Voice surgery ("CTA") with Pierre Brassard

[ainawa88]

I want VFS, and I'm interested in either Dr. Haben, or Dr. Brassard. (There's no way I'm going to fly all the way to Seoul just to go to Yeson!)

Anyway ... Of course nowhere has anywhere near as many examples of before & afters as Yeson, but at least Haben does have some. With Brassard, I can't seem to find any. I can't even find testimonials of anyone who has gone to see him. No experiences, no nothing ...

What's the deal?

[Dena]

I have been watching the voice section for over a year and I haven't seen anything posted about Dr Brassard. He may be very new at it or only does a few but with his schedule for other surgery, voice surgery wouldn't be his bread and butter. If you know more about his work in this area, we would be interested in knowing because at the moment there are three names we talk about and a fourth would be a welcome addition.

[ainawa88]

I am going to go through the process to get a consultation, so I will let everyone know how that goes ... Speaking of which, what kinds of questions should I be asking Brassard? A solid list of must-asks would be fantastic!

I know someone from the chat room here--I won't name names just in case--who saw Dr. Menard (retired now but Brassard is his protege) for VFS many years ago and who is very happy with her results. I've heard her "after" and I'd be just as happy with her results as well, but she did not have any befores to show me so it was not very useful for my decision making.

[Dena]

Number of surgeries he as done, amount of pitch change he can provide you, will you need to use a trained voice afterward, procedure he will use with you, anything out of the ordinary with your voice and what is the recovery period. Anything else you can think of to add to the list as well. The biggie will be when you can have surgery as he tends to be pretty booked up. I picked the right time for my surgery and I was able to get it in under a month but Dr Haben tends to have longer wait times than that at other times of the year.

Oh yes, is it CTA or VFS surgery?

[ainawa88]

Oh yes, is it CTA or VFS surgery?

CTA

From Brassard's website:

Cricothyroid approximation increases the tension in the vocal cords and consequentlyraises [sic] frequency from a male pattern (100-150 Hz) to a female one (200-300 Hz). Preferably, the procedure is done under local anesthesia through a short neck incision and can be combined with Adam's apple shaving if desired. It requires a short operation time (1 hour) during which you will notice an immediate change. Voice rest is recommended after surgery for a short period and the final result comes gradually within the first 6 to 12 months. Speech therapy is advised before and after surgery.

And from a post here last year:

I spoke with Dr. Brassard about this on the phone this week and he all but encouraged me to go see another specialist.  He did say that 80% of the patients have successful results from his CTA.  I asked what qualified as a successful result?  Increased pitch?  He said yes.  So, I do not know if they felt that just the pitch was raised, or they were successful attaining a feminine sound from the surgery with continued speech therapy.  At any rate, he encouraged me to continue with speech therapy and seek out a more specialized procedure.

https://www.susans.org/forums/index.php?topic=184166.0


So far that's all I know! (Oh, and the cost: CAD$ 6,460.00)

[Dena]

CTA is the equivalent of a trained voice and tends not to be the preferred surgery. Dr Haben starts with VFS and should additional pitch change be needed, he adds CTA to the same surgery. There are disadvantages to CTA in that your range many be limited. The best resource I found on this to learn about both procedures is Dr Haben's web site. In case you don't know, I am the 64 year old post surgical voice sample.

[ainawa88]

CTA is the equivalent of a trained voice and tends not to be the preferred surgery.

What do you mean by that?
If I'm understanding you correctly, my ideal result is exactly that ...
I want my female voice (my trained voice) to come out when I speak, without thinking about it, etc.

[Dena]

Any surgical voice is 50% surgery and 50% therapy. Without therapy, to teach the feminine speech pattern, the voice will not sound feminine even if the pitch is sufficiently high. From Dr Haben's web site, when CTA is added to VFS the gain is relatively small though I suspect as a standalone surgery CTA would provide a greater gain. It will somewhat restrict your range as some of the lower notes will not be accessible. CTA isn't recommended for singers because of this loss of range. How much you can expect to gain with CTA would be a question for Dr Brassard as we have little knowledge of CTA as the only surgery however others on the site may know more about it.

With VFS, my male voice was most likely 90HZ and my trained voice was 130-140. My upper trained voice was about 180 HZ. After surgery, my chest voice is around 140 Hz and my trained voice is about 220 HZ. The unexplained shocker is my trained upper limit is around 700 HZ. This wasn't expected and it may have happened to me only because my original voice was so bad.

[ainawa88]

Any surgical voice is 50% surgery and 50% therapy. Without therapy, to teach the feminine speech pattern, the voice will not sound feminine even if the pitch is sufficiently high.

All I do is raise my pitch and my voice is read as female 100% of the time. I wonder if due to my upbringing I already have a typically female voice, pitch aside ... I was raised in an all-female household, 95% of my teachers right through to college were female, my whole life all of my close friends were female ...

Going very off topic at this point, but interesting to think about!

[EDIT: I just read my discharge summary from my speech language pathologist and apparently my female voice in conversation is only 150 Hz ... And yes I get gendered correctly 100% of the time over the phone. Which leads me to believe there may be some truth to what I'm saying up there!]

[ainawa88]

My list of questions so far:

1. How many patients have you performed this specific procedure on?

2. How long/since when have you been performing this specific surgery?

3. How many of your patients have had successful results from your CTA, and what qualifies as a successful result?
[Removed because Brassard completely redid his website yesterday and this information is now included there.]

4. What is the average and/or most common pitch increase that your patients experience?

5. Do you have any examples of before and after results (audio and/or video) of this specific surgery you can share with me? If not, why is that? If so, do the examples only include the exceptional results, or do they include the average results as well?

6. Usually with CTA, between one and four weeks of absolute post-operative voice rest is recommended. At 2 days, your rest period seems unusually short. Is there a reason for this difference?

7. Whispering strains the vocal cords more than speaking does, so I do not understand the 10 day whispering period post-surgery. Why is this recommended?



Anything else anyone can think of?

[ainawa88]

Also, I have a question ... Does this seem as unusual to you as it does to me?:

"Resting of the voice -  2 days without talking and 10 days whispering"
http://www.grsmontreal.com/en/surgeries/man-to-woman/8-voice-surgery.html

That's from the newly updated website ... Just seems like an abnormally short resting period compared to literally every other surgeon who performs this exact same surgery.

[Dena]

Because the change is accomplished by reshaping the larynx by pulling it together with a wire or cable, healing only involves any place incisions are made. With VFS the cords have to heal together taking a couple of weeks or so. I see no problem with a 2 day resting period as you should be able to speak as soon as the surgery is finished without damage. I saw a report of an early surgery where the patient was awake for the surgery and the voice was adjusted during the surgery to reach the proper pitch.

[KayXo]

I wouldn't recommended Brassard for voice surgery. His technique is basic and he doesn't do many. I had my sex change with him. Haben would be my preferred option since he is more experienced and it is more his specialty.

Resonance, which is KEY to sounding female is not modified by Dr. Haben or Dr. Brassard. This can only be modified through changing the way you speak and use your muscles.

[ainawa88]

I wouldn't recommended Brassard for voice surgery. His technique is basic and he doesn't do many. I had my sex change with him. Haben would be my preferred option since he is more experienced and it is more his specialty.

Haben is my preference as well, but I'm intrigued enough by Brassard to at least go through the consultation process.

[ainawa88]

Here is the email I was sent in response to my 6 questions:

Hello Ms Aisha,



Voice surgery is currently in development at GRS Montréal. If you wish, we could let you know when we have more concrete information related to this type of surgery.



In the meantime, Dr Brassard would refer you to Dr James Thomas in Portland (Oregon).



Thank you,

Needless to say, I am no longer intrigued at all, and Brassard is clearly not an option at this time.


[Mod? You're welcome to lock this thread now.]