FFS and SRS, the top surgeons

RLT, HRT, FFS, and SRS Support

Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Mon Jul 23, 2012 10:26 am

Thanks for the clarification.
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FF surgeon list

Postby quamprium » Mon Jul 30, 2012 1:26 pm

For anybody who is still interested in FFS and undecided about picking a surgeon:
I recently put up a list in my blog (click my website symbol) with about two dozen links to the FF surgeons I am familiar with. I plan to undergo FFS next year and my decision for a surgeon stands to 98 percent.

Maybe the links help some of you if you're still looking.
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Re: FFS and SRS, the top surgeons

Postby PossiblyAnna » Mon Aug 06, 2012 8:57 am

Nabela wrote:The post, overall, was a response to you with an added response to Anna, stating that I think the possibilities of the FFS should be done within reasonable boundaries but also according to the customer's wishes. For instance, she wants her nose done and has to pay again, when it could've been done within the first surgery; if he'd been more flexible.


Surgeons don't usually require you to pay again if you want a revision. Or course, you have to pay hospital, anesthesia, etc. costs because those have nothing to do with the surgeon.

The big names in FFS each have a look they go for, and they're not going to deviate much from it. It's like a painter or something: a painter isn't going to change a recognizable style on which they've based their career.

That being said, there are lesser-known surgeons who will probably do whatever the hell you want them to. But there's a big risk to that. You might not know what makes sense, and might end up looking freaky if you direct the whole thing.

A less obvious thing to consider is the psychological part of it. It's *really* difficult to come to terms with what you look like after FFS. After 3 months, I'm *finally* starting to see what I actually look like, and I'm fairly happy with it. Body image is a really powerful thing.

I can't even imagine what this would have been like if I had a completely re-sculpted face. Looking in the mirror and seeing *someone else* has got to be horrifying; or at least, it just won't compute, and will drive you insane until you get used to it.

I spoke to a different therapist (a good one this time), and she stated it bluntly: almost everyone who has plastic surgery regrets the results for a time. It's because you can't see them, even if everyone else can. This is how people become addicted to it. Psychologically, it's a control thing: you know you can't control much about being TG, but this is something you *can* control (or, at least, you think you can). If you don't see the result, you feel like your attempt at control has failed.

My point is that I'd think twice about pushing things too far. In fact, maybe doing one procedure at a time is the best thing -- you get used to one, and then get the next. I had 5 done at once; in retrospect, I kinda wish I had done them slowly.


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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Mon Aug 06, 2012 10:17 am

Anna, if you recall, I advised a gradual approach before you had your surgery. I had the same idea. It's not only for the psychological adjustment. Each change has an effect on the whole. It's hard to know what that will be until after it's done. There's still more I might do and I'm glad I waited to see the affect of the first FFS. It makes subsequent decisions easier.

I don't think it's wrong to allow the surgeon some freedom in determining the outcome. I'll admit that I'm not really that smart about what makes feminine beauty. Deferring to an expert makes sense. I do it every time I go to a salon to have my hair done. Sure, I expect them to get to know me well enough to know what my preferences are, but they just know so much more than I do. Their knowledge and expertise is a big part of the value I expect for my money.
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Re: FFS and SRS, the top surgeons

Postby PossiblyAnna » Thu Aug 09, 2012 7:37 am

BecomingSusan wrote:Anna, if you recall, I advised a gradual approach before you had your surgery. I had the same idea. It's not only for the psychological adjustment. Each change has an effect on the whole. It's hard to know what that will be until after it's done. There's still more I might do and I'm glad I waited to see the affect of the first FFS. It makes subsequent decisions easier.


But at the same time... being past that awkwardly and obviously trans stage is a huge relief.

I don't think it's wrong to allow the surgeon some freedom in determining the outcome. I'll admit that I'm not really that smart about what makes feminine beauty. Deferring to an expert makes sense. I do it every time I go to a salon to have my hair done. Sure, I expect them to get to know me well enough to know what my preferences are, but they just know so much more than I do. Their knowledge and expertise is a big part of the value I expect for my money.


Yeah, exactly. It's just like the hairstylist. If you try to direct a hairstylist, they just mess it up. They usually know two or three styles, and you have to let them do their thing.



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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Thu Aug 09, 2012 10:39 am

PossiblyAnna wrote:...being past that awkwardly and obviously trans stage is a huge relief.

That much is certain.
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Re: FFS and SRS, the top surgeons

Postby KelleeOrion » Tue Nov 13, 2012 2:43 pm

BecomingSusan wrote:I think that the real story is that there are a lot of excellent plastic surgeons out there. I went to a local surgeon and everyone tells me he did a great job. My brow and nose came out looking great. He had only done two brow reductions before me, but had done lots of noses. He had been in business in the Bellevue/Redmond area for over 20 years, though. That told me he must be doing something right. .


I am interested in finding a local FFS person (if possible) in the Seattle Area.
If you don't mind me asking which surgeon did your FFS?
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Thu Nov 15, 2012 8:26 pm

KelleeOrion wrote:
BecomingSusan wrote:I think that the real story is that there are a lot of excellent plastic surgeons out there. I went to a local surgeon and everyone tells me he did a great job. My brow and nose came out looking great. He had only done two brow reductions before me, but had done lots of noses. He had been in business in the Bellevue/Redmond area for over 20 years, though. That told me he must be doing something right. .


I am interested in finding a local FFS person (if possible) in the Seattle Area.
If you don't mind me asking which surgeon did your FFS?

Sorry I didn't see this sooner, but I did respond to your PM. I hope it helped.
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Re: FFS and SRS, the top surgeons

Postby hthrrsln » Sat Nov 17, 2012 2:58 pm

Shiraz wrote:Hi, I'm in the process of reviewing FFS / SRS top surgeons and what my options are. Btw I tried to join the FFS yahoo group but haven't heard from them, my registration approval is still pending after a week.
It looks like Dr Ousterhout is still working but due to his age, I'm concerned. I had a consultation with Dr. Spiegel, I think he's good but not amazing. I also know a girl who had FFS with him, she had to go back twice for revisions and still not happy yet I think she was pretty feminine in the first place. Has anyone been to argentinean FFS surgeon Marcello di Maggio? And what about that surgeon in Colorado?
Dr. Meltzer is considered the best SRS surgeon in the US yet the three girls I know who went to him none of them have orgasmic pleasure, sex with men hurts but the aesthetic result is quite realistic. It looks like Dr Suporn from Thailand gets high praise on european boards, apparently he has improved his SRS techniques opver the last past two years or so with more depth and more orgasmic pleasure results.


If I can be forgiven for returning to the original topic, I would love to get more discussion of specific surgeons, costs, techniques, results, etc. In particular, trying to decide whether the lower cost providers are safe and really good enough results. Maybe the very cheapest are questionable, but some of those in the mid-range of costs are actually pretty good. I'm looking for details.

This stuff is pretty expensive for most of us, but at the same time, the quality of results is terribly important. Very tough decisions.
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Sat Nov 17, 2012 3:54 pm

I've heard of great results from DiMaggio, with some even comparing him as on a par with Dr. O, but on his website Dr. Z shows a complication repair he did that he blames on the open technique for brow work used by an unnamed "Argentinian FFS surgeon." However, Dr. Z does say that an 80%+ complication rate is an inevitable result of the open forehead technique. After reading his rationale, dealing with fiber optic camera lenses and minimal incisions versus the naked eye and cutting of facial nerves, I tend to agree with him, and really wish I could afford an American surgeon, and, at least for brow work, Dr. Z. I don't like his using an incision under the chin for genioplasty, though--it's safer for avoiding the nerves but I want an intraoral scar. Note to self: remember to get back into the FFS support group on Yahoo!
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Sat Nov 17, 2012 5:20 pm

hthrrsln wrote:This stuff is pretty expensive for most of us, but at the same time, the quality of results is terribly important. Very tough decisions.

I don't know about expensive. My SRS cost less than my car and my FFS cost less than half of what my car cost. It can be just a matter of priorities if a person has an average income. I know that's not true for many of us, but for those who do have enough income there are medical loan places out there that can put surgery cost in the realm of a car payment. I recommend to people starting transition to start putting some money away immediately, so they'll be better prepared when the time for surgery arrives. That's going to be at least a year, during which time a considerable down payment could be accumulated. it's too bad interest rates are so low right now, but it is still a good idea to start saving as soon as possible.
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Re: FFS and SRS, the top surgeons

Postby PossiblyAnna » Sat Nov 17, 2012 6:22 pm

I recommend caution with that yahoo FFS group. There's a lot of bullshit and just plain misinformation on their. And, catty bitches. Right after I had FFS, I was disappointed with the results and posted something on there about it. Someone responded "I told you so."

That was not what I needed to hear, and it was very damaging.

Be careful with them...
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Sat Nov 17, 2012 7:25 pm

Thanks!
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Re: FFS and SRS, the top surgeons

Postby hthrrsln » Sat Nov 17, 2012 9:39 pm

BecomingSusan wrote:
hthrrsln wrote:This stuff is pretty expensive for most of us, but at the same time, the quality of results is terribly important. Very tough decisions.

I don't know about expensive. My SRS cost less than my car and my FFS cost less than half of what my car cost. It can be just a matter of priorities if a person has an average income. ...


Of course everything is relative, there is FFS, and then there is FFS. Depends I suppose on what you have done, but I'm getting the impression that I'd be looking at $40k to $50k in the US. You can certainly spend that on a car, but not my car. I need major brow work and general age lift, nose work, lips, etc.
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Sat Nov 17, 2012 10:07 pm

I separated SRS and FFS because not everyone has both.

As of now, I'm a little over $50K, including 100+ hours of electrolysis. I have about 150 hours of electrolysis left, which will cost about $8,250. That will bring me to about $60K. I initially allocated $90K for this project, so I'm well within budget. The only feminizing surgery I have left is a trachea shave which my surgeon has promised to do for me for $3K. I am considering other plastic surgery for rejuvenation, but I don't consider that to be part of this project. I think I've done well, overall. I could have got the surgery for less in Thailand, but preferred to stay in this country.
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Sat Nov 17, 2012 11:59 pm

As far as FFS goes, though, you didn't have "the works," am I right? Chin, jaw, cheeks, nose, lip, brow, frontal bossing, and (yet to come) thyroid cartilage? I'm getting my ears done too, and I consider the rejuvenation part of the feminization because most of it will be to take care of hanging skin left over from the chin and jaw work.

My own "budget," which doesn't include the rise with inflation that I know will occur by the time I get there, but includes travel costs, is ≤$3K for an orchi next year, about $25-30K for FFS about 5-6 years from now, ≤$25K for SRS about 7-9 years from now, with hope that it'll be lower because of insurance, $5-10K for 50-100 hours of electrolysis, plus several thousand in dental work. Of course, hair transplants and silicone implants are extra. My savings? Zero. My best-case scenario with the job I have? Save up $5K a year. Probability? Extremely high that I'll have to have a second job for several years in a row.
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Sun Nov 18, 2012 4:29 am

Amy Farrah Fowler wrote:As far as FFS goes, though, you didn't have "the works," am I right?

No, I didn't have "the works" because I didn't need to. I did shop around and get a low-cost proposal.

One of the best things I did was to send my pics to Dr. Suporn's office. They sent back a very detailed analysis of what I should, and shouldn't, have done. That really did help guide the work I eventually had done.

As it turns out, and without any intent to be self-absorbed, I'm quite lovely (and also somewhat inebriated at this moment). I didn't need to have a lot of work done to appear female (according to Dr. Suporn's staff). The only actual feminizing thing I had done was the brow bossing. I had a nose job and blepharoplasty for vanity. I also had cheek enhancements (fat transfer).

Also, as has been said here often, HRT and electrolysis have made a very big difference. Self-confidence and skill with cosmetics makes a big difference, too. If the number of men who hit on me tonight is any indication, it's working. Hooray! It was a very good night.
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Sun Nov 18, 2012 5:03 am

You were lucky enough to need very little FFS, so your costs were lower than someone like me.

I expect I'll need "the works."
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Re: FFS and SRS, the top surgeons

Postby Nabela » Sun Nov 18, 2012 2:04 pm

Was your consulation with Suporn free? I just got an email back from Mayer and the costs seem pretty solid, though I haven't caculated them all up; should run me 50-60k for FFS. Maybe less.
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Sun Nov 18, 2012 4:20 pm

Have you looked at the amazing work done by Dr. Noorman van der Dussen? He's just a hop, skip, and a jump over from you, in Belgium. From what I've seen, his results are second only to Dr. O's. I think his prices might be comparable allowing for inflation after the quote I got from him about 10 years ago.
Last edited by Amy Farrah Fowler on Mon Nov 19, 2012 4:00 pm, edited 1 time in total.
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Sun Nov 18, 2012 4:22 pm

Nabela wrote:Was your consulation with Suporn free?

Yes. I only had to send some pictures.

Nabela wrote:I just got an email back from Mayer and the costs seem pretty solid, though I haven't caculated them all up; should run me 50-60k for FFS. Maybe less.

I would hope it's less. That's the most I've ever heard. I usually recommend a conservative approach--doing first whats needed most and that is least affected by HRT. A person may find that they don't need everything recommended by the surgeon. I'm suspicious of those guys. They're in the business to make money and we tend to be vulnerable. Caveat emptor.
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Sun Nov 18, 2012 4:58 pm

Yes, but caveat vendor as well. I'm basically demanding the works. I won't need that much to pass. I'll need it to be pretty. I want to be pretty. Not that I wouldn't go through if I couldn't be pretty, but I do want to.
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Re: FFS and SRS, the top surgeons

Postby hthrrsln » Sun Nov 18, 2012 5:56 pm

Amy Farrah Fowler wrote:Yes, but caveat vendor as well. I'm basically demanding the works. I won't need that much to pass. I'll need it to be pretty. I want to be pretty. ...


Count me in that vanity sorority! :wink:
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Sun Nov 18, 2012 6:27 pm

Well, truthfully, count me in, too. But defining "pretty" is another caveat. Those selling surgery are quick to do that for us, but in reality, that can only be done by us. That's why I recommend caution. When I started, I was convinced, by others, that I needed all kinds of surgery. There are still many things I could do.

When I was in San Mateo recovering from SRS, Dr. Beck, a noted transgender oriented plastic surgeon and associate of Dr. Bowers, talked with to try and sell me some skin work on my face to take advantage of the down-time following surgery. I thought about, but then I thought, what's this guy doing? Here in am all sedated and kind of miserable and this guy's trying to make a sale. It's just an easy $5K charge on my credit card, right?

These surgeons have web sites and go to conferences to try to sell us on a standard of beauty. They tell us how we should look to be pretty and a lot of us suck it up like a sponge. Of course I know I'm dealing with some very smart people on this forum and I certainly don't mean to insult anyone. I'm just saying, be careful and make sure your decisions are based on your needs and wants and not the idealized notions of others.
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Mon Nov 19, 2012 12:17 am

It's been nine and a half months since filling my estrogen Rx. I just looked at my face from several angles under fluorescent lighting, and the craggy indentations on either side of my mouth are no longer discernible in the mirror. They look completely gone, while the apples of my cheeks are noticeably rounder, puffier. My cheekbones are starting to appear more prominent and flared. I can actually feel the edge under my skin now where the buccal fat pad has enlarged. My cheeks used to be so hollow that I couldn't do that. My eyes seem brighter, my pores a little smaller, and my jawline has practically disappeared at the back, blending into my neck. My chin looks weaker, much less square. All this at only a 15-lb. weight difference from when I started. It's taken a while, but I can see changes in my face now that are not wishful thinking. They are definitely there! Projecting into the future, I can envision a time when only forehead work and matching the angle of the nose to the new browbone would be necessary to pass (with an undetectable hairpiece). I think with just that I could pass facially as a woman...a homely woman. Pretty would still require the works. But it's nice to imagine most of the expensive FFS being at least postponable, if maybe not optional for me.

And, as I mentioned in my HRT thread, I'm getting a butt for the first time ever. I can see and feel less definition and smaller muscles on my calves and shoulders, a hint of my forearms getting smaller, and I think some of my hair is taking longer to come back from epilation. It seems thinner, less dense. When I reach my arm across my body, I keep bumping unexpectedly into boob. YAY!
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Mon Nov 19, 2012 1:59 am

That feeling of arms bumping into boob is pretty cool, huh? Such little things can be so delightful!
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Re: FFS and SRS, the top surgeons

Postby Nabela » Mon Nov 19, 2012 1:13 pm

Amy Farrah Fowler wrote:Have you looked at the amazing work done by Dr. Noorman van der Dussen? He's just a hot, skip, and a jump over from you, in Belgium. From what I've seen, his results are second only to Dr. O's. I think his prices might be comparable allowing for inflation after the quote I got from him about 10 years ago.


I've never heard of him. This is all pretty much new to me, and at that I need to contact Ms. Hirsch back about talking with me. School and preparing for this new job have kept me hectically busy. My room's dirtyness rivals AMS' room.

I'll google Dussen though, if just to see his work. Who is Dr.O?

BecomingSusan wrote:Yes. I only had to send some pictures.


Well, that eases my nerves. I feared that I would need to pay and I just don't have the money to do so, at least at this period of time.

BecomingSusan wrote:I would hope it's less. That's the most I've ever heard. I usually recommend a conservative approach--doing first whats needed most and that is least affected by HRT. A person may find that they don't need everything recommended by the surgeon. I'm suspicious of those guys. They're in the business to make money and we tend to be vulnerable. Caveat emptor.


Well, I sort of just skimmed through, as this entire weekend has been filled with panic over my capstone class' midterm; new job fear; identification card and logistical support; and all sorts of other mess that affects my future well-being in general. I have had little if any time to consider my transitioning plan.

At the moment though, I can't even seriously consider starting HRT, but I can start working on a five-year plan built around it. I wonder if government jobs have any issue with it...
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Re: FFS and SRS, the top surgeons

Postby Nabela » Mon Nov 19, 2012 1:15 pm

As far as vanity...

I want to be mistaken for middle-eastern...or Indian, requiring double if not multiple side glances.
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Mon Nov 19, 2012 2:26 pm

Amy Farrah Fowler wrote:... it's nice to imagine most of the expensive FFS being at least postponable, if maybe not optional for me.

Perhaps thinking of it as doable in stages might help. When we make one change, it affects everything, perceptually speaking. My concern has been the possibility of doing too much at one time. The changes cannot be reversed. I chose an incremental approach, instead. At each increment, the changes, ideally, will become more subtle, more refined, and hopefully, less costly. So far, for me, this has been true.

Bone work is probably the most problematical. I had my brow reduced and my nose changed. The surgeon also had to break and reshape the bone between my eyes to give it a bit more inset. I was under anesthesia for eight hours just for that, and that was enough. Fortunately for me, I didn't have to have any work done on my jaw.

Bone work is also not affected by HRT, except to the extent that the soft tissue over the bones changes. For that reason, I would agree that bone work should be prioritized more highly than other types of surgery. I haven't had cheek implants yet, but I'm thinking about it. The thing is though, I do fairly well without them and the HRT is still progressing. If I had them installed now, continued progress of the HRT could cause overemphasis of my cheeks. This again argues for an incremental approach.

Aging affects appearance, too. Delaying some changes in an incremental approach also may allow for the accommodation of some changes due to aging.
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Re: FFS and SRS, the top surgeons

Postby Nabela » Mon Nov 19, 2012 3:32 pm

What would your opinion be on dealing with the hairline and forehead prior to HRT? I have an idea/plan of tackling them, while I deal with electrolysis. I doubt anyone will inquire into why my hairline seems more feminine, etc, etc.
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Mon Nov 19, 2012 4:22 pm

Nabela wrote:
Amy Farrah Fowler wrote:Have you looked at the amazing work done by Dr. Noorman van der Dussen? He's just a hot, skip, and a jump over from you, in Belgium. From what I've seen, his results are second only to Dr. O's. I think his prices might be comparable allowing for inflation after the quote I got from him about 10 years ago.


I've never heard of him. This is all pretty much new to me, and at that I need to contact Ms. Hirsch back about talking with me. School and preparing for this new job have kept me hectically busy. My room's dirtyness rivals AMS' room.

I'll google Dussen though, if just to see his work. Who is Dr.O?


Dr. O is a common nickname for Dr. Ousterhout, the guy who invented FFS. He's supposed to be retired by now, but if he isn't, I wouldn't be comfortable having an 80-year-old surgeon hitting my jaw with a chisel in my sleep. But when he was younger, he'd have been the only surgeon I would've gone to. He literally wrote the book on FFS (which is available at Amazon, among other places). He was also, surprisingly, not the most expensive North American surgeon. As a professor at the UC, San Francisco medical school, he also trained some of the current FFS surgeons directly.

Since Dr. van der Dussen just joined a different clinic, his old website with its fantastic FFS results photos is down, but I'd say his results look to me a lot like Dr. Spiegel's do over here. I hope you can find pics of Dr. van der D's patients before and after.

Not to leave anybody out, here's pics of one of Dr. Alter's FFS patients:
http://www.onemillionvideos.de/watch/?v=UaSG4UH_z3A#
2011 - came out to myself + began electrolysis
2012 - started HRT + completed laser hair removal
2013 - name & gender changed + full-time en femme
S00N - finishing electrolysis + FFS + BA + SRS
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Mon Nov 19, 2012 6:41 pm

BecomingSusan wrote:
Amy Farrah Fowler wrote:... it's nice to imagine most of the expensive FFS being at least postponable, if maybe not optional for me.

Perhaps thinking of it as doable in stages might help. When we make one change, it affects everything, perceptually speaking. My concern has been the possibility of doing too much at one time. The changes cannot be reversed. I chose an incremental approach, instead. At each increment, the changes, ideally, will become more subtle, more refined, and hopefully, less costly. So far, for me, this has been true.

Bone work is probably the most problematical. I had my brow reduced and my nose changed. The surgeon also had to break and reshape the bone between my eyes to give it a bit more inset. I was under anesthesia for eight hours just for that, and that was enough. Fortunately for me, I didn't have to have any work done on my jaw.

Bone work is also not affected by HRT, except to the extent that the soft tissue over the bones changes. For that reason, I would agree that bone work should be prioritized more highly than other types of surgery. I haven't had cheek implants yet, but I'm thinking about it. The thing is though, I do fairly well without them and the HRT is still progressing. If I had them installed now, continued progress of the HRT could cause overemphasis of my cheeks. This again argues for an incremental approach.

Aging affects appearance, too. Delaying some changes in an incremental approach also may allow for the accommodation of some changes due to aging.


I did fail to mention that, when my head is turned, my jawline does reappear at the back--but it's rounded off! It looks as if I've already had the gonial angle reduction surgery! That just flabbergasts me! Now, keep in mind, this isn't a hallucination, and HRT did not, of course, alter the bone. When I feel under the soft tissue, the bone is still flared at the sides and squared off, but changes in the soft tissue disguise it, and give it a gentle curve, down slightly from the ears, then a soft, not sharp, slight turn, down to my chin, interrupted a slight jowl I intend to have lifted. It's just amazing. Neither the jaw nor the chin are any smaller, naturally, but their shape has changed (the chin head-on, the jaw in profile). Wow...

Also, last night I was curious about feeling fuzz on the back of my head. Before finasteride, I could feel just a touch of peach fuzz, which was invisible in a mirror, drowned out by the shine. After finasteride, I eventually could pinch fuzz with my fingernails and with a very gentle tug to avoid pulling it out, confirm its existence. Anyway, last night, I was able to feel it between my fingers, not just nails or even the tips, so I went into the bathroom with a hand mirror. The cowlick swirl on my crown is clearly discernible, and there is dark fuzz almost everywhere, but also patches, some close to the newer hairline but some not, that, like the swirl, are terminal hairs from a half-inch to more than an inch long. Yay! I have tiny hairs changing visibly from vellus to terminal in my front hairline as well. I gotta confess, I've been using the Nizoral very infrequently and haven't taken the minoxidil off the shelf yet. This gives me the encouragement I needed to add them into the mix. Whether I end up in the future covering it with a wig, or shaving it and covering it, it stills feels good to know any of the real thing is coming back. Even just with what's there now, my crown hasn't had this much hair in at least ten years--no kidding--and that's the last time I had vellus-to-terminal changes at the front (I was on Propecia at that time). Yay again!
2011 - came out to myself + began electrolysis
2012 - started HRT + completed laser hair removal
2013 - name & gender changed + full-time en femme
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Mon Nov 19, 2012 7:04 pm

Hormones are powerful. That's why my feeling is that is best to wait a bit to see the effects of HRT. Others have said it here frequently. The combination of HRT and facial hair removal makes a big difference.

When I talk with FFS surgeons, they seem unaware of the effects of HRT, or they don't want to talk about it. I do believe it's very possible to feminize without hormone therapy. It could be done with surgery alone. I tend to think that's the surgeon's point of view. It's up to us to find the middle ground between surgery and HRT. We have to know what each is going to do. It's easy to compare the before and after of surgery. It's not so easy with HRT, and we also tend to be impatient. Being on HRT for a year or two does give a person a lot of information about how much they're going to get from therapy.

In my case, however, I did FFS sooner because of my age and I had the resources. I did focus on those areas that I knew would not be affected by HRT. Now that the effects of HRT are becoming evident, I'm thinking about the next potential surgical changes. (Trachea shave, scar repair, brow lift maybe, some lifts and/or fills maybe, skin rejuvenation eventually)
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Mon Nov 19, 2012 8:00 pm

How come a brow lift wasn't done with the forehead? What I mean is, they're usually done together, and some surgeons don't charge extra, since they can use the same incision regardless.
2011 - came out to myself + began electrolysis
2012 - started HRT + completed laser hair removal
2013 - name & gender changed + full-time en femme
S00N - finishing electrolysis + FFS + BA + SRS
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Re: FFS and SRS, the top surgeons

Postby Nabela » Mon Nov 19, 2012 8:21 pm

Amy Farrah Fowler wrote:How come a brow lift wasn't done with the forehead? What I mean is, they're usually done together, and some surgeons don't charge extra, since they can use the same incision regardless.


Hmm. Would a brow lift do the same as a scalp advancement, making the forehead seem smaller, more feminine?
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Mon Nov 19, 2012 8:35 pm

Yes. The distance between the eyebrows and the hairline would be reduced, and visually, the glabella would appear to be higher on the face. It also gives the illusion of bigger eyes, reducing the forehead in proportion. A scalp advance at the same time is even more powerful, but the brow lift is great by itself.
2011 - came out to myself + began electrolysis
2012 - started HRT + completed laser hair removal
2013 - name & gender changed + full-time en femme
S00N - finishing electrolysis + FFS + BA + SRS
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Mon Nov 19, 2012 8:40 pm

Amy Farrah Fowler wrote:How come a brow lift wasn't done with the forehead? What I mean is, they're usually done together, and some surgeons don't charge extra, since they can use the same incision regardless.

I didn't change my hairline. I did have blepharoplasty and didn't want to over correct. I might have been a little too cautious on that one. I'll never know for sure.

I don't know that the incision would be the same. I had a coronal, using the Ousterhout technique. I did have the opportunity to meet Dr. Ousterhout once. He did an consultation for me. The surgeon I eventually chose used the same methods.

By the way, the one year anniversary of my FFS was four days ago.
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Mon Nov 19, 2012 8:43 pm

I'm pretty sure brow lifts are traditionally done coronally. Open ones, anyway, not endoscopics.
2011 - came out to myself + began electrolysis
2012 - started HRT + completed laser hair removal
2013 - name & gender changed + full-time en femme
S00N - finishing electrolysis + FFS + BA + SRS
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Mon Nov 19, 2012 9:06 pm

Amy Farrah Fowler wrote:I'm pretty sure brow lifts are traditionally done coronally. Open ones, anyway, not endoscopics.

When it's done that way, it also lifts the hairline. My hairline was okay, but not great. I didn't want to make it worse. I had forgotten about that, till just now.

I have thought about doing some work on my hairline, but am thinking that just might be too obsessive. I see see lots of cis women with hairlines like mine. It's way down on the priority list, any way.
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Re: FFS and SRS, the top surgeons

Postby Nabela » Mon Nov 19, 2012 9:23 pm

Well,

The thing is that my hairline is receding. It is already like this lopsided "M", which has me freaking out enough as it is. I am demanding Finasteride, next counseling visit :cry:. So, with that in mind I'm trying to figure out how to make my forehead look smaller, not because I haven't seen cisgender women with foreheads like mine--trust me, I stare at women half-the-time on my job for discrepancies. It is something I want because it fits my view of myself.

>_< I just gotta figure out how to get it done without fucking up my hairline, after I get it fixed.
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Re: FFS and SRS, the top surgeons

Postby hthrrsln » Mon Nov 19, 2012 9:35 pm

I don't know if you have ever visited http://www.virtualffs.co.uk/ by Alexandra Hamer.

I have found her work very useful. She works with some FFS surgeons (Dr. Siegel as I recall is among them) to do photo studies. If you send her a detailed photo study (left profile, right profile, full face, left quarter, right quarter, etc.) and she will do a photoshop rendering of her recomendation for FFS results. She tends to be somewhat conservative in her changes, and seems to be quite knowledgeable of the surgical techniques.

She has done extensive studies of composites of many male and female faces to come up with relatively scientific empirical images of the average male and female (these are animated on her website if you wait a second for it to load). From this, one of her conclusions surprises some people:

"Many FFS surgeons and patients believe that on average, women have lower hairlines in the middle than men but this is not actually true. In fact, women have higher hairlines in the middle than men (you can read more about this towards the bottom of the page under "Misconceptions"). Of course men often get male pattern baldness and this can raise the hairline but when balding is not present, the average male hairline is lower in the middle than the average female hairline . If you look at the corners of the hairline the situation is reversed with women having lower corners and men having higher corners.

In terms of overall shape, the higher corners and lower middle of the male hairline tend to give it a square or “M” shape while the lower corners and higher middle of the female hairline tend to give it a rounded shape."


And, yes, I did send in a photo study to her and pay for the service (several months and 50 pounds heavier, when I get to my target weight I plan to do it again). Not real cheap, but well worth it in my opinion. She gives you a complete set of photos with different amounts of work done, and a very detailed analysis of your facial features and what FFS can do. After getting her photo study back I then used this web site: http://www.taaz.com/ to play with hair styles and makeup.

I cannot tell you how fun this is!!! :D :D :D
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Mon Nov 19, 2012 10:34 pm

BecomingSusan wrote:
Amy Farrah Fowler wrote:I'm pretty sure brow lifts are traditionally done coronally. Open ones, anyway, not endoscopics.

When it's done that way, it also lifts the hairline. My hairline was okay, but not great. I didn't want to make it worse. I had forgotten about that, till just now.

I have thought about doing some work on my hairline, but am thinking that just might be too obsessive. I see see lots of cis women with hairlines like mine. It's way down on the priority list, any way.


Image
Image
Image
Image
Image
Image
Image
Image

That last one's Maggie Grace too close up.

Feel better?
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2011 - came out to myself + began electrolysis
2012 - started HRT + completed laser hair removal
2013 - name & gender changed + full-time en femme
S00N - finishing electrolysis + FFS + BA + SRS
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Re: FFS and SRS, the top surgeons

Postby Nabela » Mon Nov 19, 2012 10:38 pm

I will when my hairline is restored.
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Re: FFS and SRS, the top surgeons

Postby BecomingSusan » Mon Nov 19, 2012 11:34 pm

I'll bet not one of those women in the pictures worries about her hairline. That last one looks very much like my own. So why am I even thinking about changing what have? It's because someone put a standard in my mind. Someone told me that women's hairlines should have a certain look and I came to believe that if I didn't look that way, I would be falling short in my quest for femininity, and that's a load of crap, in my opinion. I know many of s have hair problems and don't mean to make light of that. I'm just continuing to make my case about how to make decisions about surgeries. Do what you think is best for you, not what someone else says.
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Re: FFS and SRS, the top surgeons

Postby Amy Farrah Fowler » Tue Nov 20, 2012 12:05 am

Yeah, that last one, even though she usually wears her hair differently, wouldn't have put it up like that for a red carpet event if she worried about how her hairline looks. I don't know if you recognized her name, but she's one of the stars of Lost, Taken, Taken 2, Iron Man, and both parts of Breaking Dawn. Doubtless millions of men (and women) want her, and thousands of women would trade looks with her.

My hairline and forehead looked like Amber Heard's (All the Boys Love Mandy Lane, Pineapple Express, Drive Angry, The Rum Diary, The Playboy Club and Zombieland) before T & DHT had their way with me.

http://en.wikipedia.org/wiki/File:AmberHeard09TIFF.jpg
http://en.wikipedia.org/wiki/File:Amber ... ,_2011.jpg

Now I'd give just about anything to have Maggie Grace's hair!
2011 - came out to myself + began electrolysis
2012 - started HRT + completed laser hair removal
2013 - name & gender changed + full-time en femme
S00N - finishing electrolysis + FFS + BA + SRS
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Re: FFS and SRS, the top surgeons

Postby Nabela » Thu Nov 22, 2012 5:51 pm

So,

Here is the pricing from Dr. Mayer's office, only took 1-2 days for them to contact me back. At the moment, I am a little swamped, so taking and sending them photographs will have to wait. I really want to see what he says about my hairline. His remarks will influence whether or not hair restoration is included in my budgeting for next year, or after I get work in my field.

-Hairline Lowering and Forehead Lift with Orbital Bony Contouring **
$8,000

-Rhinoplasty *
$8,000-9000

-Chin Implant/Augmentation**
$3,675 (that includes doctor's fee, operating room fee and anesthesia).

-Chin Reduction/Contour**
$3,050 -4050

-Jawline**
$3,050-4050

-Lip Lift with or without Fascia Fill **
$3000-4000

-Lip augmentation***
$3000/4500 (1 or Both Lips)

-Voice Modification.***
$5,750

-The Fleming/Mayer Flap procedure*
$12,350 (this includes the doctor’s fee, operating room fee and anesthesia).

* Surgeries that I believe are applicable to me.
** Surgeries that I will inquire about being feasible for me, during my consultation.
*** Surgeries that I'm not sure on.

In total, I grabbed most of what I thought might be prudent for me and came to $37,450.00 for my FFS.
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Re: FFS and SRS, the top surgeons

Postby ColleenOShay » Tue Dec 16, 2014 8:35 pm

Hi Susan,
Could you tell me the surgeons you used in Seattle area? I live north of Seattle and I am now ready to start doing consultations etc .

Thanks Colleen
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