**Update: I will edit to keep my most recent before/after picture on top.
Before (45 days pre surgery)/After (70 days post surgery) **
Hey y'all!
So about a year ago, I got word that Dr. Spiegel's newest trainee was establishing his own practice... and the best thing about it? He was moving to MY AREA! Washington DC! Dr Jacob Kuperstock.
Also, tldr pics are at the end. I'm only 7 days out.
Why is this a big deal?
Well, for the love or hate that Dr. Spiegel gets, his students consistently end up being some of the best facial feminization surgeons in the United States. Jumaily, Keojampa and Madirossen all are surgeons who went through the Spiegel center. All of them put out some of the highest quality work with long waitlists and expensive deposits.
The best thing about Dr K? His waitlist is short because he's relatively unknown right now, and his deposit for me was only $1000!!!!
So, I pulled the trigger. I am only 7 days out of recovery so I'll post some pics but for now I'll describe my experience.
My first consultation was over video because it was in the middle of COVID. From what I understand, if you saw him in person when that was more okay during the COVID lull, he walks you through with a mirror and has you point at areas of your face that make you feel dysphoric. For me, though, we did it over video chat.
His demeanor is very upbeat and he makes you just feel good talking to him. He's got a funny and lighthearted personality, but he also clearly has an eye for what can be changed and helped steer me entirely in the right direction as I had NO idea what I wanted.
He and I decided to go with scalp advancement, orbital contouring, brow lift, rhinoplasty, cheek implants, mandible contouring, and lip lift. So, the works!
Here's where the real amazing thing happened. HE GOT IT APPROVED THROUGH MY INSURANCE! Mind you, you're going to have to do some of your own legwork on this but he doesn't just entirely throw you out to the wolves. He was with me every step of the way in the process and helped get my coverage requirements. I got my two letters from psych professionals that wrote about it being medically necessary, and even though my insurance generally judges it as cosmetic, they approved it. Please note: this is VERY YMMV. I'd say only 10-20% of plans out there have a gray area for FFS. But it's worth checking your plan. Mine said that "FFS is generally considered cosmetic but under certain circumstances may be judged medically necessary."
We ended up scheduling 2 surgeries. One inpatient to put in cheek implants, and then another a month and a half later to do the whole shebang.
The cheek implants I did under local anasthetic. It really wasn't that bad. Recovery was mild, and I loved my final results on my cheek implants. You can see a before and after here:
Before and after the first surgery (Cheek implants)
I was extremely happy with them, but obviously had a lot more that I wanted done and so I looked forward to the big surgery. I had mild complications (just numbness on my left upper lip, which lasted 2-3 weeks).
Going into the big surgery, he warned me that I may have significant chin numbness and scalp numbness, and I told him I was a little scared of the chin/lip numbness and weakness but that I was going to go through with it. It was still my biggest fear.
On surgery day, I was well prepared and had the surgery in Fairfax Surgical Center, though he also operates out of INOVA. Fairfax surgical center was very good with treating me well, and the nurses seemed to know how to interact with trans patients. I don't have much to say about the actual surgery - I was out for 7 hours, but when I came to, I had quite a bit of nausea/vomiting.
I left a few hours later with my face/head very tightly wrapped. This wrapping the first two days was probably the most uncomfortable thing about the whole ordeal. My eyes swelled shut and it was the cause of a significant portion of my pain. There was an issue with obtaining pain medicine though and I remember Dr. Kuperstock loudly and angerly advocating for me to the pharmacy which they ultimately complied with. That won him points in my book too.
The first two days were honestly some of the most pain I've ever been in in my life. But it was very much worth it. When I got to his office on the 2 day follow up, I was practically blind because of the wrapping and the swelling, but when he took it off the swelling whooooshed away and I could see again.
My swelling consistently went down over the next few days, as did the pain. The reason he puts the tight wrap is to prevent hematomas, and sure enough, I have absolutely no hematoma.
As for my lip and chin... ZERO NUMBNESS! I was thrilled. He told me he was able to locate the nerves and made sure they stayed in tact. Mental nerve damage was one of my biggest fears and he managed to both be aggressive with my jaw and yet spare me the numbness. I was so so so happy with him about htat.
Pics...
Before/After Cheek Implants 45 days before the big surgery
Front pre-surgery and pre cheek implants
Side pre-surgery and pre cheek implants
Obviously I still have a LOT of healing to do, and I have a lot of swelling still at 7 days. But I can see where this is going to head and I am so, so happy with my decision. Give Dr. Kuperstock a thought for facial feminization, you can likely save money and get with someone who is likely going to be one of the greats in the coming years with packed waitlists.
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