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Sarah, The Bringer of Tea - Face-Off
5th October, 2008
12:37 am

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Face-Off
Last June, I attended a lecture given by Dr Douglas Ousterhout, on facial feminisation surgery. At the time, I reported that, "I must say that the idea of facial surgery scares me half to death, but Dr O's presentation was very impressive ... I think that after meeting him, were I to seek out FFS I would be inclined to favour him as my surgeon."

Last weekend, along with zoeimogen and the_local_echo, I attended an event in London which was set up by patients of his main rival, Dr Mark Zukowski, where he was giving a similar talk on his clinic and technique.

Before the main event though, my erstwhile speech therapist, Christella Antoni, was giving a talk on "The importance of voice feminisation for a successful transition".

The three of us turned up at the venue and mingled for a little while. I knew a few of the people there, including a couple of women who are patients of Dr Z. I was surprised by the number of transwomen who were there who I didn't know. There's a trans "scene" in London, and most of us involved either know each other directly, or know of each other at least. You see the same faces at lots of different things. This one was different, in that there were a few "scene" people there, but we were outnumbered, I think, by a lot of transpeople who aren't active in it. I suspect many of them had travelled to London specifically to attend this presentation, but I also couldn't help noticing (and this might have had something to do with the topic), that perhaps a majority of those attending were those who I have heard, perhaps somewhat unkindly, referred to as the "leopard-print tights brigade".

The circles I tend to inhabit in London are very much queer-oriented, and perhaps that has something to do with it - we each present in a way that reflects who we are, and our social circle, and this served as a reminder to me that the trans and other queer people I associate with in London represent a particular kind of experience of what it is to be trans or queer. Move in certain circles long enough and it can seem like that experience is universal, but it's not.

Anyway, I digress. Before the presentation started, one of the organisers stuck her head round the door into the lobby area where we were mingling, and asked, "Does anyone know anything about Apple Macs?" Content to carry on socialising and not make this my problem (thanks Dr Demsky :-) ), I was set to ignore this, until I was volunteered by someone else anyway! Oh well - I didn't particularly object and if following along meant I got a sneak preview and perhaps a chance to network, I didn't mind at all.

I was led up to the front of the room where the presentation was to happen, where there was a 17 inch Macbook Pro plugged into a large flat screen high-def TV on the wall. Someone was fiddling with it, apparently trying to find Christella's Powerpoint Presentation that was on a USB flashdrive plugged into the Mac, and failing. The person held out his hand on seeing me and said, "Hi, I'm Mark Zukowski", before explaining what the problem was. It didn't take more than a few moments to find the file and get it up and displaying on the second monitor, and as I was doing so, Christella, who had been turned away talking to someone else at that point, turned round, noticed me and said hi. We had a bit of a chat before I went back to join the others. I do like Christella, and not having seen her since the presentation where I heard Dr Ousterhout, back in June '07, it was nice to briefly catch up with her.

It wasn't long before her presentation began. She started by emphasising that she'd not chosen the title herself, and that she didn't feel that voice feminisation was something that trans women should feel is necessary, but for those who wanted help with it, she was available to offer her services. This is part of why I like her - it's really nice to encounter someone involved in the medical side of transition who makes informed and positive noises about transgender identities and transfeminism. I know I wasn't the only one to notice, and appreciate that aspect of her talk.

Quite a few of us in the room were either former, or current clients/patients of hers, and there was one point where, in order to demonstrate someone she was saying about individual voice differences, she went round the room asking a few people she knew to say the phrase, "Any Day" out loud. When she got to me, I found myself, in a somewhat Pavlovian fashion, repeating it in my "speech therapy voice". Those word sounds (being the sort that featured heavily in the exercises I used to drive Sylvia up the wall with) exercise particular bits of the voice which Christella concentrates on in her voice training.

There was one amusing bit in the Q&A at the end of Christella's session, where she'd been talking about teaching a voice that one can use to shout at a bar and still sound female. One woman asked why she was having trouble shouting, to which came the response, "That's because you've only had one session!"

Anyway, we then moved on to Dr Zukowski's talk. In addition to having a very different surgical style (which I'll get to in a minute), his personal style seems very different to Dr Ousterhout's. They both excuded the image of a surgeon at the top of their game, but I felt that while Dr O presents his technique in a gently persuasive, "this is the result of a lifetime's work, this is the only way to do this, here's why" way, Dr Z is rather more, "this is what I do, these are the results, I stand by my work, take it or leave it."

Dr O's backgrouns is in cranial-facial surgery - he's first and foremost a skull man, and I get the impression that he bases his technique on what shape the skull needs to be, and then the rest will follow, perhaps with the addition of a facelift later to tighten things up.

Dr Z has a background in cosmetic surgery, from the U.S. Navy. He presents his approach more in a "I'll work on the bone and soft tissue to do what needs doing to make you beautiful". There are huge differences in the way they work as well.

Dr O makes a cut across the bottom of the hairline all the way to the bone, peels the face back to work on the skull, and then puts the whole lot back, perhaps with a section removed to reduce the height of the forehead. I believe he does similar things for the jaw. He tends to work aggressively on the brow bone which covers the frontal sinus and makes up the upper orbital rims, often reconstructing the covering for the frontal sinus from bits of bone fragment and bone cement.

Dr Z works endoscopically. He makes the same cut (or for less major jobs, just makes a series of slits) in the forehead, at the hairline, but doesn't go all the way to the bone. He suggested this tended to preserve blood supply and nerve sensitivity, resulting in much better sensation afterwards. The use of the endoscope (especially since I got rather intimate with one in my sinuses less than three weeks ago - there is no visible swelling and no external cuts) strikes me as a technique which is ... kinder, less scary, maybe?

One thing that I got from both of them is that they both feel that they personally are the best in the business, and I don't think there's any love lost between them at all. Dr O, in his talk, was making references to things which "cannot be done endoscopically", while Dr Z talks about "older surgeons (Dr O is in his mid 70s, Dr Z looks about 3 decades younger) who can't adapt to new technology".

There's a whole FFS community online, where proxy wars seem to get fought as well, with one particularly splendid example being this letter (page 1, page 2) from Dr O to Dr Z, and the reply (page 1, page 2), apparently copied to Dr Z's lawyer. Heavy stuff indeed!

I said in the post I made back in 2007 that after seeing Dr O's presentation, were I to chose FFS, I'd likely go with him. I'm no-longer so sure. I have friends who've had surgery with both. In each case, the recovery sounds horrific, and makes vaginoplasty look like squeezing a zit in comparison (this scares me half to death - I found the recovery from vaginoplasty to be really emotionally tough, and even the recovery from my recent sinus surgery is not something I'm enjoying a whole lot). The results from both are impressive, but on balance I think I prefer what I've seen from Dr Z. I'd desicribe the Dr O results I've seen as "classic" and "formal" - think wife of a prominent US male politician, perhaps. The results I've seen from Dr Z are more what I'd describe as "cute". I think "cute" would suit my personality better.

Were I in the market for FFS, the thing that would really swing it for me though, is that Dr Z's approach seems less invasive, and he seems a lot more open to just doing individual bits of the face (e.g. just the forehead, or just the jaw and chin, etc.), whereas Dr O seems to push the "we need to do the whole lot as a complete system" line.

I don't want FFS. I'd like to look nicer than I do, and ideally I'd like to be "unreadable". That's not just vanity speaking (although it is partly - I lost my 20s, the time when most women look their best, to gender dysphoria, and I do regret and resent that somewhat); I think it would be psychologically beneficial as well.

But it's a hell of a thing, and there are stories of it going wrong, and I really don't think my body would react at all well to much more surgery (2 general anaesthetics in as many years is exacting a heavier toll on me than I thought it would - perhaps I'm not built to take that kind of punishment). It also costs a fortune.

Part of me wants to have a consultation with Dr Z, just to see what he'd have to say. The rest of me wants to run as fast and as far in the other direction as possible. This is something that, I fear, will vex and preoccupy me for some time to come.

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[User Picture]
From:aki_no_kaze
Date:5th October, 2008 12:12 am (UTC)
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Dr Z is also about half the cost. I know a girl at IBM here in Canada who went to him and really liked the results.
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From:lisaquestions
Date:5th October, 2008 12:35 am (UTC)
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Yeah, cost + the techniques sound so much nicer.

There've been other statements I've heard about Dr. Ousterhout basically providing one variety of face (sorta referenced above) that bother me, too.

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From:katsmeat
Date:5th October, 2008 12:54 am (UTC)
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It sounds to me like you don't want to do it, but like knowing you can and wold be pissed-off as hell if, hypothetically, something medical emerged that absolutely ruled it out.

< shrugs > I personally would be inclined to go for a consultation (unless it was very expensive) even if I was 90% sure I didn't want the surgery. It's information, and you can never have too much of that.
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From:auntysarah
Date:5th October, 2008 10:18 am (UTC)
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I just worry that the consultation will seem like the top of a slippery slope, and I'll end up talking myself into signing up for 18 months of surgical recovery.
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From:katsmeat
Date:5th October, 2008 03:19 pm (UTC)
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I'd not really thought about the issues around FFS, but from reading the coments posted, I'd say now that if somebody wants it in order to look female, that's fine. If somebody already looks female (which you unquestionably do), but wants it in order to look better - well, that's warning bell territory. Luckily, yours seems to be clanging quite loudly. It's not a reason not to do it, but it is a reason to think twice, three times and more.

I can see that a bit of insecurity over appearence may lead people into the trap of overestimating the need, overestimating the benefit and underestimating the cost. But from what you've written here, you're being far to level headed for that to happen.
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From:woodpijn
Date:10th October, 2008 01:00 pm (UTC)
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I agree with this comment.

I think you need to figure out honestly whether your interest in FFS (it is a silly acronym) is part of the trans thing or part of an ordinary female desire to be prettier. If it's the latter, bear in mind that everyone has that desire, that you'll always have it, even after FFS, and that it's largely a cynical creation of the beauty industry.

And even if it's the former, I guess in the same way they bombard all women with "you're not pretty enough, you need to buy this product and have this procedure" they additionally bombard transwomen with "you're not feminine enough, you need to buy this product and have this procedure"; so figure out whether it would actually benefit you or whether you're just swayed by the marketing.

FWIW, I think you certainly look female; I met you IRL and had no idea of your history until I read it on LJ.
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From:julieisfree
Date:5th October, 2008 01:25 am (UTC)
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Hi Sarah! The Ousterhout/Zukowski debate really boils down to the simple question of what you need. That's always a very individual thing. For me, I needed primarily bony work, and I required the aggressive approach by Dr. O. I'd seen a woman who had my issues go to Dr. Z, and she came back beautiful certainly, though her face was oversized due to the addition of filler material necessary to get feminine shape and proportions. Dr. O removed material to achieve shape, rather than adding filler which is what Dr. Z does. How that filler and those implants respond over time also would be of concern to me. You're a very young woman. Whatever you do needs to last fifty or more years. Also, if you need a scalp advance, I'm not sure Dr. Z can get that with his endoscope. Don't let the recovery issues or price difference guide you either. You'd heal from either surgeon just fine. You're young and healthy. In any event, I can't say what you could use though. You look plenty feminine to me, but then I'm just an EE, not an artist nor surgeon.

BTW.. how are the sinuses? Have things sorted themselves out? Hope all is well.
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From:auntysarah
Date:5th October, 2008 10:08 am (UTC)
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Dr Z does use implants, but from his talk, it's clear that he does remove bone too, by burring it with an endoscope. I guess there are differences in what can be accomplished that way versus the open technique used by Dr O. It seems intuitive, to my non-surgically trained way of thinking, that the open approach would be able to accomplish more radical stuff.

However, my face is sorta OK at the moment (I don't like my nose, and I don't like my jaw angle, but they're "acceptable" - I think I got lucky with the brow bossing), and if I did have stuff done, I don't think I'd need to go for the radical, open bone work stuff.

BTW.. how are the sinuses? Have things sorted themselves out? Hope all is well.

Got a what I think is a postop infection presenting as sinusitis in the sinuses around my right orbital rim. It reached the point yesterday where painkillers weren't adequately dealing with it, and I was getting discharge from my right nostril that had "sinusitis" written all over it. I managed to get an emergency appointment with the GP Friday evening, and she put me on Amoxicillin, which seems to be doing the trick nicely.

Still getting post-nasal drip issues, although it feels a lot better than it was.
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From:julieisfree
Date:6th October, 2008 04:33 am (UTC)
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Yes, he does do bone removal. Normally, the bones above the brows are sufficiently thick to allow the him to burr it down throught the small incisions. Above the central sinuses is another story. That will all depend on how thick the patient bone is at that specific site. I think Dr. Z does have some tricks up his sleeve on that one though. Dr. O does it the simple way: Remove and reshape.
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From:sillystudent
Date:10th October, 2008 04:55 am (UTC)
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I like your nose.

&.02 :)

From:mon462
Date:5th October, 2008 01:37 am (UTC)
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I've met Dr. O. But I did not attend his presentation. I did attend the presentations of Dr. Z and Dr. Speigel at BeAll in Chicago last may. I also had consultations with both.

While Dr. Z does nice work, I really did not like his attitude and the way he presented himself. I think that is what ultimately drove me away from him. He was very set in his ways and tried to convince me that I needed more work than either Dr. Speigel, VFFS, or Dr. Konior (another FFS surgeon in Chicago) did.

In the end, I selected Dr. Konior. His methods are closer to Dr. Speigel. I will have an open browlift done. This is the same technique used by Dr. O and Dr. Speigel.

Of the 3 consultations that I had. Dr. Z was the most expensive. Still, if it wasn't for is attitude I probably would have gone to him. I prefer to go to local surgeons when possible.

I honestly feel that Dr. Speigel is a better surgeon than Dr. Z. But that is only personal opinion. As for Dr. Konior, I have seen his work and have met several of his patients. His work is very good and he is less expensive than Dr. Z or Dr. Speigel. All of his patients spoke very highly of him. And I really liked him on a personal level. He spent more than an hour with me in the consultation and really listened to and responded to my ideas. This did not happen with Dr. Z.

We'll see how everything works out with Dr. Konior. My surgery is this Monday, October 6.
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From:auntysarah
Date:5th October, 2008 10:02 am (UTC)
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While Dr. Z does nice work, I really did not like his attitude and the way he presented himself.

I think I know what you mean here. He's rather ... robust, isn't he?
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From:the_local_echo
Date:5th October, 2008 10:37 am (UTC)
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Listening to Dr Z speak, I felt that I wouldn't want to buy a used car from him, whereas Dr O seemed to have a more pleasant manner in my book.

I think trusting your surgeon's really important, but I wouldn't choose one over another based on their social skills - after all, Phil Thomas did a great job on Sarah's SRS, and he's got a long way to go as a conversationalist.
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From:auntysarah
Date:5th October, 2008 10:57 am (UTC)
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Phil Thomas did a great job on Sarah's SRS, and he's got a long way to go as a conversationalist.

I hear he gets a lot more fun to talk to when there's alcohol involved.
From:mon462
Date:5th October, 2008 12:52 pm (UTC)
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It's not the lack of social skills that bothered me. The fact is that Z refused to listen to my thoughts and feelings and insisted that his recommendations were the only logical ones. This was after my thoughts on FFS were verified by 3 other reputable sources (2 ffs surgeons and VFFS).
From:mon462
Date:5th October, 2008 12:48 pm (UTC)
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Robust??? That's an understatement. Arrogant is more like it.
[User Picture]
From:auntysarah
Date:5th October, 2008 10:09 am (UTC)
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And good luck with your own surgery! Will be crossing my fingers for you.
From:mon462
Date:5th October, 2008 12:48 pm (UTC)
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Thanks!
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From:terry_terrible
Date:8th October, 2008 11:52 pm (UTC)
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Just curious, where is Konior based out of? Is he that new surgeon out of Chicago?
From:mon462
Date:9th October, 2008 01:52 am (UTC)
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Yes. Knonior is in the Chiago suburbs. He's hardly new though. He's been doing ffs for many years. He just does not market like Z, O and S does.
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From:nicollegurrl
Date:5th October, 2008 05:44 am (UTC)
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Dr Noorman van der Dussen from Antwerp is not bad either,
I have a friend who went with him, she is very very happy
with the results!! :-)

http://www.drnvdd.com/index.php?lg=english&str=cms_text&c=27&sc=14




Edited at 2008-10-05 05:47 (UTC)
[User Picture]
From:auntysarah
Date:5th October, 2008 10:01 am (UTC)
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A friend of mine (who I've never met in the flesh, but have chatted to via webcam) went with Dr van der Dussen, and she looks really good.
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From:cmmathieson
Date:5th October, 2008 06:11 am (UTC)
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I had a set of photos done by the VFFS lady some time ago and decided that the results were not really worth the enormous cost. Although the dollar/pound ratio would make it easier now and cheaper for a UK person to go to the USA.

I also know several women who have been had FFS and they all look great. However several of them warned me that if you have had FFS then you will need to go back every 10 years or so to have "adjustments" made as your skin ages.

It's surprising the differences in outcomes as well and I can confirm the existence of the ousterhout nose.

Sarah, I don't think you need FFS either and I note your comments about having too many surgeries. My ability to survive even one concerns me.

Caroline.
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From:auntysarah
Date:5th October, 2008 10:17 am (UTC)
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I also know several women who have been had FFS and they all look great. However several of them warned me that if you have had FFS then you will need to go back every 10 years or so to have "adjustments" made as your skin ages.

This is one of the things I found attractive about the endoscopic approach - those sort of issues seemed less likely.

But it's a concern - the moment one opts for plastic surgery, it seems long term maintenance becomes a worry. Dilation from SRS I can handle, but the idea of having face work or breast implants redone every decade is just ... do not want!

Sarah, I don't think you need FFS either and I note your comments about having too many surgeries. My ability to survive even one concerns me.

*hug*

Purely technically, I'm sure you'd survive SRS, as I did. That's different to taking a long time to recover from the damned good kicking your body gets in such a procedure though. Pre-op, I always thought the issue would be physical pain, but it's not that at all (SRS barely hurt me, to be honest). It's the lethargy, and depression, feeling run down, the emotional strain and the anxiety over whether things are healing properly. That's what got me, and it was really a year before it was better.
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From:the_local_echo
Date:5th October, 2008 10:29 am (UTC)
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then you will need to go back every 10 years or so to have "adjustments" made as your skin ages

I do find that a concern (I'm trying to talk Sarah out of it). As julieisfree commented earlier, if you have implants or filler paste, it's not clear how well they'll last. Conversely, the more bone you have removed, the more need you will have for a facelift in later life because you'll have too much saggy skin...

A few weeks ago the BBC showed a programme about the history of cosmetic surgery and how 100 years ago doctors were injecting hot paraffin into women's noses which could be sculpted into an attractive shape as it cooled down and solidified. Unfortunately the long-term results were quite appalling, as lumps of it migrated all around the face. And then 50 years later liquid silicone was causing similar problems. At least we hope that people have learned a few lessons since then...
[User Picture]
From:cmcmck
Date:6th October, 2008 12:17 pm (UTC)
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Having met you, Sarah, I don't think you need FFS. You have a great skin tone and nice cheek bones. My view would be leave well alone :o)

It's all too easy to become a surgery junkie!
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From:zoefruitcake
Date:5th October, 2008 08:29 am (UTC)
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IMHO you do not need any intervention to look great. Like most women you have things you'd like to change, and if you go for that that's fine, but you don't need to x
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From:auntysarah
Date:5th October, 2008 10:00 am (UTC)
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Thank you. *hug*
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From:tartful_dodger
Date:5th October, 2008 09:22 am (UTC)
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Leopard print tights brigade? *confuzzled*

It sounds vaguely hooker related, like the 'clear heels girls'?
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From:auntysarah
Date:5th October, 2008 09:53 am (UTC)
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I guess. I don't entirely feel comfortable commenting on the appearance and presentation of others, but I did notice that things were somewhat polarised in that room. At times, although perhaps I'm imagining it, I could almost feel vibes of "ur doin' it wrong" going both ways.
(Deleted comment)
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From:auntysarah
Date:5th October, 2008 10:20 am (UTC)
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I guess one could describe the particular aesthetic as drag queeny, yeah.
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From:the_local_echo
Date:5th October, 2008 10:53 am (UTC)
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Yes, their style of dress would have fitted right in if they were going for a night out clubbing, but to me it seemed a little over-the-top for attending a medical presentation.

I didn't get talking to the women there for long enough to really know their situations, but I am speculating that for those who are unlucky enough to really need facial surgery in order to blend in, they're going to try to get that surgery before socially transitioning. So, there will be those in the audience who are inexperienced with presenting in girl-mode, and those who don't get the chance often so want to go a bit wild and enjoy it in a safe environment!
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From:cmcmck
Date:6th October, 2008 12:21 pm (UTC)
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It isn't new. Even way back when there were those of us who dressed in the hippy chick style prevelant at the time and those who went for micro skirts and tops with exploding boobage (and a fifty year old (as I am now) really shouldn't have been doing that sort of thing :o)
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From:techiebabe
Date:5th October, 2008 09:27 am (UTC)
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Dr O makes a cut across the bottom of the hairline all the way to the bone, peels the face back to work on the skull, and then puts the whole lot back

Flipping Heck! That's drastic. I'd assumed it was all done with minimal cuts to each individual bit - which turns out to be how Dr Z operates.

I don't think you need the surgery, you're pretty as you are. Honestly. The only thing I noticed about you was your voice, and then only on one or two words rather than all the time. But I often talk to women on the phone and they have very deep voices and sound like blokes, so does it matter?

If you don't mind me asking - does your voice change after the surgery and with the hormones, or do you have to deliberately adapt it? I appreciate that in either case speech therapy might help people, but I can't guess which it would be.
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From:auntysarah
Date:5th October, 2008 09:59 am (UTC)
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If you don't mind me asking - does your voice change after the surgery and with the hormones, or do you have to deliberately adapt it? I appreciate that in either case speech therapy might help people, but I can't guess which it would be.

I don't mind at all. SRS and hormones do pretty much nothing for the voice - once it's broken in a male puberty, it stays broken. The voice I have today is the result of speech therapy, and yeah, I know it tends to slip a bit when I'm in comfortable company, and that does bug me a bit. If I'm in a situation where I'm aware that I *need* my voice to pass, such as dealing with people in public, or on the phone, I make a conscious effort, but otherwise things tend to slip a bit.

There is a surgery they can do called Cricothyroid Approximation, which ties together bits of the vocal chords in an attempt to block the lower frequencies, thus forcing one to stay in the right pitch range. It's not always successful though.

I think the voice I have at the moment falls into the "mostly good enough" category, although it is the thing that is most likely to "give me away", I think. :-/
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From:auntysarah
Date:5th October, 2008 09:59 am (UTC)
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I don't think you need the surgery, you're pretty as you are.

And thank you for that! *hugs*
(Deleted comment)
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From:auntysarah
Date:5th October, 2008 09:59 am (UTC)
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Then he gets the power tools out.

Yeah...
(Deleted comment)
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From:auntysarah
Date:5th October, 2008 10:20 am (UTC)
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You cute already.

Thanks :-)
From:(Anonymous)
Date:5th October, 2008 10:25 am (UTC)
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I've been considering FFS (which still looks like "For Fuck's Sake" (said exasperatingly) to me) for a while now, but Jenny and I are still of the opinion that it's not something to do so soon after surgery. We've pretty much settled into the idea of seeing where the full term of puberty-like hormone levels will take us before deciding whether we'll need more invasive surgery. Perhaps that's a plan that could work for you, too? To me it's like keeping our options open and thus, effectively, getting the best of both worlds.

Zoë
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From:auntysarah
Date:5th October, 2008 10:34 am (UTC)
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As others have said to me, you're already cute :-)

BTW, is everything still looking good for the first weekend in Nov?
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From:snakey
Date:5th October, 2008 11:26 am (UTC)
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FWIW, you're more than cute without.

The process sounds...eep.
From:(Anonymous)
Date:5th October, 2008 01:37 pm (UTC)
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Having read your journal and seen the pics you've posted, I think you look great and I would never have guessed your history if I'd met you in social circumstances. Not sure how much that's worth from an internet stranger, but there we have it. On the flip-side to that, I have a friend who's transitioned from female to male, and he is, to my mind, very feminine in appearance, although I didn't know him as a woman.

Oh, and I have leopard print tights, and a leopard print fake fur - I was born trashy, and love it! (Although I only wear the tights with knee-high boots and cropped trousers - there is a limit.)

Cat
[User Picture]
From:snakey
Date:6th October, 2008 07:22 am (UTC)
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You might want to reply directly to sarah rather than to me. ;)

On the flip-side to that, I have a friend who's transitioned from female to male, and he is, to my mind, very feminine in appearance, although I didn't know him as a woman.

...uh, I'm sure your friend loves you telling random strangers on the internet your judgement on his gender presentation. That seems a poor way to be a friend.
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From:alicephilippa
Date:6th October, 2008 09:17 am (UTC)
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Poor way to treat a friend?

No, it's an appalling and insensitive way.
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From:snakey
Date:6th October, 2008 09:24 am (UTC)
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Well, I was being polite. ;)
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From:sillystudent
Date:10th October, 2008 05:00 am (UTC)
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An exceedingly poor way to be a friend.

Bah
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From:terry_terrible
Date:8th October, 2008 11:48 pm (UTC)
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Dr Z has a background in cosmetic surgery, from the U.S. Navy. He presents his approach more in a "I'll work on the bone and soft tissue to do what needs doing to make you beautiful". There are huge differences in the way they work as well.


One thing I'll say about Z and his "beauty" thing is that he will back his work. I have a friend who transitioned in her late fifties. She went to Z, who promised to make her "beautiful". Her surgery turned out "okay" by what she wanted. So she went back to Zukowski and told him that while the results were satisfactory, it didn't meet the standards that she thought he was promising, so now she's going back for a free revision at the end of the month.
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