, I'm going to try and dye my hair this morning.   I STILL haven't even though I said I would 2 weeks ago.  Somehow life keeps getting the in way.  If the dye works out then I will actually get my 6 week site post up this evening (only 2 days late).  I'm done with the surgical look pictures.  No more scar closeups.  From here out it is going to be real life pictures (IE: "town" clothes, smiles, makeup and hair actually somewhat styled).

Check out my Henna experience.

As far as healing goes, I'm feeling great now.  I have almost all of my voice back.  My forehead scar hasn't spit any more sutures since Wednesday morning and where I have kept it covered with Vasoline it is healing nicely.  My neck scar is starting to close up without scabbing too.  Behind my ear where a suture popped loose and I had a flap sitting up has almost healed back down flat.

After the hair dye I'm also going to play with my hair and see if fillers like topix can help make it look a bit denser so I can avoid hair transplants.  He brought my forehead down a LOT, but I still have a bit of a empty circle on each temple that my hair is too fine to cover completely.

OK, the week 6 update is on our site now.  I feel great.  I'll still keep with updating it at 2 months, but I think I will drop to monthly after that.  You can see that I still get some swelling/sag in my neck.  The scar is almost completely healed now.  But for 5 or 10 minutes after a massage it looks great.  You can sort of see my new jawline in the second picture and my chin in the first.

Here are the better pictures from our site.

I had my first laser hair removal appointment since FFS today.  Since I can't pluck my eyebrows yet I just had her zap them.  I was actually planning on increasing the areas we were working, but we only had time for my regular face/neck, eyebrows, and hands.  I've got a follow up appointment for my lower arms, under arms, and chest on Friday.

I've had another one of the mega serendipitous occurrences that I've been blessed with through my transition.  It turns out that just this week, they acquired a RN/LMT to offer massage services.  And he specializes in lymphatic drainage and deep tissue massage for scar reduction.smoothing after surgery (they use him for their laser lipo all the time).  He uses cupping, which is lighting a flame inside a jar and then putting it out and while it is still at negative pressure pressing it against the skin like a suction cup.  Sounds a whole lot like Rina's suction cup looking thing she used on the face doesn't it?  So I start with him Friday before I get my arms and chest fried.

She turned up the juice when she did my hands and forgot to turn it back down before starting my face, but I convinced her to leave it set higher (I was worried it was a bit low).  It was more intense at the lips and jawline, but I found that while I have touch sensitivity in my neck, I didn't feel the pain of the laser treatments so I must have more nerve repair to go yet.

Cool. Dr. Z told me to find a local masseuse. How's the jaw swelling? Still noticable? Mine definitely is. That's all I'm practically waiting for. Waiting for it to go down. The nurse where I work removed the suture that had spitted to the surface of my forehead yesterday. I didn't feel a thing.

Quote from: JenJen2011 on February 14, 2012, 03:07:22 PM
Cool. Dr. Z told me to find a local masseuse. How's the jaw swelling? Still noticable? Mine definitely is. That's all I'm practically waiting for. Waiting for it to go down. The nurse where I work removed the suture that had spitted to the surface of my forehead yesterday. I didn't feel a thing.

My jaw isn't so bad.  I guess it is technically swollen, but it is smaller than before because of all the work he did to the flab and muscle.  It is the same with my neck really.  I am swollen, but he reduced it so much that I still look so much better.

Most sutures aren't bad at all, you'll get the hang of it soon enough.  Once mine started popping it was almost non-stop.  They've stalled out now though.

My jaw is still swollen to the point where I can't see a difference from before yet. Because of the swelling, I don't look normal, for lack of a better word. So, I continue to wear the head garment out in public 5 1/2 weeks post op. I can't wait til I feel comfortable enough to go out without it.

Ok, I learned something new today.  I had my massage appointment and he worked mostly on my scars and then taught me a few things I can do for my limited jaw opening.  While I was there I opened enough to clear 3 fingers, while normally 2 is all I can open.  It is back down to 2, but he said over time it will relax and working it will help.

This person is an ICU RN, but he does massage therapy on the side.  He said that we can't open our mouth that wide because all of the trauma in our chin and necks has caused the muscles attached to hyoid bone to become tense.  This supports Wendy's theory that it is neck work not the jaw work that messes with our jaw range of motion.

He told me to put a finger in my mouth at the gum lines and push from tooth to the roof of my mouth.  This makes a crunchy sound and feels really odd.  You do that all the way around.  That relaxes one set of the muscles.  Another exercise he showed me was to turn my finger sideways with nail against the tooth and then bend it streching the skin away from the jaw.  Just doing this massage over each part of my mouth twice was enough to get another finger width. 

He also told me to try and manually stretch my jaw.  You grasp upper and lower teeth and pull apart WHILE resisting as much as possible with your jaw muscle for 8 seconds.  Then you relax that muscle and stretch it open as wide as you can for 5 seconds.  He said after 3 or 4 self treatments it will start relaxing back to normal all the time.

Quote from: JenJen2011 on February 15, 2012, 03:24:01 PM
My jaw is still swollen to the point where I can't see a difference from before yet. Because of the swelling, I don't look normal, for lack of a better word. So, I continue to wear the head garment out in public 5 1/2 weeks post op. I can't wait til I feel comfortable enough to go out without it.

Wore head garment for 8 weeks and removed for shower each day.  Wore for 16 hours for ninth week.  Wore at night for tenth week.  No head garment for past 4 weeks.
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Quote from: Jeneva on February 17, 2012, 02:13:52 PM

He told me to put a finger in my mouth at the gum lines and push from tooth to the roof of my mouth.  This makes a crunchy sound and feels really odd.  You do that all the way around.  That relaxes one set of the muscles.  Another exercise he showed me was to turn my finger sideways with nail against the tooth and then bend it streching the skin away from the jaw.  Just doing this massage over each part of my mouth twice was enough to get another finger width. 

He also told me to try and manually stretch my jaw.  You grasp upper and lower teeth and pull apart WHILE resisting as much as possible with your jaw muscle for 8 seconds.  Then you relax that muscle and stretch it open as wide as you can for 5 seconds.  He said after 3 or 4 self treatments it will start relaxing back to normal all the time.

Jeneva you should start seeing pieces of stitch separate as you massage inside mouth.  Do not pull on them as they will dissolve.

At 14 weeks jaw opens wide but my neck is still swollen.  I aggressively worked under chin and I now have swollen lump on right side of neck.  Think I have a swollen lymph node as you explained.
.........

Have not seen piece of thread from forehead for over a week but spots keep spitting whitish dissolved stitch.  Front area of forehead scar seems to be stabilizing.  Back half of forehead scar still yucky.

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Lower back part of left ear still scabbing and annoying.

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Starting to see a chin and skin under chin in front of scar is starting to move but is partially numb.

Still have not gained full mobility of left side of lower lip.

Nose swollen each morning.  Massage nose 2-3 times each day.  Pig nose is gone and nose looks better.  Right nostril has not gained full air flow.

Ok, I understand why he kept pushing me to see a massage therapist.  After that ONE session, I've got no more extreme droop on that one side of my chin.  I could massage it up, but it only lasted for a short time.  Today after 5 hours out and about in town it was still balanced.

If anyone has any problem spots that just won't firm up, it might be worth a shot.

He worked around the stitches in my mouth until I could ask Dr. Z if it was ok to work that area.

Wow, it has been 8 weeks since I had FFS.  It seems just like yesterday.  The swelling is down tons.

I got to talk to Dr. Z yesterday and he did confirm that Seth's (massage therapist) push out along the jaw line massage to increase jaw motion is fine to do now. 

I'm going to try and update our website with pictures either tonight, tomorrow, or the next day (it depends on what else is going on here).  I'll pull out the better ones and share them here too.  I finally had to give in and buy a hairpiece for the center of my head.  Even with the lowered hairline, I still had half circles on each side and it was so thin on top.  I found a mono filament human hair one from Estetica that I'm experimenting with now.  We found that color 4 blends almost perfectly with my longer hair and It stops just before my curls really start so it doesn't look too fake.  I may try for a transplant to fill in later, but I want SRS/GCS first.

I found a great tool to use for working on scars is this roller pen with silicone.  I don't know if the silicone is going to do anything or not, but the design of the pen is AWESOME.  I've been able to break up the thick lump on my left side of the neck scar with just using this tool as a massager.  If I'd known that this was so useful I'd have bought this just for the massage utility.  It is also breaking up some of the smaller lumps in my lip that I've not been able to do before.  The rollerball design makes it incredibly useful.

Here is a picture of it from Amazon

I had a hair appointment last night and we decided to use those pictures for the 8 week update.  I've already posted them up on Susan's in this thread.  The pictures do have a couple of decent facial profile so you can see the work he did on my forehead/nose/chin.  The frontal picture does make my chin look a bit squarer than it is (or even was before FFS), but I think that is because I still have a bit of swelling/droop in my neck because of the amount of work he did there.  It gets better all the time, but isn't yet totally gone.

The Joan Jett look hair actually fit my outfit yesterday pretty well since I a nicer black blouse with jeans and my black suede boots with silver buckles.  I had my long black wool coat instead of my black fake leather motorcycle jacket, but even the long coat went ok with it.  I think I'm going to run with that hairstyle for a while since it does fit well with my tattoos and piercings (even if I got rid of my snake bites).

Almost to three months so I asked Shannon to take a few pictures for me since I was dressed nicer for a Dr. appointment.

The neck scar is continuing to get smaller.  My nose scar is very light now.  I've been using a modified cupping technique that the massage therapist recommended.  He pointed me to a pistol grip plastic cupping set and it is working wonders on breaking up the cross links and thinning the scar.  I've had itching in my forehead and the last night I actually had minor pain for a few minutes (nerves are reconnecting).

I absolutely love the work Dr. Z did for me.  The difference in my neck alone was huge and I'm very happy with my nose.  His recommendation for the breast augmentation was also a very good fit for my frame.

I hate that this will impact how quickly I can afford to have GCS, but I would do it again in a heartbeat because it has made a HUGE difference in my appearance and confidence.