I had surgery with Ann Sluzky on March 12th 2023 in Yerevan, Armenia. The procedures were feminising rhinoplasty, frontoplasty (forehead reconstruction), tracheal shave and a v-y upper lip plasty. Sluzky is known to often use facial implants but I did not have any. For those who aren't aware of her history Sluzky is a Russian surgeon who left Moscow following the Russia, Ukraine war. Her full name in Russian is Анна Вадимовна Слуцкая - I share this as any searching under the English translation will omit reviews from Russian surgeon review websites that I was unaware of prior to undergoing FFS with her. Russian doctor review websites all appear to require the full name including middle name/s.
Prior to my surgery with Ann Sluzky I had given FFS a massive amount of consideration over 10 years. I had done a virtual assessment with Alexandra Hamer of Virtual FFS, whose advice I think is invaluable to our community. I had also consulted with FacialTeam Spain, both online and in Marbella. I had joined FFS social media groups. Bought and read the Ousterhout FFS book that's now out of print and also read just about everything I could find online. I had talked to friends in person and online who had already done FFS and I even chatted to a patient of Sluzky. I had a pretty good idea of what procedures I wanted and what procedures I didn't and why. Despite that it's a life altering surgery and I don't think anyone could honestly say they weren't scared of undergoing it. I was.
Communicating with Sluzky was difficult from the get go. She didn't have a manager at this time and was living in Israel whilst operating in Armenia. She often ignored messages or didn't answer questions. At this point I got the impression she was somewhat eccentric and blunt but I liked her results and her use of modern technologies and her lack of aggressive marketing made her seem honest so I decided to overlook the shortcomings of her online communication at that time and where she was working from. She seemed a good surgeon, and her patients seemed happy - that was what actually mattered, not slick branding or being adept at social media. I eventually got a video consultation with Sluzky, who loaded up my CT scans in a computer imaging software to manipulate in real time. Sluzky explained some things and said that despite my sinus anatomy being only present on one side of my forehead (this occurs in around 10% of patients so not extremely rare) she would still do a type 3 reconstruction across both sides "for stability". FacialTeam Spain had also told me they would do exactly the same thing, in order to 'guarantee stability', so I was reassured by the consensus regarding that physical abnormality. I felt this initial consultation was good and I had not been terribly impressed with my other consults so I decided to go ahead with Sluzky. Following consultation, after sending many messages and being about to give up on her as an option I finally got a response to asking for a possible date to arrange FFS. The definite hospital date itself would be arranged when we were both in Armenia and I would pay in cash. I felt suspicious of this arrangement but considering her prices and the situation she had found herself in with leaving Russia I thought it seemed understandable and she had been my first choice for surgery, irrespective of cost or location. I didn't exactly feel confident about doing surgery in Armenia or paying in cash but I was not the first trans woman to do so and I felt it was worth it to finally do FFS with a surgeon I felt confidence in. I felt that if I went with a safer choice such as FacialTeam I would probably always wonder "what if I went with my first choice?", and a face is obviously a very personal thing. This is all to say that the comparatively low price of Sluzky's work was not the deciding factor for me, though it played a part in my decision making process. I was determined to make FFS happen having waited so long already, even if it meant risking transphobia, travelling with a large amount of cash and staying in a part of the world that doesn't speak a lot of English that is not known for a high quality of healthcare. The risk of not doing FFS for another decade was a larger concern to me.
Around when I had confirmed a block of time to be in Armenia for surgery I asked to do a video call to discuss the nose in detail specifically as we didn't have a plan on what to actually do with it yet. During the consult I had just been shown examples of lots of things Sluzky *could* do to my face with little, if any, discussion of each procedure. Sluzky responded by telling me we would decide it in person, before surgery. I also confirmed with her the surgeries I wanted were rhinoplasty, frontoplasty and tracheal shave. I was confident in my choice of surgeries. I had opted to avoid lower face work having given it a lot of thought. The benefits seemed seemed marginal, Sluzky had concurred during consultation and the other FFS specialists I spoke to all said similar with one telling me his opinion was that I should do not do any chin or jaw work to preserve a nicer aesthetic. I am 185cm tall with a slender build so a bit of length to my face matches my overall body type.
We set a provisional date for surgery of around the 10th March. I booked everything I needed to and let Sluzky know the details. I arrived in Yerevan on the 7th. This was quite stressful as when we pulled up to the AirBnB my airport transfer was stopped by police, and when we got inside the AirBnB the WiFi password was on a website. My e-SIM wouldn't work so we had to wander around Yerevan aimlessly until we found somewhere that could sell us a local SIM card that morning. Once that was sorted out I let Sluzky know I was there and there was apparently some confusion. I think she forgot when it was I was arriving and so I ended up being in Yerevan for a few extra days whilst Sluzky arrived on the 10th (the day we had provisionally planned to do surgery). Before Sluzky arrived in Yerevan I had a barrage of tests done (bloods, ultrasound of legs, chest X-ray, ECG). I took the extra days to do some walking tours of Yerevan that were very cool and in hindsight the only good thing about this experience.
I met with Sluzky and had a very trying pre-op consultation in which we re-planned which procedures we would do. I also said hello to the anaesthesiologist who didn't respond to me for whatever reason, I later learned he did speak English so maybe he was just in a bad mood. Sluzky tried to convince me at this stage to change the previous plan we had in place and to do a chin reduction in this session instead of doing the tracheal shave planned and to consider FEMLAR and bull-horn lip lift with her at a later date. She was *very* insistent about these things but I didn't want to alter the plan as I had given everything a lot of thought already and there were reasons I didn't want to do any of those procedures. Still, it threw me to consider changing even the basic plan so close to surgery. We went over things a bit and I had some concerns I tried to address which even despite not sharing a first language I feel she was needlessly obtuse about. I don't think it's fair to blame this on any language barrier. You don't need to share a first language to understand when I touch an area of my nose what area I am referring to and her English is of an acceptable standard. I also brought an iPad to the consultation with the thought I could use the accurate photo simulations Alexandra Hamer of Virtual FFS did for me as a reference for my preferences. Sluzky didn't want to look at these though, so we just used her more limited 3d modelling software. There was no discussion of the risks of surgery at this or any point and Sluzky's simulation seemingly could not show a reduction of the radix or an accurate simulation of what she planned to do to my forehead. After we reached a point where I felt exhausted and overwhelmed by all this we concluded the consultation, with Sluzky remarking that she had never found it so difficult to communicate with me or my mother (who was attending the consult with me). Perhaps she did find the communication a little difficult due to not being a native English speaker, but this was something I would come to learn was a personality trait of hers, telling me she had already told me things which she had definitely not already told me, blaming me for her errors, that sort of thing.
Following this difficult consult I didn't exactly feel confident about my surgery as I felt we had discussed things which I didn't even want to do such as a chin reduction, lip lift, hair transplants, FEMLAR... and given that, we had only barely managed to cover my bigger concerns with the surgeries we actually had planned. I still felt that the smaller things such as the many details that make up a complex surgery made up of many sub-procedures that is rhinoplasty had not been given adequate attention. This worried me a lot and I started to panic and spiral. I messaged Sluzky to ask if we could go over the nose again before surgery to which she agreed and I felt a bit more relaxed about everything. Or at least as much as I could whilst being in a country that doesn't respect the existence of transgender people, doing major surgery on my face.
I gave the nose more consideration and surgery day rolled around. I arrived early to try to ensure we had plenty of time to discuss things and I let Sluzky know when I was at the hospital. Eventually Sluzky arrived, I paid her the money in cash and got into the surgery pajamas, at which point I requested we go over the nose specifically as agreed with Sluzky informing me that the surgical team were already expecting me. Sluzky flipped through examples using her computer imaging software faster than anyone could reasonably comprehend and blamed me for the situation of leaving the rhinoplasty planning to this point of everyone waiting on me (despite my asking twice to make time to discuss the nose specifically and her agreeing - I still have the messages). I had to ask her to slow down the computer slides and I did my very best to ensure I was comfortable with what would be done to my nose whilst being aware of the limited time pressure, not wanting to disrupt my surgery happening. Sluzky made it very clear she was frustrated by this situation and audibly sighed a few times which was obviously very distressing for me. I couldn't quite believe this person I believed to be an accomplished surgeon was behaving like this, she hadn't bothered to make the time to discuss the rhinoplasty and didn't even seem to give a shit about making sure we planned it properly. At my insistence we very briefly went back over lowering the bridge, removing the dorsal hump, reducing the radix/nasion area, rotating the tip upward, narrowing the tip "a bit" and preserving the supratip break I had. I wasn't even close to 100% on all these things or the degree to which we would do them due being pressured to make a rushed decisision but I did agree to them. Crucially though, we *did not* discuss reducing the nasal columella (which is the area between the nostrils) at all. As I think I've explained here, I did my best to try to engage with the process of planning this rhinoplasty, but it's a collaborative process so both parties have to be diligent, each sub-procedure should at least be verbally noted. Had Sluzky been so boarish and unprofessional prior to the day of surgery I think I would have bailed.
As I walked toward the operating room, Sluzky pulled out her phone and said we would make a video. Overwhelmed and terrified I just went with it as she asked me on camera what I was about to do (I think I responded broadly by saying "facial feminisation surgery" and I may also have also listed the major procedures). She would upload this to Instagram along with a video taken during my surgery which I obviously couldn't consent to as I was unconscious, before and after photos were also uploaded without consent. I walked into the operating room and lay down with a massive sense of dread that I would wake up with a botched rhinoplasty but at this point, having travelled, paid, already prepared for surgery and with the prospect of potentially never fulfilling the long held desire to have FFS should I back out now I went through with it. I was not asked if I was comfortable with what was about to happen, nor was the entire list of procedures and sub procedures run through with me which would have been another chance to avoid mistakes. Instead, this surgeon was only interested in farming my surgery for social media content.
I woke up later in the day, with a pretty bad tension headache. I recall seeing some kind of metal corridor above me and saying I shouldn't be awake and that my head hurt, next I recall being properly awake in my hospital room and my mother and some nurses being there. The surgery itself didn't seem to really bothering me at all just the headaches I'd gotten throughout my stay from how stressful this experience had been. I took some selfies as one does and let people know I was awake. Sluzky had left by then and there had been mention of some painkillers I could have, so thinking I ought to try to get some rest for the night I asked for them and as soon as the nurses gave me them and turned off the lights in my room I vomited. Annoyingly, the nurses had just taken the sick tray away for some reason so I did my best not to make too much mess. I was concerned about whether or not immediately vomiting was a problem for the rhinoplasty and in trying to be fair in talking about this I would be remiss not to mention that when the nurses contacted Sluzky on my behalf to check if there was any reason for concern she visited the hospital and even went with my mother to the supermarket opposite the hospital to try to find me yogurt she thought I should try to eat. I'm not sure why the hospital didn't have any food available.
I left the hospital the next morning after a short checkup with Sluzky and walked back to my AirBnB which was on the same street as the clinic. I felt like a loose sack of jumbled up bones. Over the next few days having bandages removed I realised my upper lip looked very long now, it was already slightly long before surgery but now it looked even more so and I thought the tip of my nose was looking pinched and weird. I felt extremely worried and upset that under the cast my nose may be entirely disproportionate to my face as I had lost all confidence in Sluzky as a surgeon, the experience had been so shockingly unprofessional, I hadn't felt what I wanted mattered and I had been rushed through the decision making process. I would learn a year later that the reason my upper lip looked much longer was due to a nasal columella reduction I never even had the opportunity to discuss as it was never mentioned to me. I did not and do not want to do a bull-horn lip lift as 3 FFS specialists and 1 dentist advised me a shortening of the upper lip could look strange due to my existing prominent upper teeth show so reducing the columella compounds a facial masculinity I shouldn't even try to resolve with a bull-horn lip lift. Sluzky was the only one to have disagreed with that consensus and I also think she is mistaken. My "rabbit" teeth were something I was bullied for growing up until I grew into my features. I wouldn't want to return to looking like that.
During these early days of recovery I also noticed my brow felt lumpy and uneven and even at this early stage with all the swelling it seemed there was a big dent in it. There seemed to still be bossing between my eyebrows and I felt my eyes still looked somewhat hooded by my orbital rims. I was very upset by everything, extremely tired from hardly sleeping the entire trip due to worry and my thoughts became somewhat dark. I catastrophised due to the circumstances surrounding my surgery. I had the irrational feeling of wanting to rip this new nose off my face to undo it all and cried a lot privately. I worried I had made a massive mistake with this surgeon and was terrified of what the extent of the outcome could be.
I dealt with the physical recovery stuff as I think most do, it wasn't bad at all, just uncomfortable. I think my throat actually hurt the most. I had been given some medication to use by Sluzky after surgery, antibiotics and such but no direction on what to take and when. I had stopped taking the painkiller: ketoprofen (an NSAID) on day 3 as it seemed to cause my nose to bleed excessively each time I took it which worried me. I met some other trans women undergoing FFS with Sluzky who were nice but we didn't spend much time together. One of them mentioned the chaotic nature of communication around surgery and we shared notes on what we thought we were supposed to be doing re. recovery but they still seemed happy with things. So I tried to be positive around them.
I would attend daily checkups with Sluzky for a few days in which she questioned why I looked sad as if her behaviour immediately prior to surgery was totally normal. I asked how the forehead operation had been performed and Sluzky confirmed she had used a combined type 1 and type 3 reconstruction as I suspected contrary to what we had discussed prior when she said she would use type 3 reconstruction across both sides of my brow. She seemed surprised by my asking if a combined approach had been used. After a few days Sluzky left Yerevan and her surgical assistant Edgar [?] took over the care and discharge. I was told stitches are all removed on day 10 but as I had a flight booked Sluzky decided we would try to remove them earlier, so on day 8 Edgar removed my nose support and all the sutures from my nose and scalp. I recall flinching excessively as these things were removed even though they didn't really hurt. I suppose I just felt completely unsafe at this point. When he was done he told me I could now examine my new nose for the first time. I walked over to the mirror to try to assess the situation and he asked me what I thought of the nose. When I turned towards him to answer I noticed that he was filming my reaction on his phone. Again without consent. I said that I didn't know how it would turn out. I thought I looked freakish honestly but I was prepared to look weird at this stage of rhinoplasty recovery and I was taken aback by the privacy intrusion during such a vulnerable moment. It seemed such a creepy thing to do. I assume if my reaction had been positive it would also have ended up on Instagram. Edgar told me that "we [himself and Sluzky] have done a great job" which alarmed me a bit as I thought I had paid Sluzky to do my FFS, not this random guy she had found to assist her whose qualifications I know nothing about. I was told that my inability to breathe through my right nostril at all at this point was just due to swelling. Edgar tried to take my forehead compression bandage away until I informed him Sluzky herself had told me to wear it for a month whilst I slept, but I only had the one compression bandage I had already been wearing for a week. I was not told when I could wash my hair so I just washed it right after I got back to the AirBnB which I later learnt from another patient I wasn't supposed to do. It struck me as very poor that the person doing my discharge wasn't even aware of the advice to wear the compression bandage for a further 3 weeks but this reflected the standard of care throughout. If I didn't ask questions or repeatedly chase things up I was on my own.
I travelled home 9 days post op. I had a letter for the Armenian flight security that lied about why I was bandaged up and looked different saying I had a traumatic deformation of the skull corrected, this was to avoid issues flying home. That was the only documentation of the procedures I left Armenia with. I had no trouble from the airport security and besides a couple of insignificant incidents I had no trouble with Armenians whilst I was there. The nursing team didn't seem to bat an eyelid at me for being transgender either. I had intentionally travelled under a male passport and tried to boy-mode to avoid problems travelling. I've heard of LGBTQ abuse being prevalent in Yerevan but I guess I passed as cis male as I had also cut my hair short prior to surgery. We flew via Warsaw which was a bit scary considering the political situation but I had no problems there either.
On returning home I felt relief that at least I could feel safe again. I finally caught up with sleep and acquired some more compression bandages to use on my forehead. I didn't bother to ask Sluzky about acquiring bandages because asking her for anything was more trouble than it was worth so I mostly just figured stuff like that out for myself.
I had 2 friends I talked to around this time who had both already been through FFS with different surgeons. I listened to their advice about trying to be patient and not judge my results too early but I started to become quite depressed and withdrawn as weeks progressed and I felt the likelihood of needing revision was very high. I looked strange and swollen as most people do early in recovery, which is very difficult in itself. I also experienced a lot of shock hair loss, but even as the swelling started to reduce and I recovered things still looked wrong. I noticed a visible dent above my left eye, I was very uncomfortable with how my nose looked but couldn't put my finger on quite why and I realised I still had brow bossing between my eyebrows. I also had noticeable tracheal shave scar adhesion due to her using an anterior (over the surgical site) approach as opposed to the more modern sub-mental approach (tunnelling down to the surgical site) which avoids that complication. I had some further communication with Sluzky regarding some issues with the coronal incision not closing for a couple months and pain above my left eye I was experiencing.
Around the 3 month mark I asked Sluzky for my surgical report (a report of everything that was done surgically) as I expected to want to consult with another surgical team for revision and thought it wise to get hold of this document sooner rather than later considering how disorganised she is. Sluzky made this standard request that I understand is typically granted without question unnecessarily difficult and tried to bargain for photos and updates of my recovery in exchange for the document. Despite having stating that I did not want a discussion, only the report. I calmly explained my issues with my results so far and the serious concerns I had with the planning of my surgery. Sluzky responded completely ignoring all of this, saying that she was confused why I want my surgical report as the only thing I had told her was that I have post-op depression and asked for photos again... Eventually after a month of back and forth of this unprofessional nonsense I finally got the surgical report which again confirmed the combined type 1 and 3 approach, though contained very sparse detail of the major procedures with no mention of any materials used or sub-procedures and omitted the V-Y lip plasty procedure which was something Sluzky had thrown in for free. The report also mentioned septoplasty which wasn't planned - I'm not sure whether this was actually performed or not. I had no further contact with Sluzky after I received the report at 4 months post op and so all the worries I had, such as how breathing through my right nostril has remained intermittently compromised for this first year of recovery are things I went through without professional advice as I no longer considered her at all trustworthy or competent. At this point interactions with Sluzky had just become a cognitohazard.
Fast forward to a year post surgery I consulted with a well regarded FFS team who confirmed the dent in my forehead bone structure via CT scan, which they referred to as a bone defect, along with what they thought to be a hole through to my sinus cavity. I learnt that my nasal columella had in fact been reduced without my knowledge or consent. When I mentioned having a partial type 3 reconstruction they strongly refuted this as they did not consider the technique Sluzky had used to resemble a type 3 reconstruction at all. I was also able to confirm that the forehead feminisation was incomplete with their specialist analysis. Whilst I do look less masculine post surgery I am still misgendered most of the time even before speaking, even with long styled hair, form fitting clothes, laser hair reduction and electrolysis, eyebrow shaping, a push up bra and many years HRT under my belt. Even with a medical-mask covering everything but my upper face. Sluzky had not set back the forehead at all, only removed the prominences directly above my eyes so I still have bossing between my eyebrows and my orbital rims were only thinned, not shaved from below as many FFS surgeons do to open up the eyes to have them meet cis female averages. Anyway, the result is that I still read as androgynous. I already read as androgynous pre-op so the surgery has had essentially no real world effect on my social interactions. Sometimes I get gendered correctly, but still most often I do not. The bone defect is only mildly visible to me currently, causing a slight depression, loose skin and a new wrinkle above my left eye. However it was stated by the FFS team I met with that as I get further post-op and as I age and my soft tissues inevitably thin this could well become a clearly noticeable disfigurement to other people. As of writing this I am 36 years old so it is a valid concern. I also still occasionally experience pain above my left eye, probably from the very poor bone work, and I have some bare patches of scarring on my scalp which can be visible when I tie my hair back. I continue to have to use the Cottle manoeuvre to clear the airway of my right nostril at times which may indicate a partially collapsed internal nasal valve. At 13 months post-op I doubt that breathing is likely to improve much more. I feel disgusted by the appearance of my nose as reducing the columella makes the lower third of my face look more masculine by elongating the upper lip and Sluzky has ruined the balance of what was a decent, albeit large, nose pre-op. I will admit it's probably not as ugly to other people as I see it having lived with my nose all my life but this works directly against my goals in doing FFS. These were to feminise my features, most importantly to do so whilst preserving my identity and not detracting from or removing what *I* felt was attractive about my face. Columella reduction was not a procedure I would ever have consented to had it actually been discussed with me and it was completely unwarranted. I didn't have excessive columella show previous to surgery and shortening the nose to this degree looks unnatural on my long face. The tip also looks pinched and the supra-tip break that was present before surgery is gone and the nostrils are flared. The dorsal hump is straightened out but the lower part of the nose is a mess. I wonder who even did that part of the procedure. Frankly the nose looked far better before. I still have tracheal shave scar adhesion but it has become much less noticeable now and doesn't move around when I talk anymore so I suppose it is no longer problematic. Possibly my vigorously massaging the area multiple times a day to try to break down the scar tissue helped. The mild Adam's apple protrusion I had is at least no longer present. The V-Y procedure had very subtle effect once the swelling subsided. It hasn't shortened the upper lip (it isn't supposed to) and it hasn't changed the shape at all, but it has projected the upper lip slightly which I think I prefer as this was a bit recessed before and looked a bit harsh. Unfortunately this makes only 2 out of 4 successful procedures.
During the recovery I had tried my best to look after myself and not let myself become too depressed by focusing on hobbies, spending time with family and trying to remain patient about the final result but it was extremely hard on me and I really wish I had not done surgery with Sluzky at all. It was not worth either the extreme stress of the surgery experience nor the fact that I will need more expensive revision surgeries involving grafts to reconstruct my forehead integrity, complete the forehead feminisation and restore the function and appearance of my nose to maybe something like what I could have expected if the surgery had been planned appropriately. All of this burdens me with significant extra costs, and increased risks associated with revising surgery. It has been one of the worst things to happen to me. For many months I would wake up half-expecting for it to reveal itself as a bad dream and to see my old face again, masculine or not it was still better than being landed with this mess. I felt traumatised by this experience and became deeply depressed. I got myself on an SSRI medication which I took for 9 months to try to protect my well-being. A botched transgender surgery is an awful, incredibly lonely experience to go through. I had hoped to do FFS and try to move forward with my life as I'm sure many of you understand. I felt having a male facial bone structure had held me back from a feeling of comfort in my own body for 10 years as I tried to find a way to afford surgery and then also delayed it due to the covid-19 pandemic. After surgery with Sluzky I felt robbed of finally achieving this goal and my mental health reverted back to what it had been early transition. I now lack even the level of confidence in my appearance I had prior to surgery. It's deeply upsetting to think about the rhinoplasty result and it's implications.
The feeling of shame over having volunteered for FFS with this surgeon is also a very difficult thing to contend with. Even if I do logically realise much of what happened was out of my control it's still very hard to not feel as if I was the reason for this outcome and the disgusting way I have been treated. As I said, it has traumatised me. As it stands I don't currently look disfigured and I don't currently have major functional problems but doing surgery with Ann Sluzky has made my life as a trans woman worse. It has given me new insecurities, not properly addressed the ones I started with, impaired my breathing and left the possibility of disfigurement looming over me. It has put acquiring possible subsequent interventions such as professional voice therapy or vocal surgery (my choice would be glottoplasty over the risky FEMLAR surgery Sluzky insisted I should do) another step or 2 away from me financially. To say I feel angry would not do the feeling justice. I do not regret attempting to do FFS, doing surgery in Armenia, or my actual choice of surgeries. I would choose to do FFS and these surgeries again and Armenia itself was fine. My regret lies entirely in choosing this surgeon. I was prepared to not always pass post-op and to still sometimes think I looked male, or unattractive. Was prepared to battle brain-worms and doubts during recovery and risk some smaller irregularities or less than ideal scarring due to the nature of surgery. However, considering the forehead and nose were the key areas I needed to address and both are areas that would now require revision just to repair the damage my primary surgeries caused I think it's fair to say my FFS with Sluzky was a failure.
I have now got back in touch with Ann Sluzky to ask her if she would be willing to refund me the cost paid for these 2 failed procedures. I have sent her images of the CT scan, clinical photos and a report of the findings of her medical peers which confirms a bone defect and incomplete result of the forehead reconstruction. As I expected, on bringing the issues to her attention she ignores anything is wrong, instead callously mocks and gaslights me as dysphoric, verbatim: 'sorry to hear about your disphoria darling'. She fails to even take partial responsibility for the botching of the surgeries she and her colleague performed and instead gives obnoxious deflecting responses that avoid addressing the objective issues I have raised. Telling me I need to do more procedures, in spite of clearly botching the ones I actually wanted, telling me to "say hi from me" to the surgeons who provided the report on her shoddy work. When I directly asked if she denies that the CT scans show a bone defect following surgery with her she wouldn't answer. When I directly asked if she thinks I agreed to columella reduction she wouldn't answer. Her response? 'Sorry I am not going to play your games *wave emoji*'. I am not even joking, this is actually how this surgeon behaves. No accountability, no empathy and no professionalism just snide mockery and abuse. I suppose if nothing else at least I stood up to her.
I personally understand that FFS is cost-prohibitive but unfortunately I can't recommend anyone do FFS with this surgeon at all, no matter how much more affordable it is to do surgery in Armenia. I would avoid her for any surgery in fact. My opinion, as a former patient of hers, is she lacks an appropriate level of professionalism, a respectful attitude towards patients and seemingly the ability to do a forehead reconstruction properly. With forehead reconstruction being regarded as the most powerful FFS procedure this is the most important skillset to have in FFS. Communication was abysmal. She took liberties with my face, and didn't even know what she was doing. In terms of a bedside manner, she doesn't have one. She was weirdly rude about my appearance on more than one occasion (she seems to think she's funny) and is just unnecessarily rude towards people in general. The hospital she is using for surgery badly needs repairs and renovation (the building is collapsing) and staff smoke in examination rooms. Sluzky is no ally to the trans community - taking money out of our pockets for procedures she can't do properly and even making faces more masculine in the example of my botched rhinoplasty. She seems to lack both the basic craniofacial training and knowledge of facial proportions that someone calling themself an FFS surgeon ought to possess. If you are unhappy with your surgery with her, or even if you just want to consult with other surgeons about her work, well, you can judge from my post how she may handle those scenarios. I'm not sure what this surgeon's problem is but it doesn't need to be yours.
My advice having learnt from this experience is to go to a surgeon who can do a standard type 3 forehead reconstruction which will also include a set back of the forehead and a shaving under the orbital rims if applicable to your case. Don't risk the wild west of surgeons doing hacky unorthodox things that surgeons like Sluzky call FFS techniques but the medical consensus of the field doesn't recognise as such like her type 3 -puzzle technique. They likely lack the ability to do these surgeries effectively using time proven techniques. FFS is a relatively young and niche area of medicine but some standards have developed. There are studies that show what works - the standard type 3 reconstruction works. Work with a surgeon or surgical team who use those techniques and technologies and respects the body of research so that you at least control all the variables you can. Don't put yourself through all this just to needlessly risk only achieving a half-baked degree of change and/or a botched outcome.
[I have attached photos of my CT scans which show the bizarre state of my forehead prior to doing any revision surgery on it and the fairly mediocre level of feminisation obtained relative to what could have been. The grey area within the dented area that looks like I got hit by a stray golf ball (sluzky's 'puzzle technique') is completely recessed, a cavity or gap of around 1-2 cm across. You can see there were no permanent fixation materials used as Sluzky uses absorbable sutures only. If you look carefully you can see some bone loss on the opposite side of the brow where the type 1 (burring) was done despite being told only type 3 would be done to avoid this occurring and if you look directly above the nose you can see some remaining brow bossing which is most obvious in the profile view. If you look at the upper-outer edges of the eye sockets you can see these are still quite hooded/low as they have simply been burred from above, not below as is commonly done in FFS. If you look at the cross section view you can also see the central bossing that remains. In this view it also appears that there is a hole through to the sinus cavity. This could theoretically be a very thin area of bone (<1mm) and therefore not picked up by the CT scan but taken at over 12 months post surgery it is concerning either way]
[I have also attached a diagram which explains the relationship the columella has to the rest of the face as rhinoplasty procedures can be difficult to visualise]
TLDR:
* Surgeon said she would do type 3 forehead reconstruction despite partial sinus during initial consultation, instead used a combined type 1 and 3 approach without discussion
* Surgeon rushed patient through rhinoplasty planning moments before surgery, not making time to discuss it properly as agreed to
* Surgeon made changes to the nose without discussion, making an already long upper lip even longer than prior to surgery (see diagram). Not a desirable outcome in FFS as cis men typically have a longer upper lip. This requires a cartilage graft to repair
* Surgeon and surgical assistant filmed video of patient, including during surgery which was shared to social media without consent
* Surgeon left a bone defect / dent in patient's forehead (see CT scans) that requires a graft from the back of the skull to repair
* Forehead feminisation was also left incomplete as confirmed by a well regarded second FFS surgeon
* Communication was abysmal and surgeon was rude and abusive, mocking and gaslighting patient as dysphoric when legitimate problems with evidence were raised post-op
* Surgeon takes no responsibility for any undesirable outcomes, completely ignores CT scan evidence and report prepared by well regarded second FFS specialist team
[Update 24/4/2024]: I have discovered Sluzky is aware of this post and is using her professional social media profile to screenshot and attack it and direct her followers to it... take the comments with a pinch of salt I guess.
Sluzky is also using her platform to try to claim she doesn't share photos without consent so I have decided to attach receipt of having my image removed from her public Instagram profile in accordance with my country's data protection law.
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