11 month post op Yeson photo

[Jennygirl]

Hi all! Today I saw Los Angeles based otolaryngologist Amanda Salvado. She was incredibly nice.

When I first started talking to her, she asked me about my surgical history and I told her about Yeson's procedure. She was quite familiar with the idea of making an anterior "web" to shorten vocal cords. She then said "but I have only ever seen this done for transgender people". Suddenly I realized that she did not even realize I was transgender. Coming from a voice specialist, that was HUGE for me and a testament to how well my voice is passing these days She looked shocked, and most of all very excited!

I told her I specifically wanted her to look for vocal tremor, and to comment on the healing overall.

But before getting started, she said that my voice seems to have a very good quality to it, does not sound hoarse or anything (which I guess is a complication of making an anterior web) and she could not hear the presence of vocal tremor. She was very impressed with the way it sounded.

Down went the laryngoscope and she had me to a set of "Hee" "Hee" "Heee" at different pitches which I was easily able to match to her voice in terms of pitch. She just kept saying how good it looked!

When it was over, I was able to watch the video and she printed out some photos. She said that she cannot see any evidence of vocal tremor and thought that botox would not do much for me. She also said how beautiful the work was that Dr. Kim had performed. I mean it healed perfectly around the vibrating areas. There is a small granuloma farther down in the non-phonating part of the muscle which she said is probably just a reaction to the suture. There was an excitement in her voice that really made me feel so incredibly good, and it's nice to know that I do not have vocal tremor.

Here are the photos


As far as not having the same upper range extension as a cis female, she said that it was probably due to the network of muscles around the larynx.... that mine is simply not set up for those frequencies. She said I do have a slight gap in low notes, but this also probably contributes to the sound of my voice (she said it sounds very delicate and smooth instead of bright and raspy).

Overall I am stoked!

Well there it is. 11 months post op and things are healing wonderfully, and I don't have to keep getting botox injections. It makes me wonder if Dr. Kim just likes to apply botox in the beginning to aid in healing since it keeps the vocal cords loose. Either way, he is doing his job incredibly well. She was blown away and said that she would be showing my results to all of her colleagues.

Looks like Dr. Kim's exact method will probably pick up steam in the U.S. Based on what she had said to me, in the U.S. they typically use a laser to form the web. Dr. Kim uses a microscopic scalpel instead... I wonder if that's what makes the big difference.

[Jessica Merriman]

Suddenly I realized that she did not even realize I was transgender.

I would have loved to see the smile on your face at that moment!

Glad it healed nicely!

[abbyt89]

Wow Jenny, thanks for this!

Your surgical site looks amazing! I remember Dr. Kim showing me my vocal folds at 1 week and I was already impressed by how normal it looked. It's great to know that other voice professionals are pleased with his work

[Shantel]

Suddenly I realized that she did not even realize I was transgender. Coming from a voice specialist, that was HUGE for me and a testament to how well my voice is passing these days She looked shocked, and most of all very excited!

Get used to it Jennygirl, most if not all cis women will be having the same reaction, soon you will have no reason to ever out yourself to anyone again for any reason.

[Jennygirl]

Thanks everyone! It has been a great day.

Just so insanely glad I have no vocal tremor! Did not want to get botox injections in my throat forever. And I figured this information might be useful to those looking into VFS with Yeson.

Going to do a 12 month interview video for them sometime in the upcoming weeks!

[AmyBerlin]

Dear Jenny,

congratulations on your super-nice results! What an uplifting experience that must have been for you! I suppose Dr. Kim just likes the effects of Botox (and it might indeed contribute). Your laryngoscopic pictures look great, glad it healed so well!

I hope everything goes as well for me as it went for you – 2 weeks to go!

Love,

Amy

[Jennygirl]

Especially after seeing this, I'm sure it will go well for you Amy

Another thing I didnt mention, he did fix the asymmetry in my vocal cords and evened the lengths perfectly. One side is still a little bit bigger, but the hemorrhage is no longer there at all.

Here is my preop and immediately post op photo for comparison:

pre:


immediately post (may 2013):

[anjaq]

Wow congrats Jenny , also for that great experience of the ENT not thinking of you as transgendered, thats really nice - Pretty neat. I am glad that she liked the results!
Just two little questions or remarks.

I do not see any threads in that picture. Does Dr Kim use threads that are dissolving eventually or did they basically just "grow in" so they are not visible anymore?

I can see a hint of what I had developede over time with my vocal chords and that I posted about - that slight hourglass shape - did your ENT comment on that, is it unproblematic or is it something you should keep an eye on? It should not get worse or rather improve with doing voice exercises, but I was just wondering as I still had my larynx photos in the back of my head.

[Jennygirl]

I thought it was a permanent suture material, but I don't see any sutures... So they must have dissolved? Good question.

Also yes, you are talking about the gap. She mentioned I have a gap towards the commissure but only for low notes. She said that perhaps it was intentional by Dr. Kim in order to make the voice softer sounding at lower frequencies. The gap is pretty much nonexistent at the higher frequencies.

I think this likely attributes to why I lose my voice so quickly if I talk in the lower range at high volumes for extended periods of time... because that would mean that the vocal folds are making contact with each other at one point instead of along the whole edge and it probably causes it to swell.

I have another appointment set for August because she wanted to keep a loose eye on the granuloma, so any questions you have I can for sure bring up to her then

[anjaq]

Also yes, you are talking about the gap. She mentioned I have a gap towards the commissure but only for low notes. She said that perhaps it was intentional by Dr. Kim in order to make the voice softer sounding at lower frequencies. The gap is pretty much nonexistent at the higher frequencies.

I think this likely attributes to why I lose my voice so quickly if I talk in the lower range at high volumes for extended periods of time...

interesting thoughts. yes i had the same gaps and also my ENT noted that it was happening mostly below 200Hz. my speaking range is about 120-180 Hz , the upper end of it is straining most but the lower end as well. I wonder if I had just kept speaking at a higher pitch it would have occured less? but as i understand it, it is due to the muscles tightening up in the wrong way. basically how my voice rehab person that i was sent to after this was diagnosed fixed this was by increadin my airflow with exercises like lip flutter and such. Maybe this would help you. And yes, this thing does feminize the voice a bit, but they said if it stays like this for too long it can cause nodules or something like that. I doubt that it is intentional by Dr. Kim as he basically diagnosed this in the video I sent him and said it would complicate the healing process. Does it have any effect on the voice quality that ar enegative - some breathiness would be the usual guess although I had none notiveable when I had this issue. (To all other members who read this: I did not have the surgery - I just had this issue from using my trained voice for a long time)

[Ducks]

As far as not having the same upper range extension as a cis female, she said that it was probably due to the network of muscles around the larynx.... that mine is simply not set up for those frequencies. She said I do have a slight gap in low notes, but this also probably contributes to the sound of my voice (she said it sounds very delicate and smooth instead of bright and raspy).

Jennygirl, thank you for your openness about this, it is amazing to hear your voice and see the results you are getting!  I assume from the quoted passage of your post above, that you are a singer?  Can you tell any difference in your ability to 'hit' the notes you want to sing immediately from before?

Loss of singing has been hard for me, but if this surgery will let me keep my pitch without leaving me a baritone trapped in an alto's body, I would get on a plane tomorrow!

[Jennygirl]

Jennygirl, thank you for your openness about this, it is amazing to hear your voice and see the results you are getting!  I assume from the quoted passage of your post above, that you are a singer?  Can you tell any difference in your ability to 'hit' the notes you want to sing immediately from before?

Loss of singing has been hard for me, but if this surgery will let me keep my pitch without leaving me a baritone trapped in an alto's body, I would get on a plane tomorrow!

Hi Ducks! I like your name

I used to sing all the time when I was in HS (my mom is a even voice teacher), then kind of fell off the bandwagon some years ago.

I'm still not really back on the bandwagon, but that's not because I can't. I can still sing, I just have a slight bit less range than I used to... It sounds more female to me, though!

If you are hoping to be a professional female vocalist I'm not sure if this is the surgery for you, but you will probably still be able to sing (you just won't have the low notes and you'll probably gain a few on the top end). Chest to head voice transition feels new, too.

Hope that helps!

[Ducks]

Hi Ducks! I like your name

I used to sing all the time when I was in HS (my mom is a even voice teacher), then kind of fell off the bandwagon some years ago.

I'm still not really back on the bandwagon, but that's not because I can't. I can still sing, I just have a slight bit less range than I used to... It sounds more female to me, though!

If you are hoping to be a professional female vocalist I'm not sure if this is the surgery for you, but you will probably still be able to sing (you just won't have the low notes and you'll probably gain a few on the top end). Chest to head voice transition feels new, too.

Hope that helps!

It does help!   I am not a pro, but I love singing and my fear is/was that I would suddenly lose my ear and become 'tone deaf'.  If I can sing in my female voice I would be ecstatic.  I've already lost my range due to lack of use.  Anyway, thanks about the name and for the info

[Jennygirl]

It does help!   I am not a pro, but I love singing and my fear is/was that I would suddenly lose my ear and become 'tone deaf'.  If I can sing in my female voice I would be ecstatic.  I've already lost my range due to lack of use.  Anyway, thanks about the name and for the info

Sure thing! I can definitely confirm that voice surgery will not affect your sense of pitch at all!

I had perfect pitch before and can still tune a piano

I bet that some signing would probably do a lot of good for re-realizing the new range of a voice following this vfs. But with vocal tremor, it makes it harder. Care has to be taken not to damage the vocal cords (because with vocal tremor they are not colliding perfectly). That is another reason I don't sing very much- Dr. Kim said go light on the singing because of the disorder. That is, unless I am getting regular botox injections (which I don't so much want)

That said, the doctor I went to told me that she saw no vocal tremor. Dr. Kim's tests were about 1000% more involved though... everything from breath flow tests to super slow motion video of the flapping motion. So, I am airing on the side of caution.

[Ducks]

Sure thing! I can definitely confirm that voice surgery will not affect your sense of pitch at all!

I had perfect pitch before and can still tune a piano

I bet that some signing would probably do a lot of good for re-realizing the new range of a voice following this vfs. But with vocal tremor, it makes it harder. Care has to be taken not to damage the vocal cords (because with vocal tremor they are not colliding perfectly). That is another reason I don't sing very much- Dr. Kim said go light on the singing because of the disorder. That is, unless I am getting regular botox injections (which I don't so much want)

That said, the doctor I went to told me that she saw no vocal tremor. Dr. Kim's tests were about 1000% more involved though... everything from breath flow tests to super slow motion video of the flapping motion. So, I am airing on the side of caution.

Wow, perfect pitch is the gold standard so if you can still realize that in your new voice, it makes me feel that much better about having surgery.  Of course, go slow and build back to singing if that is what Dr. Kim says, it is a gift you won't want to lose. 

If you don't mind my asking, what does the botox do?  It wasn't clear to me how that helped or why it isn't desirable (for you at least) to have the injections. 

[anjaq]

Chest to head voice transition feels new, too.

Hi, Jenny. This one interests me a lot. Its because this transition is hard for me now, my voice therapist keeps trying to push me over it while speaking for enunciation and such, but it feels like I need to control it very carefully and just am not comfortable using it in my regular voice, so I usually just stay in chest voice which obviously is way too deep (just yesterday someone asked me again why I have a male voice and if I was "a >-bleeped-<". I told him I am not and he apologized later when he was sobre, still... annoying!). The problem I hit with voice therapy and when we try to push up average speaking frequence a bit is that I have to pass over that chest-head transition more often to not sound monotonous. The result is that I tend to sound more monotonous when raising pitch. So I would be really interested in how this feels differently. My problems now with it is, that I have less pitch control in that area than elsewhere (while speaking) and that I massively loose volume/loudness there.

I have a totally unrelated question too for all who have been to Yesons - if you hear your voice now on a answering machine or recording of any sort, does it sound undoubtedly female to you? I find it so hard to judge - I did a redording in voice therapy and she said it sounds female, to me it sounded totally male. When I started Hormone therapy, 1 year later to me my face looked male or male-sih forever - with some hints of femaleness at times. At that time I cannot recall anyone looking oddly at me anymore, so I guess I did not look male-sih and if I look at photos, I dont see it either. Yet in the mirror I still have similar issues even now. Would this be happening with the voice as well - that divergence between self perception and perception by others, or is it differently and sounds ok to oneself as well.

[anjaq]

I am a bit curious about the terms assymetry and vocal tremor. I think different people seem to use it differently. What Jenny seems to describe above as vocal tremor - then the two vocal folds do not hit each other perfectly, I think my phoniater describes as an assymetry (because they are not hitting each other symmetrically), while Dr Kim seems to talk about an actual assymetry in thickness or length of the vocal folds when he uses that word. I feel this may be so and cause confusion as my phoniatrist told me about the assymetry (in hin definition) and Dr Kim said I have an assymetry plus a vocal tremor. So I was confused and the people here actually do not know what he means with that "vocal tremor". Also I still dont know how Botox really would help , given that it seems to make the voice worse during the first few weeks for some who had it at Dr Kim's - I guess it may be used differently...

[alexiakk]

Looks like Dr. Kim's exact method will probably pick up steam in the U.S. Based on what she had said to me, in the U.S. they typically use a laser to form the web. Dr. Kim uses a microscopic scalpel instead... I wonder if that's what makes the big difference.

CONGRATZ Jenny!!

As the difference between suture and laser, Dr. Kim told me that it does not overkill the entire tissue in that area - which means that the process is possible to be reverse (However the quality will not be 100% as pre-op as the area is already damaged although not entirely dead). I also have asked Dr. Haben on this question and he said they are for the same purpose - he sometimes uses suture as aux. too.