I wanted to provide an update now that I am 3 years out from my surgery.
What I Had Done
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Surgeon: Dr. Jordan Deschamps-Braly (San Francisco, CA, USA)
Date of Operation: April 14th, 2017
Cost: ~$50,0000 USD
Procedures Performed:
- Scalp advancement
- Forehead contouring and reconstruction (Type III)
- Rhinoplasty
- Chin reduction
- Sliding genioplasty
- Mandible contouring
- Masseter muscle reduction
- Trachea shave
NOTE: I also had a hair transplant done 8 months later with a different surgeon, as Dr. Deschamps-Braly suggested I would have better success with the transplanted hair surviving if I waited until my scalp had fully healed from FFS.
About the Photos
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The “before” photos are all taken within a couple of months of one another in the winter of 2017 with an iPhone 7 Plus. I am not wearing any makeup. There are applied filters that I am unable to remove. I had been on HRT for roughly 11 months and had done ~6 sessions of laser hair removal on my face. I was still presenting male in public.
The “after” photos were taken this past week (August 2020) with an iPhone 11 Plus. I am wearing some color corrector under my eyes, mascara, and a lip tint. There aren’t any filters and no post-processing has been applied. I have been on HRT for almost 4 years now (4 mg Estradiol x 2/day, 100 mg Progesterone 100 mg x 1/day – I’m not taking spironolactone anymore). I have done roughly 12 - 15 laser hair removal treatments on my face, and I imagine I’ll have to continue to do so periodically. I had FFS and I had feminizing hair transplants done 8 months after. I get botox treatments every 4 - 6 months and hyaluronic acid fillers once a year.
My Thoughts
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With regard to choosing a surgeon, to be frank, facial surgery is no fucking joke – both from a technical standpoint on the surgeon’s end and an emotional one on ours. I met with a number of surgeons before I decided on DB, and I didn’t feel confident with them for the following reasons: 1) their aesthetics didn’t seem refined, which was likely the result of 2) not having performed enough surgeries to really hone their technique and style, and 3) I didn’t feel like they were personally invested in me. Additionally, 4) they didn’t have the necessary craniofacial training to be as aggressive as I was hoping with the bone structure in my face, and 5) they weren’t up for the demanding task of doing it all in one shot – for context, my surgery ended up being 12 hours long.
Lastly, everyone has their own experience, but I can’t say enough good things about DB as a doctor. When I walked into his office, back in 2017, I was still presenting male, doing my best guy voice, and despite all of that, he took my request to have FFS as part of my transition with seriousness and respect. I can't think of another time in my life that I felt so hopeful – like I had met someone who actually understood what I was trying to do and could help me get there. Most importantly, though, beyond his aesthetic sense and technical qualifications, I could tell he really cared; nothing demonstrated this more so than when I came to after the anesthesia had worn off, and he was the first person I saw. I have had surgeries before in my life – unrelated to my transition – and this was the only time my surgeon was there to wake me up. That, to me, speaks volumes – that someone would stick around and wait after having been on their feet for 12 hours straight instead of delegating a task to someone else.
FFS was, and is, the most impactful, transformative, and essential step I have taken in my transition. I was 29 when I started my transition, and it was tough to come to terms with the arduous path that lay before me as a result of avoiding the truth about my gender identity for so many years. Now, at 33, I can say that I still wake up every morning, look in the mirror, and am truly baffled that this is my life and not a dream. I am so grateful that I took the plunge, did the research, scraped together the money, and made this all happen – despite the hardships and challenges, both personal and financial, that resulted from those choices.
I hope this is helpful; it seems like timeline posts and before/afters are so much more common these days than when I first went looking for an FFS surgeon – which is such a sign of the incredible progress our community has made – but I wanted to give an update, as I still receive messages regarding FFS. Be safe everyone!
I mean I have at least 50k in savings, BUT i don't want to just spend it all on my face. :(
Ikr 😭😭
I thought mine was long at 9 hours
I agree, ffs was the most important, impactful, would kill a man to get it surgery. My life was changed to exactly what I hoped it would be, and I love it.
I'm about a month out from getting mine. I'm curious, How possible were you beforehand versus after?
Before, everyone read me as female, almost never misgendered. But I also put some effort into presentation.
Now, people gender me more. I learned that before, people were avoiding pronouns and labels to avoid confusion. Now I hear "miss" non stop.
And that's when I wear boy clothes, no makeup, and roll around in horse manure. I can't get misgendered even if I try.
Perfect, that's exactly what I was looking for. Thanks!
I'm 100% at the time read as female right now. I usually have little to no makeup on. However, due to my height, I think every now and then and I route gets raised.
I'm thinking and hoping that FFS will push me over to the edge that there will be no question, ever. That gets me really excited!
I'm 5'11, nobody cares
I'm almost 6'2. Hope it works at the same for me. Lol
Your doctor agreed to a 12h surgery?
Good to know, I was just talking to a surgeon and he said they get worried about anesthesia for longer than 5-6h.
Yeah, he had performed a lot of surgeries of that length, so it wasn't new to him. My understanding, from last time I had been in for a follow-up, is that he has cut his time in the OR down to half of what mine took.
He spent 12 hours on me too. 10+ hours isn't uncommon for FFS.
My FFS was 11 hours. With everything that can be being done it would almost surprise me if a lot of people were done in 5-6 tbh.
I did mine in different years (for various reasons), so it spread out the work. My most significant one, forehead + jaw, was 4.5h.
FFS is several surgeries performed in one session. I think mine was around 10 hrs. If you get fewer procedures (e.g. forehead and nose) it might be more like 4 or 5 hours.
My ffs (the works, type 3 forehead) in 2003 with dr Ousterhout was 12 hours. Recovery was brutal
Yeah echoing what the OP said deschamps-braly has cut his OR time down quite a lot since then it seems though it's obviously variable still between patients. I had pretty much the same things done as the OP except no masseter muscle reduction and it took 5-6 hours. He will still do longer ones though.
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Ah wow! That is so awesome to hear. I feel very fortunate to have found him, and after I had such a life-changing experience, I wanted to make sure more women like us knew about his work.
Wow did you get jaw and chin work? The reduction is a lot! Are you sensate?
I had a chin reduction, sliding genioplasty, and mandible contouring; the only places I have reduced sensation are certain areas of my scalp
Forehead numbness seems common whoever you go to and we don't really use foreheads for anything so I guess it's fine
My forehead is fine, actually. It’s really the top of my head
Cool 👍👌
50k, urgh...I was under the impression it was around 40k. Did you have to save a few years?
It was several years ago, so it might be different now. It also depends on the procedures you get. I told him to do whatever he wanted, and didn’t provide much input aside from photos of women’s faces that matched my aesthetics.
As for how I got got the money, I sold my car, a ton of music equipment, maxed out my credit line, and worked two jobs for the past few years. I consolidated my credit card last year and now pay a $890/month.
Worth it? 1000%
Curious, when he did the scalp advance did he close the gaps in your hairline? He recommended that for me and I’m thinking of going that route but curious to hear others thoughts.
Yeah, he did that, which made the hair transplant a lot more effective and significantly less expensive – since there was less area that needed to be covered. It's so crazy, but my hair line is one of my favorite features now.
Looking gorgeous :) I remember following your posts on Reddit 3 years ago after your FFS. Your results pretty much sold me on Dr. DB. Thank you for sharing throughout your recovery :) It really helped early on.
Really awesome to hear that!!! I feel like I came across him by chance, because he doesn't advertise or market like other surgeons, and when I told he should after my surgery, he demurred. So, I really wanted to make sure our community knew about him as a resource. So happy to hear from you :D
Thanks! I just booked with DB for the fall and I’ve been a little freaked out just because it’s a huge thing and I’ve never had surgery before. Your post made me feel better. 😊
I found DB very good hands to be in for this surgery.
Had my consultation with him back in 2018...still saving money for it lol
By the way he did a really great job on your lips!
It'll be worth it. Just stay focused and do what you need to. Patience is the most essential tool with regard to transition lol
Yes, he did fat grafting in my lips, but I also go to this doctor in NYC once a year for fillers, so he doesn't get all the credit for that: https://drgerstman.com/
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Thank you. I really love my nose. I like that he didn't just give me the typically "ski jump", and preserved a bit of the bump; people are always shocked when I tell them that I had my nose done – or anything on my face for that matter.
You commented on your nose - So I have a very prominent aquiline nose. TBH I love it, but many would consider it something to be fixed. Would it be okay to tell your surgeon, hey, I know that it's unconventional, but I would really appreciate you not messing with my nose and try to find better places to work on things? Did you have this with other aspects of your face, things you were fine with and wanted untouched?
I think almost every girl I have ever dated has had an aquiline nose; I have always loved that feature. If you like that nose shape, just tell the doctor, and they can either leave it alone or refine it.
Depending on what your forehead needs, it's reasonable a doctor would agree to leave your nose alone. It is possible that there would need to be some nose work done to blend everything though. FFS surgeons tend to prefer different aesthetics, so it's a matter of finding one you agree with.
Hmmm. Okay, thanks. I'm new to this but have been finally deciding "fuck it" and kind of don't even know where to start despite being well into all other aspects of trans medicine. So this is reassuring, great!
Many surgeons will be fine not touching your nose. There may be a need or desire by the surgeon to change the radix of the nose (where the nose meets the forehead ) based on what is done to the forehead. Some surgeons may argue for a reduction rhinoplasty that keeps the nose shape but reduces it in size to keep proportionality on your face depending what you have done (if you reduce your chin height and lower your forehead for instance then you are making your current nose proportionally larger )
Very pretty. Congrats!!!
Thank you :D
Dat pout tho 👍
HAH! I was trying really hard to take photos with a relaxed face.
Any chance you could post the picture of you on John Roebling's famous bridge? That was inspiring!
Ah! That's one of my favorite photos of all time. Is it not still up on my profile somewhere?
Found it !
Very awesome! So happy for you. I had ffs with him a month ago and even though I'm still healing the change already feels transformative.
Congrats!!! That's so cool to hear, and, honestly, I feel like I am only now really starting to settle in and appreciate my face
Wow! Very cute, and I feel like you'd look just as good without lip filler.
Did you have a consultation with Dr. Toby Mayer? Was there anything about him you found off-putting?
My hair is my favorite too and I have curly on top and straight in the back. Trying to minimize the amount required for a transplant.
Tbh there is better ffs surgeons with less money 💰 my surgeon of choice in Amsterdam and she ask for 13k euro for the whole face
I've been thinking about going to DB now because this is a lovely result. I have a somewhat feminine face and believe he could make it even better. The price is pretty steep and I'd have to put off doing breasts/butt/hips/waist for another 10 years if I go to him and that makes me kind of sad.
Honestly, those other things are much easier defined surgeons for due to the lower complexity of the procedures. FFS is really tricky stuff, and, at the end of the day, it’s your face; also, if somebody gets it wrong – procedurally or aesthetically – it’s a lot more expensive to fix than a breast augmentation revision. You also can’t cover it up.
To each their own, but I definitely wanted to make sure I got my face right, and I will figure out the other stuff later 🤷🏼♀️
The results are subtle but big impact, very pretty p.s your eyebrows slay, wish I had thick eyebrows
Can I say, you were the one who inspired me to get FFS last year (with Keojampa though). It was as life-changing as I was hoping. I'm almost exactly a year post-op.
How long did you continue to notice changes after your surgery (due to settling, reduction in lingering swelling, etc)? Also, if you don't mind my asking, how much did your subsequent hair transplants cost?
That's so cool to hear!! Really makes all the harassment I have had directed at me worth it – to know that others benefited from my openness.
I would say you can expect it to take about a year.
Well, now I see that I need to get a chin reduction. And brow work
I think those two are the most impactful, and I definitely chose DB, because he has the training to actually perform a Type III forehead reconstruction in an aggressive way and produces consistent results – though I didn't know that when I found him lol
I've been debating on whether or not I want to get my chin worked on for the longest time. It's something that I often look at and go "ugh", but other people never tell me it's something that they think needs work
My chin is very similar to yours pre-op in terms of size. I think if I get that done, along with brow work and a rhinoplasty and maybe a lip lift, I'll be good to go
You don't want your chin to look too small compared to your nose.
Oh for sure. Right now my face actually seems unbalanced to me, with my chin looking disproportionate to the rest of my features. I do have a 'tall' nose, kind of like OP does, but my chin is both wide and jutting (projected) while having very small lips. I don't want my chin to be reduced quite as much as OP's was, but I do want it made smaller/slightly more pointed. My problem is less to do with chin 'height' and more to do with chin width and projection
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