Jump to content
  • Welcome to the TransPulse Forums!

    We offer a safe, inclusive community for transgender and gender non-conforming folks, as well as their loved ones, to find support and information.  Join today!

Choosing The Doctor For FFS...


Jeanette West

Recommended Posts

I've had  quite some time to contemplate my doctors and I had thought I knew who I wanted to do my face; Dr. Spiegel, in Boston Mass. I even have my consult all set up for Sept 18th. Then I made the mistake of reading Yelp reviews. Okay, I fall back on my second choice, Dr. Toby Mayer in Beverly Hills, California. I read his too. What a mistake! (Insert facepalm). 

 

I have seen and read about the work of Facial Team out of Marbella, Spain, and they've been mentioned in a  thread here too. I know all docs make mistakes, and they wouldn't be in practice if they made too many, but dang! I am only going to get one shot here so I want to spend my money to get the best for it.

 

This being said, here is my question: Facial Team is up front about their digital FFS construct so you can see very near what you'll look like with each procedure performed. I have seen no U.S. based clinic or surgeon with this available. Does anyone know a doc who can do this? My recourse here will be to spend the coin to consult with Dr. Mayer and Facial Team. I have no problem with this, but I would rather have U.S. based surgery.

 

Thank you, and any suggestions appreciated.

 

Link to comment
  • Forum Moderator

Jeanette, remember the adage that a dissatisfied customer will tell 10 people of their experience while a satisfied one will only tell 1.  So I expected to primarily read negative posts on sites like that.  I had Dr. Spiegel do my trach shave and I was very satisfied.  Any doctor will have "issues" where the patient was not happy, but we never know how much of it is attributable to their perception of what they should look like afterwards.  That, and each of our bodies is different and will react to surgery in their own way.  

 

  

Link to comment

Thanks! I am starting to get nervous, and I have only yet to even go to the consultation! HA!

Link to comment
  • 2 weeks later...

In Wilmette today for electrolysis with Precision Hair Removal and met Dr. Zukowski. I have followed (and dreamed about), getting work done here since I saw his website back in 2000 when I was in university. He took the time to go over everything, spending about and hour and a half with me, and really put me at ease. All I can say is that I about about to write a check! I'll wait 'till the excitement wears off and I have my other consults. He suggested 500mL implants being the minimum for me! Yikes!

 

Facial clearing tomorrow, beauty sleep coming. :)

Not used to this 87* (30.5*C) temperature. It was 51* where I left. Phew, thank Goodness for air conditioning.

 

Link to comment
  • Forum Moderator

Best of luck tomorrow.   That was good to have a meeting with the doctor.  I'm glad to hear you were still enthusiastic after talking with him.  Sounds like a good fit.   Not knowing your frame size that doesn't sound too large. 

 

I know what you mean about the heat!   Argh! 

 

Jani

Link to comment
On 8/12/2020 at 2:02 AM, Jeanette West said:

This being said, here is my question: Facial Team is up front about their digital FFS construct so you can see very near what you'll look like with each procedure performed. I have seen no U.S. based clinic or surgeon with this available. Does anyone know a doc who can do this? 

 

Jeanette, there is actually an independent service that can do a digital FFS based on photographs.  Do a search on "Virtual FFS".  The service is provided by a transwoman in England who did a dissertation on FFS.  She reviews your photos and writes an analysis discussing which procedures would be best for you, along with providing excellent digitized images showing what you would look like afterwards.  Her recommendations are welcomed as input by a number of the FFS surgeons in this country and elsewhere.  I used the service, and was extremely impressed by what I got.  The cost is very reasonable, too.

Link to comment

@Jeanette West -- Just an update on what I posted earlier.  I went back to the Virtual FFS website to refresh my memory.  I have two points to add from that review:

  1. The transwoman who provides the service (Alexandra Hamer) did a thesis on FFS, not a dissertation (still impressive).
  2. She actually works with Facial Team as a virtual FFS artist and consultant, so the quality of work you receive by engaging Virtual FFS would be comparable.  (I found this on the "Disclaimers, Promises and my Qualifications" page of her website, which is worth a read.)
Link to comment

Thank you for informing of that website! I will most certainly use her service as soon as the swelling due to the electrolysis goes away.

Link to comment
  • 3 weeks later...

Had my Skype consultation with Dr. Jeffery Spiegel this afternoon, 5:30 p.m. his time in Taxachusetts. This may explain what happened while I was talking to him.

 

His surgery scheduler had asked for a list of procedures Dr. Zukowski had suggested, so Dr. Spiegel could go over them and add or subtract from what he thought might be good for me.

 

Okay, we introduced ourselves, he asked me what I was thinking of, then asked me to turn to profile, and 45*, then back. He told me, "okay, this is what I think we should do....", and pretty much outlined exactly what Dr. Z was going to do. He went through this list quickly, so I asked him, "you can do this just from looking at me over a computer camera?" {MISTAKE} His reply was kind of off, I could tell I had insulted him but he hid it well, "I can tell this by the way you move, your profile and how you look". I was kind of flabbergasted. I know this guy is one of the best in the world, but still...

 

And that was where it ended, with him almost visibly disengaging, becoming positively uninterested. I hadn't meant to deliberately insult him, but there it was. So how much was I quoted? Are you ready?

$85,310.00 USD, which is twice what Dr. Z quoted for the same procedures. This is kind of fantastic as I saw a physician on Realself list a load of procedures for which she was charged $56,000.00 so why were mine so high?

 

I got a really bad feeling during the Skype, like I was just a ticket, not enough of a challenge, what-have-you. It really crushed the rest of my day. So there it is.

Dr. Zukowski is trained as a plastic surgeon, cut his teeth rebuilding people during his military stint, and has been in the game for 22 years. He actually suggested getting my breasts done while I was having FFS.

Dr. Spiegel is an ENT who has taken the ball and run with it. The photos on his website are like miracles. And I pissed him off. And he suggested I wait on the implants, "this will be a long afternoon", meaning this procedures will take a long time. And I pissed him off.

-crap-.

Link to comment

Over $85,000!  Sheesh.  I wonder what Dr. Deschamps-Braly would charge (he's Dr. Ousterhout's protégé, now that Ousterhout retired).  Or the Facial Team, for that matter.

 

Sounds like Dr. Spiegel is a bit touchy.

 

There is a Dr. Katherine Gast I heard about recently who works out of the University of Wisconsin School of Medicine and Public Health.  She is the Department Medical Director, UW Health Comprehensive Gender Services Program, and apparently does all gender alignment services including FFS (being that much of a jack-of-all-trades seems a bit of a stretch, but . . .).  She might have more reasonable rates.  I'm not sure how many FFS procedures she has 'under her belt'.  People seem to like her GRS work.

 

I'd shop around, both for rates and personality/bedside manor.

 

 

Link to comment
1 hour ago, Jacqui said:

I'd shop around, both for rates and personality/bedside manor.

 

Or even bedside manner.  (I've got to stop posting at 4 in the morning!)

Link to comment

How did I not see this thread before. Dr. Zukowski's office is really close to me. I see they offer a 30 hour electrolysis package that can be done in 2, 7.5 hour, days. It would be real nice to get all my facial hair removed in a matter of days instead of months.

Link to comment
2 hours ago, ElizabethStar said:

How did I not see this thread before. Dr. Zukowski's office is really close to me. I see they offer a 30 hour electrolysis package that can be done in 2, 7.5 hour, days. It would be real nice to get all my facial hair removed in a matter of days instead of months.

 

They'll do exactly that!

Link to comment
4 hours ago, Jacqui said:

Over $85,000!  Sheesh.  I wonder what Dr. Deschamps-Braly would charge (he's Dr. Ousterhout's protégé, now that Ousterhout retired).  Or the Facial Team, for that matter.

 

Sounds like Dr. Spiegel is a bit touchy.

 

There is a Dr. Katherine Gast I heard about recently who works out of the University of Wisconsin School of Medicine and Public Health.  She is the Department Medical Director, UW Health Comprehensive Gender Services Program, and apparently does all gender alignment services including FFS (being that much of a jack-of-all-trades seems a bit of a stretch, but . . .).  She might have more reasonable rates.  I'm not sure how many FFS procedures she has 'under her belt'.  People seem to like her GRS work.

 

I'd shop around, both for rates and personality/bedside manor.

 

 

 

I cannot explain it. Like I said, I must have really made him burn up. And all by asking a question. Oh well.

Link to comment
14 hours ago, Jacqui said:

So what are you going to do now (if I'm not being too nosy)?  (If I am being too nosy, feel free to tell me.)

 

I have a phone appointment tomorrow with Dr. Z. I'll ask some more questions, and while I am waiting for the date to come up, look at Dr. Toby Mayer. Remember, this is what Z has been doing for over 20 years.

Spiegel has an excellent web presence for sure, very nice, very flashy. Do they do the same quality work? How can one actually know if one is good enough to keep working without feeling the necessity to have a flash web presence and jack up their prices to the sky? And then maybe Spiegel really is a medical miracle. I have three months, I will figure something out.

Link to comment

Had my phone appointment today with Dr. Z, made me feel comfortable just as before. He answered all my questions, assured me all would go well, very strongly suggested I continue to exercise and eat really healthy to heal quickly and well. Asked about my outlook for the near future and also told me to continue working with my speech therapist so that I would be ready for the voice surgery.

So now I will keep working as much overtime as I can handle and wait for the clock to tick down. :)

Link to comment
  • 1 month later...

Back from another trip to Chicago. Met with the doctor to go over everything again. In order to dial in the correct size for implants I have purchased a graduated cylinder off eBay so I know what the volumes of rice are (and I can trust the precision and accuracy of the measurements), so I can fill the nylons and see just what size looks best. The doc thinks 575 to 650's and 700's are not out-of-the-question. I am NOT on the same wavelength.

Tomorrow I will get my measurements and buy some bras shotgun style so I can fill in the cups to visualize what I am getting into (pun intended). I'll also try the Mentor visualizer to see how that works.

Another thing that is bothering me; he is seemingly fixated on smooth saline, which is my original desire, but I've changed my mind and am looking at the Siltex round moderate plus extra. I want the viscous squishiness of silicone. I will call Mentor tomorrow to ask for more info on the Siltex exterior.

I paid for the upcoming FFS too. That was an enormous load off my mind and a checked box in The Countdown. :) I also received my letter from my therapist today for my name change.

Link to comment
  • 2 months later...

I have been to PHR in Wilmette, IL several times over the past 18 months, each time with Dr. Z doing the twilight and facial numbing. While I liked the man (and really liked his daughter when she came through one time), I have always thought he was exceptionally cavalier with his numbing, which made me worry a lot about how he would be in an actual surgery. For instance, he uses one hand with the syringe, and the other hand is not stabilizing my head/face. Several times the needle has gone through my cheek, into my mouth, leaving a bunch of lidocaine in my mouth, and then straight through the inside to another part of my skin. Even with the twilight medicine it is literally the most painful thing I have ever experienced in my life so far. And MANY people have had amazing results from Dr. Z. For me though, he came off the list of possibles after my second round of numbing with him. 

 

Katie

Link to comment
  • 2 months later...

I had FFS last July with Dr Jens Berli at OHSU in Oregon.   Initially, I was all set up to go to Marbella, Spain, for the Facial Team.    Then the pandemic hit and I was unable to travel.   About that same time, my insurance came through and agreed to pay for the FFS with OHSU.   Dr Berli had done some training with Facial Team and he is very well versed in the elements of the procedures.  In my case, he consulted directly with Facial Team to develop my plan.  

 

He did not provide any pre-surgical imagery.   He said that OHSU would not allow it because those types of images lead to people with unrealistic expectations.  So I went into it blind hoping for a good outcome.   At least I had a good friend who had her FFS with Berli and she came out great.

 

The procedure was about 11 hours long and my insurance paid well over $85,000 to OHSU.   In addition, they paid out all the CT 3d Scanning.   Plus, they paid an additional $20-$30,000 for an earlier botched FFS attempt at OHSU where there was a medication error that almost killed me.     

 

Then, Dr Berli followed up with my eyelid surgery and lip lift in October, 2020.   

 

I had my final procedure to basically clean everything up last week.   I switched from OHSU to Dr Petroff.  SO glad I did.

The difference in patient care, communication, and attention to detail and planning was night and day.  Petroff center is amazing.   The work that Dr Petroff did is really stunning and I can't wait to show it off.   If I had it to do over again, and I was paying out of pocket, I would have Petroff do everything but the forehead work.   He doesn't do that.

 

Petroff came out about $2,000 cheaper on their quote for the final surgery than OHSU, and they did a lot more than what was in Berli's plan for the final surgery.  The final surgery was all out of pocket and cost about $12,000.00 all in.

 

If you have any questions let me know.  By the way, Berli quoted about $40,000 if I had ended up having to pay out of pocket.   So I do think he might be a bit more affordable than some of the other stateside options.   But either way, the whole thing would have been at least $60,000 even if I paid out of pocket.

 

Link to comment
  • 7 months later...
  • 5 weeks later...

There seem to be more options now for FFS now that insurance companies are paying. I have talked with Dr. Spiegel. He seemed affable. I hear he does some great work. As for the Yelp and Google reviews, I do not pay those much attention. I know of a hospital that manipulates their google reviews by having various members on their staff go online and post these glowing reports. It makes the place look better than they are. There is no question that having a rapport makes things better. I am anxious to meet Dr. Z. I am looking to go to Chicago by March for electrolysis. As for the lidocaine injections, yeah, sometimes no matter how careful you are, one can go right through the skin. This can occur no matter how careful you are. I would not beat up on Dr. Z for that. Yeah, needles in skin are not good. It's funny, I do not mind shaving my legs all that much, but ugh, I hate having to shave my face. 

Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Who's Online   4 Members, 0 Anonymous, 77 Guests (See full list)

    • Stefi
    • VickySGV
    • Evelyn J
    • Susan R
  • Recently Browsing   0 members

    • No registered users viewing this page.
  • Forum Statistics

    • Total Topics
      80.5k
    • Total Posts
      767.2k
  • Member Statistics

    • Total Members
      11,942
    • Most Online
      8,356

    taxicab
    Newest Member
    taxicab
    Joined
  • Today's Birthdays

    1. Amyjay
      Amyjay
      (58 years old)
    2. bettyjean
      bettyjean
    3. Breanna
      Breanna
      (52 years old)
    4. Emily Ayla
      Emily Ayla
    5. JET182
      JET182
  • Posts

    • awkward-yet-sweet
      Colorado isn't exactly a Republican place, and won't become one anytime soon.  I think those folks might be better off not spending their time playing Don Quixote.    We certainly have our share of California "refugees" moving into where I live, so I wouldn't be surprised to start seeing Coloradans too.  I suspect the trend over the next few years will see the blue areas getting more blue and the red areas getting more red as anybody who can relocate tries to find a place where they fit better.   
    • awkward-yet-sweet
      Well, at least it'll be a place some folks could choose.  Options are a good thing.
    • awkward-yet-sweet
      My family would have gobbled that jar up in a minute or two.  When we do have pickled herring, its usually for Christmas.  I didn't grow up with that particular dish, but I grew up in a Greek family so I like just about any kind of fish if I can get it.  However, ocean fish and freshwater fish taste so different.  We usually have more catfish and tilapia to eat than anything else.    What I can't quite get used to is the tons of cabbage my GF insists on eating.  When you live with a Russian, there is always cabbage soup.  Always.  When I first moved in with her, breakfast was "shchi" for soup and either bread or "kasha" which is a bowl of boiled buckwheat with butter and salt.  Those dishes can be made in any number of ways, some are better than others.  In the winter, it can even be salty and sour like kraut.  Not exactly sauerkraut, but packed in tubs with vinegar and salt so it keeps partially for the winter.  But I drew the line when the cabbage soup included pieces of fried snake one day.  😆
    • Ashley0616
      Good evening to you as well @Mmindy   That is awesome that you have support from her side. My dad has communicated with me once and that was because he was forced to. His new wife wanted to spend time with my kids. He hated me so much he was in the process of taking my rights away as a parent to my two boys. He was talking to a lawyer and I called him out on it. I don't love him at all. I'll respect him because I wouldn't be here without him but I wished I had another father. My uncles don't talk to me and unfriended me on Facebook. Almost all cousins except for two are still Facebook friends but they don't give me any support. My mom said she won't support me with that but she has said that she loves me. I have nieces and nephews that are still Facebook friends but they have yet to talk to me. I have one sister that supports me out of three. The other's disrespect me by deadnaming me. They have never called me their sister. I think for them they think it's still a phase. They don't ask questions about me being trans. I have to bring it up and on the look of their faces they don't look comfortable about it. 
    • Mmindy
      Good evening @Ashley0616,   I just got offline with HP tech support trying to get my printer tool box icon locked to my tool bar. This is one of the most important features of my printer that I like because it keeps track of ink, paper, and scanned documents. I'm diffidently not a computer geek.   I'll catch up with the other bookmarks next week. We leave to go home for the Easter Holiday with our families. Saturday with her side, and Sunday with my side. What's odd about that is I'm out to more of her side and they're reluctantly supportive. My side on the other hand are less supportive, and my sister just under me in age will not acknowledge my being there. She will be constantly moving to keep from dealing with me. I'm dead to her.   Hugs,   Mindy🌈🐛🏳️‍⚧️🦋  
    • Ashley0616
      I used to follow baseball and the team I would cheer for is Boston Red Sox. My favorite player was Papi. He was an awesome guy and even held a child during the National Anthem. I haven't watched baseball for a long time. It just died off to me. 
    • Ashley0616
      That stinks that nothing transferred, and no bookmarks were saved! 
    • Ashley0616
      I'm doing patches for now but I think soon I'll go to shots because it's hard to alternate when you are doing two xx patches at once. Unless she gives me Estradiol and progesterone
    • Sally Stone
      Go Cleveland Guardians!  I love baseball and I loved playing it when I was younger.  
    • Sally Stone
      My view is we are "dependent" on government, because as a society, we are too lazy to stay actively involved. So, we let politicians do our bidding for us.  I think we'd be in a better place government wise if we policed the actions of our politicians.  We elected them; they work for us.  Sadly, we are allowing them to run amok.  We are where we are because we have chosen to let politicians make all decisions without us.  Remember "by the people, for the people?" That was the intent of our democracy.  Today, however, it is "by the politicians, for the politicians," the people be damned. 
    • Mmindy
      "Play Ball! Batter Up!" is the closing line of the National Anthem as far as I'm concerned. It's the call of the Home Plate Umpire and signals the start of the game. I grew up in the TV and Radio broadcast of the St. Louis Cardinals. Harry Caray, Jack Buck, Tim McCarver, and Mike Shannon, were the voices on my transistor radio. KMOX 1120 AM pushing 50,000 watts of Class A clear-channel non-directional signal. It could be picked up all across MO, IL, IN to the East. KS, OK, CO to the West. IA, MN to the North, and KY, TN, AR to the South. There has always been a rivalry against the Chicago Cubs, in the National League. As for the American League, I have to pull for the Kansas City Royals. I've also been a Little League Umpire, and fan of everything the Little League stands for. Going to Williamsport, PA and seeing the Little League World Series is in my top 10 things to do on my bucket list.   Mindy🌈🐛🏳️‍⚧️🦋
    • Mmindy
      Good evening everyone,   I don't think my mother ever cooked a meal that I didn't like. We also had a kitchen where mom fixed the food, dad filled your plate, and you eat it. It wasn't until our baby brother was born that we could have Pop-Tarts for snacks. Before that all snacks had to meet mom's approval, and in her opinion wouldn't prevent you from eating supper.   Well my day started off on a good note, but has become frustrating because my IT person didn't transfer my saved videos I use for teaching. Then I found out that they didn't save any of my book marks for websites I use frequently.   Best wishes, stay motivated,   Mindy🌈🐛🏳️‍⚧️🦋
    • MaeBe
      The number is relative to method of deliver, the time of the dose, and when the blood is drawn. However, I do want to keep away from DVT and other potential issues. I assume I may be getting backed down from my current dose, but my doc told me to stick with the higher dose, so? I also wonder if this has anything to do the my breast growth and mental changes that have been happening over the past few years, like I have some estrogen sensitivity so a little goes a long way or something? I don't have enough data to postulate, but who knows!   With weekly, subcutaneous, shots you expect to see big swings of serum level estradiol from shot to peak to trough. My doctor is interested in mid-week testing (for E and T levels only), which would be post-peak blood serum levels but they will be higher than trough. Most, if not all, resources I've seen online is to measure at trough (which I might do just to do it next time) along with a SHBG, LH, and other metrics.   This is from transfemscience.org for Estradiol valerate in oil, which is very spiky compared to some other estradiol combinations. It's also for intramuscular, which will have a slower uptake and is usually dosed in higher volume due to the slower absorption rate from muscles. They don't have subcutaneous numbers, which I would expect to see similar spikes but higher levels at similar doses due to the relatively higher absorption rate direct from fat.   Are you doing pills, shots, or patches? And when you do get your levels checked are you getting that done when your levels are lowest or some other time?
    • Willow
      Both of my parents were from the “North Shore” of Boston.  My mother Lynn and my father Swampscot.  They had an early 1900s Scots-Irish New England diet.  My sister and I were born in the 40s in Ohio well away from New England seafood and in an area where food was more German and Polish.  My first experience with liver and onions was during basic training.  They ate salt cod but never forced us to eat it same with oysters.  My dad ate oysters but my mother wouldn’t.  Anyone who ever ate an oyster can figure that one out.  I grew up eating lamb.  My wife won’t touch it. I love brazed ox tail, again no way. And the list goes on.  
    • KathyLauren
      My mother was German, so yes, I think it was a cultural thing.  If I'd known you when we were cleaning out my mother's place, I could have sent you her "threat jar". 
  • Upcoming Events

Contact TransPulse

TransPulse can be contacted in the following ways:

Email: Click Here.

To report an error on this page.

Legal

Your use of this site is subject to the following rules and policies, whether you have read them or not.

Terms of Use
Privacy Policy
DMCA Policy
Community Rules

Hosting

Upstream hosting for TransPulse provided by QnEZ.

Sponsorship

Special consideration for TransPulse is kindly provided by The Breast Form Store.
×
×
  • Create New...