wendler glottoplasty with Prof. Remacle

[Lilykit]

Hello Everybody.

I had my VFS with prof. Remacle and thought it would be nice to open a real-time Q&A thread ( which ,I guess ,will present a more accurate represntation of how it feels to undergow the surgury).

So first of all some 101:
So if you search prof. Remacle name in the forum you'll see that he is situated in belgium.
THAT IS NO LONGER THE CASE. As of september he moved to luxembourgh and operates at the ORL department of luxembourgh hospital.

His prices went up a bit but pretty close to the estimate given previously ,of course if you're a EU residence it'll be cheaper.

The mandated hospital stay (at least in my case ) is one night at the hospital.

So far the staff is lovely(And the prof. is really nice ) , even if some struggle a bit with english (which, to be fair, is understandable when most staff talk at least three different languages ).

How do I feel(about ten hours post op):
Right now I feel fine. There is a slight iritation I my throat like I'm holding a cough , but this goes away for some time if I drink water.

If there is anything you would like to ask I'm here for you

Lilykit.

[Lynne]

Hello Lilykit,

Thank you for sharing your experiences, I'm very interested in results from Dr. Remacle as this option is the most realistic option for me considering the costs and travelling.

[Lilykit]

Hello Lilykit,

Thank you for sharing your experiences, I'm very interested in results from Dr. Remacle as this option is the most realistic option for me considering the costs and travelling.

You'll have to wait a bit for yhat but why not.

I intend to post a 1 month post op recording. Sadly I dont think I have pre-op recording ,but my orig. pitch was at the mid 130's.

[Lynne]

Oh and I forgot, good luck with the recovery!

[kwala]

Hello Everybody.

I had my VFS with prof. Remacle and thought it would be nice to open a real-time Q&A thread ( which ,I guess ,will present a more accurate represntation of how it feels to undergow the surgury).

So first of all some 101:
So if you search prof. Remacle name in the forum you'll see that he is situated in belgium.
THAT IS NO LONGER THE CASE. As of september he moved to luxembourgh and operates at the ORL department of luxembourgh hospital.

His prices went up a bit but pretty close to the estimate given previously ,of course if you're a EU residence it'll be cheaper.

The mandated hospital stay (at least in my case ) is one night at the hospital.

So far the staff is lovely(And the prof. is really nice ) , even if some struggle a bit with english (which, to be fair, is understandable when most staff talk at least three different languages ).

How do I feel(about ten hours post op):
Right now I feel fine. There is a slight iritation I my throat like I'm holding a cough , but this goes away for some time if I drink water.

If there is anything you would like to ask I'm here for you

Lilykit.

Best of luck, Lilykit and thanks for sharing.  There have not been many examples of Dr. Remacle's work so it's great that you are willing to post about your experiences.

[anjaq]

Hi - good luck and it will indeed be interesting to hear more reports and voice samples from Remarcle here. Recently everyone seems to talk only about D rHaben

Its a bit sad that you did not do a pre op recording - don't they make a pre op recording at the clinic there? Dr Kim at Yeson does that everytime...

[Lilykit]

They don't really insist on it as they don't publish the results.

I'll look around my computer once I've gotten home to try and find a voice sample, though even if I can't find one I did a pitch check before and my natural voice was 132 hz so we'll have that baseline to work with .

[anjaq]

Ah - Ok, I thought they usually do before recordings everywhere to have at least the option of asking the patients to show the results in comparison to potential patients...
Ah well - just remember its not only pitch that makes a good voice and that is changed by this procedure - And sometimes it can help for ones own confidence to compare to old recordings to see just how much it has changed...

[Vii]

I had a short consultation with Prof. Remacle yesterday and he seems like a very nice person, though I felt like he simplified the whole thing a bit too much. According to him, no patients had any regrets yet, but I'd love to hear that from an unbiased source...
Sadly when I asked him about the difference to Yeson, he didn't know what to say, except that he hears that question somewhat frequently. But maybe I formulated my question badly; I was nervous as hell sitting there.

He seems pretty confident in what he does, so if nothing else, that makes me shiver a bit less while I wait.
After I asked my questions, of which I forgot half I had meant to ask, He stuck a camera in my throat, made me say eeeeeeeeh, explained to me what he'll be cutting off on the video feed and where the sutures go and then I filled a questionaire about how I feel about my voice currently.
I've been coughing and sneezing a lot lately so I asked about that, but he said since it doesn't make my vocal chords vibrate, it's not too troublesome if I can't avoid it.

So now I got an appointment in early January. I'm equally scared and excited. Will be my very first surgery and anesthesia. And I get to save roughly 2k on my FFS cause Remacle does a tracheal shave for free 

[Lilykit]

First of all sorry for the late response ( Work has been hectic with the holidays and taking some time off) so I haven't noticed the thread.

From what I gathered the prof. is also the one that is responsible for doing the children ORL operations over there , that might be why he is used to simplify the surgeries he is going to do (Most kids ORL surgeries are far more complicated and due to far greater problems, explaining it technically to the parents might not be the most viable thing).
When I showed some knowledge on the operation he became a bit more technical, but as it's not that much of a complicated(though a very skill oriented one) operation there really isn't much to explain .

As for the difference between Yeson: Remacle uses a system similar to Haben, meaning laser to create the initial wound and scaring, while using dissolving threads. Yeson uses permanent threads and microscalpels to make the initial scaring.
Both ways have their pros and cons ( Ideally I would go for a laser +permanent threads combination, as the microscalpels tend to cause a greater trauma and require a longer healing period ) but in both of them the end result is up to how skilled the surgeon was.

Regarding my level of satisfaction : it's too early to tell what my end voice is going to sound like (currently it's too breathy and hoarse) but I made a short test in PRAAT with a somewhat stable voice and it seems like I avg. 215 HZ  and get to 245 on the clearer portion. If the voice will clear out fine I would be super happy about this

[anjaq]

Both ways have their pros and cons ( Ideally I would go for a laser +permanent threads combination, as the microscalpels tend to cause a greater trauma and require a longer healing period ) but in both of them the end result is up to how skilled the surgeon was.

I am not so sure about the part with the microscalpels causing more trauma... If you use a very sharp blade to cut skin, it heals fairly quickly... the advantage I see with the use of miscoscalpels is that the top layer of the vocal chords, which is a mucous membrane, is not removed, but just sliced open. after the surgery it can thus grow back over the scar area. With LASER I would be worried that that layer is simply lost (evaporated) and due to the heat scarring may possibly not grow back, leaving more scar tissue exposed. But thats just a theory, I have sadly no statements about this from the surgeons.

[Lilykit]

If the surgeon is skilled enough than it will just make a slice rather than evaporate.
Modern CO2 lasers are very focused and of a very coherent beam , so unless the freq. is accidentally close to the self frequency of the mucous layer(it probably isn't) it would just cut through.

with scalpels the avg. cut depth is bigger ( hence why YESON require a more strenuous healing regime ) and I would fear of clotting.

All in  all it's more like what's the surgeon is more skilled with rather than what's best (Both aren't horrid in the hands of a skilled surgeon) , but still I would love to hear Dr Kim's reasoning for the micro-scalpels ( the permanent stitches I get)

[anjaq]

Sadly it is hard to get medical details on the procedures from the surgeons... ...

I would be a bit worried about thermal damage to the surrounding tissue though. The surgical area is literally just 3 mm in size... but then again, they use laser in eye surgery, although in that case it is more about ablation and not about microsurgical incisions

[JaniceNL]

Does Prof. Remacle provide voice samples of the results of the surgery during the consultation?

I have only heard the result of one patient who went to him online recently and it was a bit squeaky. Is there a chance of avoiding this or avoiding any of the other more common complications if you instruct the surgeon to be more conservative?

I might be ill informed but in the T community around me they all warn me for the danger of sounding like Micky Mouse. And more importantly can complications be fixed afterwards?

[anjaq]

There is one woman here who was with Remarcle. I think she called herself "Crystal" here. She was quite happy with the surgery, she gained over 100 Hz in average pitch with the surgery. Another patient I know of had much less increase and she had another surgery with Remarcle which brought her pitch up where she wanted it with a Laser based method.

Generally if the voice is not high enough, other surgeries are possible, if the voice turns out to be too high for your taste, its harder - with glottoplasty it is not really feasible to change this, with CTA it is theoretically possible to reverse part of the change. If the voice sounds like MICKEY mouse, it may be that the patients who report this ( I heard this a lot from the surgeries of the past decade and before) either does not have good voice training or adaptation in order to get resonance right - or the surgery was a CTA, which does not shorten the vocal folds and thus leaves the "male" stronger and lower timbre in place - glottoplasty also changes the timbre in some way.

[gentlebreeze]

Does Prof. Remacle provide voice samples of the results of the surgery during the consultation?

I have only heard the result of one patient who went to him online recently and it was a bit squeaky. Is there a chance of avoiding this or avoiding any of the other more common complications if you instruct the surgeon to be more conservative?

I might be ill informed but in the T community around me they all warn me for the danger of sounding like Micky Mouse. And more importantly can complications be fixed afterwards?

Voice surgery is a throw of the dice. There is always a risk of it going wrong, but also that things might turn out better than you think. There are no guarantees. Last time I heard the going rate with Prof.Remacle was near the 6000 Euro mark, not much cheaper than Yeson which gives more aftercare.

[Lilykit]

Actually the price for VFS with prof. Remacle (at least according to the price from oct) is 4366 EUR and thats including 800 eur for guaranty in case more days in intensive care are required.

For me the end price was 3900 EUR, but that's without medicare cover as I'm not from the EU (for EU residents the surgery might be as cheap as a few hundred euros, depending on their country and/or medical insurance)

[gentlebreeze]

Actually the price for VFS with prof. Remacle (at least according to the price from oct) is 4366 EUR and thats including 800 eur for guaranty in case more days in intensive care are required.

For me the end price was 3900 EUR, but that's without medicare cover as I'm not from the EU (for EU residents the surgery might be as cheap as a few hundred euros, depending on their country and/or medical insurance)

The price will not be much less than the 4000 Euro as a self paying private patient.. If EU citizens use their private insurance, then the cost would probably be a few hundred Euros. If an EU resident is referred to him via the EU NHS then it will be free, including all travel and hotel costs.