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Went to FFS consult yesterday!


jae bear

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 I went to my FFS consult yesterday at Kaiser in California, I’m going to cut to the chase and tell you that it was absolutely amazing and beyond my wildest expectations. For those of you not in California I will clue you in,  The covered California insurance program through Kaiser covers FFS!  I took a dear friend along with me, he’s had his top surgery recently and is hardly two months out of his own surgery and technically still recovering, then again we’re talking about a warrior, this guy’s crazy amazing  and he went to support me on this awesome day. Everything went according to plan, we weren’t rushed, we were on time, we were seen immediately, we had a few minutes to chat in the exam room before the doctor showed up. Dr. Charles Shih ( pronounced ’she’ ) is really a fun and amazing person,  he was very personable, absolutely spot on with his pronouns and very in touch with his patients, he would have to be the high point of my experience so far in the trans care team at Kaiser, then again everyone has been wonderful ...  after introductions we started measuring and examining my face, my hairline to brow line, the depth inset of my eyes to the brow, my brow width,  The projection of my nose, the distance from my nose to the top of my lip and every other little thing you could think of. After going through all the details we started talking about what could be done, ways that the extreme dysphoria that I feel when looking in a mirror could be mitigated.  We talked about the things that were quite obvious, the projection of my brow was rather prominent, and he could re-shape and reconstruct my forehead to remove this prominence and allow a female profile to emerge, not a compromise,  but a complete reconstruction to a female shape!  We looked at some pictures of before and after and I was blown away, I know that surgeons are only going to show you the successful pictures but I was still astounded at the difference in these before and after photos, some people started from a fairly OK and marginally passable structure and some were more pronounced and so masculine it was unbelievable,  but all the after pictures had one thing in common, they were perfectly female and couldn’t be perceived any other way. My friend and his husband are amazing researchers and will be checking the rest of Dr. Shih’s work against different resources, He mentioned trans bucket as an image resource and I’m curious what this turns up, but so far all of my own research has shown that Dr. Charles Shih is simply amazing.  We went on to talk about a nose job, luckily, and not to my surprise, I just don’t need a nose job, thank goodness! We discussed moving my hairline down, pulling my recessed peaks forward And raising my brow line in the process, and guess what, no more wrinkled forehead!  Then we discussed what could be done with my cheeks, I definitely could use some volume here but I let him know it wasn’t the most important thing since there has been a very small amount of change during HRT and there might be more, he was more than gracious and explained how a small amount of fat could be removed from my tummy and injected to volumize my cheeks, I was elated at this prospect as I didn’t really expect to you have this option. Then we discussed a lip lift,  A fairly straightforward procedure, a small elongated M shaped incision below my nostrils, they remove a subsection a few millimeters wide with an upward tug before re-suturing, lifting the lip upward creating a female upper lip rather than straight little line I’ve always lived with!  Then something rather shocking happened, something I didn’t even think of, he told me about an option I had only dreamed about, he said we could take a strip of dermal material from the area of my four head that would be removed during the hairline drop, he could lace this dermal material through the inside of my lips to give them volume, both upper and lower lips would receive this treatment if I wanted it!  I was blown away, I didn’t know this was an option, I had dreamed of something like this but didn’t realize it could be done during the surgery, I about jumped out of the chair at this idea. I glanced over at my  hardened warrior,  and he, like myself had his square jaw wide open in amazement, we both just stared each other with our mouths wide open in astonishment !  I don’t remember what my answer was but I must’ve said 10 or 12 times yes this must be done I need this you have to do this I can’t believe this please do this I want this done, etc. etc...  while there had been before and after pictures for everything up to this point he did not have before and after pictures for this one procedure, but I have faith in Dr. Shih, I am absolutely certain this will be wonderful and he’ll finally have some before and after pictures from me and they will be dramatic because I have no upper lip, like nothing, like a straight flat little line !  The euphoria of this process was starting to make me feel rather high and a bit emotional, but we moved on to talk about my jaw,  and to my absolute amazement, my jaw needs nothing !  Dr. Shih and my fantastic friend both explained to me  that my jaw is already narrow, already pointed, and couldn’t really be improved, what I perceived as incorrectly masculine was simply extra tissue from being nearly 50 years old, just a bit jowelly With excess skin below my neck line. At first I was a little disappointed and wasn’t sure what could be done now, but that lasted about a second once doctor Shih said that all I needed was a facelift, and it hit me like a ton of bricks and a light went on over my head...  all I needed was a facelift, I would actually have a defined chin and lower neck, something I’ve never had it all and didn’t consider having the option to achieve ! Note just for reference this would not be a free paid for insurance option, and it could not be done simultaneous to all the other surgery, but it was available and it was affordable, it was within my reach and I decided right there in that nanosecond that Jackie was going to get a facelift, somewhere in between breast augmentation and bottom surgery, and that by the time she was done and she had her 50th birthday she would be the envy of all of her friends because she was going to be a 50-year-old woman that got some work done!  Jackie was going to get the movie star treatment !  and I felt a little like crying, but I managed to hold it together and giggle about it instead. Dr. Shih then started examining my trachea, and once he finally found the thing he looked at me and said “goodness you don’t need a tracheal shave it all“!  and I laughed about his words as I knew I could hardly find that thing myself, it was nice to hear him verify my suspicion that I didn’t need any help in this one area that so many struggle with, I may not have any lips to speak of but along with that I also didn’t have much of a trachea to speak of, thank goodness ! Dr. she then went on to describe a few more elements of the process, and he seemed very happy that I didn’t really need any work on my jaw or my neck, and that would make things so much simpler and rather easy for him, to only work on the top half of my face. We talked about timelines and he started to worry that I would be upset with what he was about to say, he described that it takes about 1 to 1&1/2 years to get into the surgery schedule and that he is very very busy and works with his partner to keep their caseload moving along as quickly as possible. I pretty much knew this coming in and have no problem with the timeline, I’ve got a lot of things to do between here and there, I’ve got at least another 30 pounds to loose just to make myself happy even though I’m currently under the 30BMI limit for bottom surgery, and I need another year or more of electrolysis to get myself close enough to a happy place concerning my facial hair. And one more year of HRT would certainly be helpful for the shape of my face, it would be nice to know that most of the things that could be achieved with HRT would be finished, mostly, before the reshaping of my face occurred. The only two things I chose as additional options not covered by insurance we’re the cheek augmentation, and the lip augmentation because they were both considered cosmetic, and I agree with his assessment, they are purely cosmetic and not 100% necessary, but I am going to enjoy them none the less! I can already hear you asking me, “how much is that going to cost”, and my answer is going to knock you flat, it’s only about an extra $5000, that’s it, not some crazy outlandish amount of money, it’s something affordable, something I can manage, basically a couple months of driving for Uber!  and when the time comes somewhere between breast augmentation and bottom surgery I will be having what every 50-year-old woman dreams of, a facelift !  I plan on getting some mileage out of this, what woman in my position wouldn’t want this? It’s like turning the clock back on my transition, I have been been bemoaning the fact that I waited so long, not as long as some but we all feel to some degree that we would love to of started a bit sooner if we could have, well,  I just found out that a trip in the Time Machine only costs $15,000, and that is quite a bit of money, but not out of reach, hardly even the cost of a good used car, and something I could certainly save my money for and in my estimation worth every penny. I know a facelift isn’t for everyone but I’ll remind you, I used to weigh 350 pounds, and I’ve got a heck of a lot of flesh under my chin, I definitely would be a good candidate for a facelift, maybe someday I won’t have to lift the Camera so high above my head just to take a selfie !  I wish I could share all of the before and after pictures that I saw here with you, they were astounding, the Battle worn soldier I brought with me was nearly emotional about this, he and I both stared at these images in disbelief, every single photo had the same result, the after picture was clearly and decisively female, so much so more than I could have imagined, and my photo is going to be with those in less than two years, my after picture is going to blow the minds of future patients of Dr. Shih!

 Hugs, 

Jackie

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Wonderful news, Jackie.  Dr. Shih does seem like an excellent doctor.  I've heard many good things about Kaiser overall.  They have taken the lead as far as medical groups go, IMO.

 

Carolyn Marie

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It sounds like it was a very good meeting for you.  I can tell you're happy with the conversation.

 

Jani

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 Oh my gosh Julie you kill me !!!  Ha ha !!!!  Stop taking videos of me dancing in front of my door way !?

 I really think Dr. Shih is an exceptional person as well as an amazing surgeon, I’ve had a lot of surgeries in my lifetime, like I mean a crazy amount, surgery after surgery after surgery just to put me all back together, and while the surgeons were nice they were nothing like Dr. Shih! I just realized something else, my spellchecker doesn’t catch it when I voice text it comes up as “doctor she”,  this seems oddly appropriate to me !  I have to agree with you Carolyn Marie, Kaiser really is taking the bull by the horn‘s here, or rather the cow by the nose? I can’t think of a good analogy ...  at any rate I feel fantastic, even after dealing with lots of crappy paperwork all day long at work I still feel great !  And I’m very excited to go see my new electrologist on Sunday !  

I did a lot of searching for minivans today I think I struck the jackpot, I found a 2006 and a 2007 Ford Freestar minivan, both about $1700, I’ll just pick a good one and drive home, drop it off at my mechanic and make sure it’s all tippy top and smile all the way down the road. The Ford minivans work perfect for me because they have a removable center console insert under the dash, And since I only drive using my left foot I take out the middle console cover and put a floormat there so I can rest my right foot in the middle of the floor while driving. Then with a 2006 or 2007 minivan in good running condition I will be able to drive for Lyft and Uber to make extra bucks!  Luckily I get to continue earning a modest salary while telecommuting to my current job, I’m going to set up a laptop and a Wi-Fi hotspot to login to work and network into all of the sales portals and machine program access points so I can do my job in between driving trips, I can also answer customer emails and questions, do bookkeeping on QuickBooks and even process payroll with direct deposit to all the employees accounts. Hopefully this will work well for me, at any rate I’ll sell my two old Ford Windstar minivan’s and recoup almost all of the money from buying the new one, or I guess I should say new-ish one, however once I steam clean the living snot out of it  The interior will feel just like a brand new van, I’m really good at steam cleaning car interiors, like I mean ridiculously good !

 Hugs, 

Jackie

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