Hello all,

I've been lurking around Susan's for a while and finally decided to register

My name is Michelle. I'm a 20 year old male to female transsexual, I've been on hormones for about 4 1/2 months, and I was looking for advice on my FFS plans.

So here's what's up: I have scheduled a surgery date with Dr. Zukowski on April 14, but I am kind of regretting jumping into this so quickly. I know he is well respected in the trans community for his work, but I learned recently of his malpractice from just last month (sad story, check it out if you haven't heard). I understand doctors make mistakes from time to time, but I'm a little hesitant to undergo my surgery with him nonetheless.

Dr. Z gave me the list of procedures he recommends, and just from the list I can tell he is a bit of a salesman (although this seems to be the case with most plastic surgeons). Being on the phone with him is no different; he wants you to believe you need all of the procedures lol. Here is what he suggests:

1.   Feminizing biplaner variant endoscopic browlift with orbital rim burring/scalp advancement and temporal fat grafting
2.   Feminizing rhinoplasty/septoplasty
3.   Right Medpor cheek implants thru an intraoral approach with screw fixation
4.   Chin bone burring with soft tissue reshaping, a tracheal camouflage and a minimal scar variant neck and jawlift
5.   Jaw angle bone reduction with masseter muscle excision
6.   Fat grafting to the lips, cheeks and nasolabial folds

I just really feel.....like I don't need all of these things lol. In fact, I already know I don't want any fat graphs (mainly because over time they will melt away and I would need to have them redone from time to time), a cheek implant just seems unnecessary, and I don't think there is anything wrong with my nose. So I used VirtualFFS to get an idea for what I SHOULD have done VS what Dr.Z WANTS me to have done. Alexandra (the woman who runs VFFS) suggested that all I need is forehead, chin, and some hairline work done. The images I got back from her look great, and I was really excited to see that I didn't need a lot of surgery. Alexandra also gave me some images of what my face would look like if I did decide to go with all of the doctor's recommendations....and they are scary lol.

After going over the images (minus the "Dr. Z suggestions" images, because I feel like they would have been a little insulting to his practice) Dr.Z still highly suggests that I get jawline work done, and he really feels like I would benefit from a cheek implant (apparently my face is super asymmetrical). I know peddling people for their money is part of his job, so I don't blame him for that, but I really would like a better idea of what I should get done. I mean...VFFS is great, but isn't his professional opinion just as (if not more) legitimate?

Also, I understand the VFFS pictures do not represent what I will ACTUALLY look like after surgery, and I feel like the "Dr. Z suggestions" pictures probably do not give him enough credit.

So I guess I'm just looking for some of y'alls perspective. If you have had surgery with Dr. Z I would love to hear about your experience, as well as anyone's else's experience with FFS

I have linked the images I sent to and received from VirtualFFS so you guys can judge my face lol.

http://i44.tinypic.com/14lsdna.jpg (front before)
http://i42.tinypic.com/2ujld06.jpg (front after)
http://i42.tinypic.com/110dj6r.jpg (dr. z front)
http://i39.tinypic.com/16lik50.jpg (side before)
http://i42.tinypic.com/331ke84.jpg (side after)
http://i43.tinypic.com/35bdpxd.jpg (dr. z side)
http://i41.tinypic.com/11gj7sm.jpg (3/4 before)
http://i39.tinypic.com/2whdtvd.jpg (3/4 after)
http://i44.tinypic.com/nvodi1.jpg (dr. z 3/4)

Also, here's a couple pics of me when I don't look so awful lol
http://i40.tinypic.com/a4fh4.jpg
http://i43.tinypic.com/2ekqgs8.jpg

Thanks!
Michelle <3

He always suggests the cheek implants, but if you say no he will listen to you.  I'm 38 and had surgery with Dr. Z on 12/29/2011.  I have a thread in this sub forum you can look at for pictures (or hit our site).

Of your list I had everything but #3.  The fat grafting doesn't necessarily ALL fade away and it is fairly low cost (I don't think it was but a $300 line item on my cost sheet).  If you can't get it done while you are under it does HURT!!!!!!

Do you have any breathing or snoring problems?  If so you may want to have the nose work just so he can correct whatever was wrong.  I can breath and smell so much better than before.  Evidentially my nose was broken when I was fairly young and like most things from then it was hidden from me.

I really didn't think I needed a lot of what he suggested, but he did say several pieces would really hurt the end result so I left them because he does have more experience at FFS evaluation than me.  In the end I'm glad I did.  I like what he did for me.  It is a lot of money, but a second surgery is even more.

So basically I'm saying that I am totally satisfied with what I had done and would do it again in a heartbeat.

Don't feel like you have to do everything he suggested. I personally feel he recommends what he truly thinks you need but the decision is ultimately yours. Don't feel pressured. Make a decision and be stern about it.

Out of everything he recommended for me, which was less than yours, I opted not to have the cheek implants. Everything else I gave it a go (forehead, jaw, chin, lip lift, fat injection to lower lip) and so far I'm happy I did. I'm still healing but everything is looking good.

VFFS can be a helpful reference but it's not something you should strictly go by. Alexandra told me I shouldn't do my forehead, scalp advancement, or brow lift and I'm happy I decided not to take her advice on that.

Good luck.

i think your nose is very nice as it it..other stuff he suggests looks ok imo but not really necessary, up to you and your finances.

IMHO I think if you had the hairline thing done and your nose fem'd up you would be fine. You look pretty now but the profile of your nose and width of the nostrils are a touch masculine. Even the "dz z" picture isn't what I would suggest. The profile shape looks OK, maybe -slightly- turned up more but the nostril flare should be reduced too if you do this. A smaller nose will make your eyes/cheeks appear larger and balance the nose/lip/chin ratio as well.

I honestly think the rest is so subtle given the extensive surgery required, not sure if it's worth the small changes. I would NOT mess with your cheeks or your lips! If I was going to do any of the other, the brow first (if you plan to wear your hair up most of the time) and maybe the chin smoothing but your jaw line needs nothing IMHO.


My surgeon had a laundry list of things he suggested but in the end I decided to only do my nose (which he was fine with) and am very happy with the results. I think even my surgeon was surprised how much of a change just this made. I have no plans to do any more work on my face.

You might want to check out Dr Speigel, there are a few younger people on this board that had amazing results with him.


if it helps here are some pictures of my vffs and photos of me before and after surgery with dr Z.


Virtual FFS:



Before:


3 weeks after ffs:


5 weeks after:


6 weeks after ffs:

IMO you shouldn't get a procedure done which will result in you looking like a freak as a male. Anything like high brows, narrow noses or tiny chins would be borderline acceptible in a woman, but not in a man. Opting to have features which appear normal in both genders will create a more natural look.