I had a type 3 cranioplasty, orbital rim shave, and brow lift. The first night was the absolute worst. I have had an orchi and a BA before, but my reaction to the anesthesia this time was just waaay more difficult.
I'm happy to answer any questions.
How much was he able to take off your orbital rims?
I don't know the exact amount, but holy shit it was a lot. He offered me two options, he could either shave them down or cut them out. I went with the cut them out method.
My forehead is like super flat, and my eyes are very forward now, where before they used to be set pretty far back, enough to cast a shadow below my eyes and make wearing eye shadow a no go.
He did mention at my 1 day follow up that he was able to set back my brow ridge/forehead by 14mm, which sounds like it was fairly aggressive, according to his tone.
Super interesting! I didn't realize he was doing orbital osteotomies. What made you go for that over burring?
I was nervous about losing definition/uniqueness. So, initially I suggested just burring. But then he showed me some pics of someone who had similar eye features to me and who had them cut back, and her results sold me. I was afraid it would look unnaturally flat, but now I think it just looks really feminine, and my eyes are really open (except for swelling) and my lashes look way longer.
Since covid, I have been getting misgendered with a mask on, when usually I never am. So this kind of pushed me to being a little more aggressive.
Keojampa throughout was very accepting in allowing me to take the lead on this, which I found very nice. He also recommended against doing any jaw or nose work, and this really helped solidify my feelings about him having his patient's best interest in mind.
Thanks. I had a consult about some revisions with Keojampa but decided to go with another doctor for various reasons. I had a type 1 forehead procedure and my orbital rims were barely touched. I'm not sure that my surgeon offers orbital osteotomies so I was wondering if the same results are achievable.
How long did it take from consultation request to consultation to surgery? I'd love to consider Keojampa, I've heard fantastic reviews, but I've heard his waitlist is enormous.
I had my consult sometime in May. They scheduled me for early Feb 2021, but I told them to put me on a waitlist if anything came up. I guess they had a cancellation, and so they offered me the date four days ago. I don't know what factors made me get the early date. Maybe that I was paying cash, I was only doing my forehead (shorter surgery), I indicated I could do either location, or that I was really on top of giving them all the docs they needed. Whatever reason, I feel really really lucky.
Wow that's... A lot faster than expected even if you got in early. Did you do a video consult or in person?
Damn. That's just so cool. I'm really happy for you!
Ya it was wild. I had a week to decide to accept the date, and I just was like, "oh fuck, Oh Ok" and had to wait like only a month after hearing back.
My first consult was a video consult because covid. I knew I needed face scans eventually so I scheduled an appointment for like early July to do the in person, and it all just worked out really well.
Ok I think last two questions:
Did you get minimal work done because that's all you wanted or because that's all Keojampa recommended?
And did you consult with any other ffs surgeons?
Just... Wow. I'm trying to imagine going from "almost a year to wait" to "it's in 4 days". I'm sure you're thrilled but that had to be stressful!
I should hopefully have everything locked down on my end next week, and it sounds like I might be adding Keojampa to my official list.
I went with Keojampa because I knew I wanted my forehead done, and knew he was like, one of the best. Another alternative was Deschamps-Braly, but Keojampa is much closer to me.
My consult with Keojampa went really well. He treated me like a human being, and was honest and straightforward with his assessment. I was basically sold on him after the consult.
I got only the forehead done because of his suggestion, mixed with my own apprehension about jaw, chin, and nose work. My forehead was the most troubling spot for me. I already have a feminine lower half of my face, and I wasnt sure how much my dislike for my jaw or chin would dissipate after getting my brow done. I figured, I can do the top part now, see how it looks, and if I really need to in the future, I can get the rest of my face done.
Keojampa also recommended that I only do my forehead and some hair transplants, and MAYBE cheek implants if I wanted to be super feminine (I decided neither was worth the cost at the moment). It was actually very affirming to be told that you have a very feminine face from a FFS surgeon. He also recommended that I keep my nose if I'm 70% satisfied with it, as you often end up chasing the perfect nose when you mess with it.
EDIT: I think I was unclear. I received the surgery date a month ago. So I did have more time to prep than four days, lol. Still, going from almost a year to "this month" is a big jump.
OH duh. For some reason I was thinking this was day 0 post op for you and... Reading is hard, woops. Right. A month prior. Still crazy!
And sorry... You've raised some more questions. To date I've only consulted with Facial Team. Going in I thought I knew what I wanted, but had a similar experience to yours: they told me I was lucky to have my face. They recommended brow/orbital work, and said I should pretty easily find cis women with jaws/chins similar to mine. Hair transplant were also an option but similar idea of "helpful but not necessary".
That really got me thinking about myself and how much was dysphoria vs dysmorphia vs insecurity. It really was super affirming but also like... How do I deal with still seeing so much masculinity in my face? I still don't like my jaw, but why risk it if I don't need it?
Alright sorry so actual question: Do you have any feeling one way or the other on if you're more okay with your jaw now? I'm sure it's tough to tell at 4 days, but this is something I've been trying to figure out for myself for the past month or two.
Also DB was on the list but I've not heard good things about his staff, and I'm not gambling $7500 just to see if insurance might help. Also his website just gives me really unsettling vibes for some reason.
You've got me kind of excited for Keojampa!
Lol, no worries. This is why I made the post!
I think we all struggle with what you're talking about. Even though I pass like 99% of the time, the dysphoria caused by my brow ridge was too much. It was just heightened with mask usage.
When I look at face app filters for my face, basically the only thing they change is my forehead.
As far as passability and jaws go. I think we focus on the jaw line a bit too much. The more important piece is our chin coming to a point. If you have a pointy chin, having a square jaw won't detract from passability. You'll at least be in cis ranges.I happen to have a pointy chin, so I got lucky there. Also, my upper lip reveals my teeth while I'm talking and such... Could it be fuller, yes, but i didn't think it warranted surgery for a fix.
I went to keojampa wanting to not look too artificial or to look like a frog person. I've only seen my face without wrappings like once, and I still have a lot of swelling, but getting my forehead done has greatly changed how I feel about other parts of my face already. We'll see how things progress through recovery.
Just remember my experience is my own, and obvi not all that worked for me or what I wanted will be the same for you.
Jaw surgery is no joke. Surprisingly, forehead feminisation is like one of the least difficult recoveries for ffs. With that only it's an outpatient procedure, and recovery is surprisingly fast. With jaw, all sorts of things can go wrong, it's inpatient, risk of nerve damage, infection, more difficult recovery, etc.. if you need it, do it, but I don't think I did, and if I do, I'll cross that bridge when i feel I need to!
Thanks for sharing your experience about your forehead surgery. I'm also interested in little to no jaw surgery on account of the recovery difficulties.
Hope your recovery goes quickly and smoothly.
Day 12 now, and I feel a lot better. I got staples out on day 8, which was not the most comfortable feeling, but having them out makes me feel a bit better. Shampooing is still a bit sensitive, so I'm looking forward to when the incision is a bit less sensitive.
The pain is super minimal, it's like having a headache and I'm off pain meds but for tylenol at night.
At two weeks I'm supposedly able to not have to wear the headwrap anymore nor use bacitracin on the incision. Just one step closer to feeling normal.
I'm still a little swollen on my forehead area, but the surgeon says like 80% of swelling goes down by week 4.
Hello I am so sorry to respond so late to this. Can we see your results?
First of all, congratulations!
Second, I'm curious if you have any images of ct scans or x-rays, specifically pertaining to your orbital rim shave.
Thank you!
Thank you! I don't have them yet, but he did take them. I expect I'll get my post surgery scans at my one week or one month visit. I'll be sure to share them when I get them!
Okay, awesome!
he’ll give them you whenever you ask! i got them emailed to me the day of!!
Does he take a scan right after surgery then?
yknow, i’m actually not sure!! i was so out of it by the time i was discharged. my surgery started late, and i woke up from anesthesia around midnight (!), and then left the aftercare facility at 8am the next day. my family and i don’t respond well to anesthesia, so i was a mess by the time i left.
Congrats!!! Way to go. I remember when you posted about the date recently and I'm glad it went well. If you may recall, I'm having the exact same things done in October with Dr. Keojampa as well. My questions for you:
- Could you speak a little more about your reaction to the anesthesia, and why it was difficult?
- Did you do the hairline or coronal incision, and what were the deciding factors for you?
- How long did Dr. Keojampa say you needed to keep your wrappings on?
Thanks so much!
1) The only other times I was on anesthesia was for max an hour and a half. This surgery is like 4 hours long. I think the longer you're on it, the more difficult it is. I could be mistaken and my nausea was caused by the surgery itself. But for the first night I couldn't keep anything down and any food made me feel super nauseated. I threw up stomach liquid with blood like a garden faucet like 7 times. It wasn't until the middle of the next day that I felt like I could drink broth and feel ok about it. On this point, try to drink as much water as you can. The thought of dry heaving blood platelets alone sounds real terrible.
They did give me fentanyl after surgery and I had two percocet on an empty stomach. So maybe that is what did it. But it could also be the fact that the surgery messes with your temporal nerves, which throws off your balance/equilibrium, that your skull has been cut into, that you have swallowed blood... I mean, nausea seems a little overdetermined here.
2) I did a coronal incision. Keojampa thought my hairline was in normal-cis-range, so no real need for hairline advancement, and a coronal incision is easier to hide.
3) I'm not entirely sure how long I really need to keep the wrappings on. I think he mentioned that I should keep them on for roughly a week to keep swelling down. I'll double check when he removes the sutures on day 8.
Thanks so much for all your very helpful thoughts. I am very happy for you and can't wait to see the results!
ofc!
Hey there! Any chance you might feel up for some post-operative photos (of just your forehead), or might it feel too early still? I would love to see how lovely you must be looking and feeling! :D
Hello! It's still a little early. And I'm not sure how comfy I am posting identifying features on Reddit. BUT I will give you an update!
My forehead is def for sure swollen rn. And my orbital rim area is def still puffy. This stage kind of sucks, tbh. I used to see other girl's before and after photos where they're like "1 month post op, still really puffy" and I would be like, "what?! You look amazing", and now.... Now I get it.
You see a really dramatic difference day 1. And then you kind of blow up. And then you wait like 3 months for your face to get back to what you saw day one. It's... A struggle.
Also, my hair is just an absolute mess of bacitracin and a little dried blood here and there. This stuff takes forever to get out of your hair, and the incision still feels too raw to massage at all, so I look like I have a scar headband where the hair is parted. Idk how other girls get their hair in a functional state so soon.
My forehead is def smoother. My eyes def more forward. But my whole forehead is frustratingly puffy. And I have this one really sensitive spot that is painful to the touch (Dr said that sensitivity settles after 3 months). But other than all that, at nearly 3w now and I'm feeling faaaar better than before, and I do see light at the end of the recovery tunnel. I kind of am super thankful I got this done during quarantine. Makes it really easy for me not to have to see anyone right now.
Edit: I forgot one of the worst bits for vanity is I can't pluck my eyebrows until 4w. So my brows are just a huge mess of thickness (thanks genetics)
Thank you SO much for your reply! (No worries on pics, I get it)Oh goodness. I'm sorry you're going through some difficult times in recovery, on now, what-Day 18 or so? Poor girl! :( Do you wear an actual headband? My friend did after her own cranioplasty (also with Dr. K) to help camouflage it!
It's great to hear that you are liking the results overall, and great to hear about the differences it contributed too!
I wasn't expecting you to undergo so much puffiness. Not to be too self-centered right now, but, it does make me think of my own procedure in mid-October. So, I'm in a senior leadership position at my job--meaning lots of face time with many people, speaking to the media--and I was hoping that I would be pretty good to go after Day 8 when my stitches are removed. My friend felt she looked normal again after that point, and Dr. Keojampa also had told me how most people can get back to work within 1-2 weeks.
So I'm a little concerned--I can't take off too much time because of how central I am to our operations. My team needs me, as does our constituency! So I have been planning to just take off through Day 8.
But if I'm looking like the Stay Puft Marshmallow Woman...awkward. And not in a funny way. Do you feel your puffiness is evident to others, or just something you are especially seeing?
Hoping you heal up sooner than 3 (!) months!!
Edit: Does your hair help cover your puffiness at all?
I should be really clear. I look very normal. It's just I know I'm puffy. I know that my orbital rims are now further back that the swelling shows. I lost most of the obvious puff after about 6 days. I was looking pretty normal at that point.
Still. My forehead looks big right now. And I think much bigger than it will eventually look like.
EDIT: you will be totally good to go at 14w. You'll just have to deal with really gross hair. Idk, maybe you'll be more bold than me on washing. I'll flag that I don't think I'd be all too happy getting back to work the day after staples are out. I'd give it at least 12 days personally. But I'm kind of a big baby.
Ah I see, thank you for clarifying. You've been so helpful. I'm in the midst of hair removal, but this will be my first bigger-type surgery (I previously had a small round of FUT, but that was it). Thank you so much for helping me in my planning!! A lot to consider right now. I'm also still deciding between coronal and hairline incisions. Hairline would be great for the brow lift aspect, help remove some fine forehead lines I have. But if I go coronal, I'll have to take out some major credit ($14,000 worth) to cover the cost of hair transplants to make up for the 1mm along the front of the hairline that will get pulled back after removing some bone, as well as rounding out the hairline to finally create a feminine shape (my FUT was simply to fill back in the masculine shape a couple years ago). But you did coronal--did you find it moved your hairline back at all? Dr. K said it would move back up to .5mm--perhaps 1mm--if I didn't refill with grafts.
Yes, I have noticed my hairline has been moved back. I'm not sure how it will pan out. I might refill later. I'm not sure.
child comments hidden
[deleted]
Thank you! Every day is getting better!
I didn't use insurance, so I didn't really need any documentation. I believe they'd need two psych letters if I were to use insurance. Note that I do plan on making a claim with insurance and appealing their inevitable refusal. I plan on using psych letters and standard wpath protocal stuff for that.
I did have to do the standard physical and blood work if the physical doc thought it necessary.
The consult went really well. He sets about an hour or so. You talk a bit about yourself and about his history. During this time he's actually assessing how your face looks and moves. Then he works top down suggesting what he thinks would feminize your face. He's def willing to work with you on what you are worried about. I was explicit that I wanted to look natural, just like myself without the worse effects of testosterone. I asked about recovery and the procedure. I also brought some pictures of who I would want to look similar to.
My first consult was telehealth, due to covid, so I made sure to make an appointment for an in person consult as soon as I could. You need to have him take scans of your face bones before surgery. I think you can get these done somewhere else and sent over, but I opted to use his office.
I think the consult was like 250 or something, which goes towards surgery cost and is non refundable. To set a date for surgery I think I had to out down 5k.
I'm not sure. I've been on hrt for a month shy of two years at time of surgery. We did discuss cheek implants, but he recommended I wait until two years are fully up before I make my decision on that. I agreed.
all 35 comments