Facial Feminization Surgery

Greetings All!
Starting the final phase of my surgical transition with FFS/FGCS with Dr. Kyle Keojampa in Los Angeles, CA. My surgery is set for November 21, 2018. A bit about me, I am a bi-racial (AA and White), 28 years young, transgender woman. I work as an attorney in my day-to-day life. I started my transition when I was 18. I have been living “fulltime” (hate that saying lol) since I was about 20. I have been medically transitioning since 2009, that is when I started HRT. I had Vaginoplasty and Breast Augmentation on June 07, 2017 and some minor FFS/FGCS on July 26, 2017. I posted reviews about them, check them out. I did all of those surgeries with Dr. Jess Ting in New York, NY at Mt. Sinai. This FFS/FGCS is part revision and then adding in some more surgeries. As it stands, Dr. Keojampa will be performing:- Type 3 Forehead Feminization Cranioplasty (Revision)- Hairline Advancement (Revision)- Orbital Shaping (Revision)- Eyebrow Repositioning - Brow Lift - Cheek Augmentation with Implants (Submalar)- Lip Lift- Jaw and Mandible Contouring- Sliding Genioplasty Simultaneously, Dr. Monica Kieu, Dr. Keojampa's partner, will be doing hair transplants to disguise the hairline scar, fill in my temples, and just fill in my hairline. Woooo, say all that 3 times fast lol. It's a lot. I am nervous as always but terribly excited. Any surgery is scary but this means so much to me. More than I can say. First up, I should explain why I am having a revision of the brow ridge, hairline, forehead stuff. My first round of FFS/FGCS with Dr. Ting was fine. I chose Dr. Ting, not on impulse but because of time constraints and the fact that he was the only surgeon in NY that could get me on the calendar before my insurance expired. He is also a great doctor. I do not know Dr. Ting's full experience with FFS/FGCS. He is an amazing surgeon and I have seen girls since that look great. However, for me he only suggested those three minor things. I appreciated that lol. The other doctors I consulted with back then kind of made me feel bad because they threw everything at me. Dr. Ting felt I did not need much. This is my face so I went with him to be conservative and if I wanted more I could always get more at a later date. Much like cooking, it is always easier to add than to take away lol. Overall, I was happy with the results Dr. Ting gave me. You can check out the full review for more. After a year of recovery though, I realized I should have done it all. Ultimately, there are just differences in male and female faces that cannot be overcame with post-puberty hormonal treatment. I want to feel my best and look my best and my facial features were a really big part of my gender dysphoria. Moreover, as my forehead and brow bone were my major insecurities, after they were reduced by Dr. Ting, it kind of made the other things stand out more, if that makes sense? Things were out of proportion. So honestly, I decided back in December 2017 that I wanted to do more. So, I started consulting. I kept Dr. Ting on the list but I think I knew I wanted someone else. I consulted with Dr. Kathy Rumer in Pennsylvania. Dr. Rumer does not do bone work and thus she was off the list. I consulted with Drs. Martinez and Bluebond-Langner in New York. I just did not get a good feeling with them. They were both perfectly sweet but some of the procedures (buccal fat removal in particular) were just not what I had envisioned and when I think about how I would look as I age, I am just not sure that is a good procedure to have unless you have extremely fat cheeks lol. Which I did not, not at all. I finally found myself consulting with Dr. Keojampa via Skype as he is in California and I am in Georgia. I met with Dr. K on June 05, 2018. As soon as we got off the call I knew he was the one. Dr. K trained with Dr. Speigel in Boston and his credentials are impeccable. We had a 1-hour consultation. I had sent him photos prior to our consult. He was so kind, knowledgeable, and his way of explaining things just really drew me in/sold me. FFS/FGCS are standard facial plastic surgery procedures but it takes a really experienced and knowledgeable surgeon to execute them well and to perform them all in harmony to come out with a good result. He was able to answer all of my questions. I told him about my other consults and that did not change his attitude. He was extremely gracious and I had that feeling, the feeling that I did not have with Martinez and Bluebond-Langner. I paid the deposit and booked for November 21, 2018. I am not paying for this surgery and neither is insurance, it is an employer situation, but the total cost was 51k~ for everything he recommended. Dr. K does accept insurance though! So please try to seek coverage prior to paying out of pocket. It takes a lot of self-advocacy but I got all of my previous surgeries covered through insurance. I should also say, everything he recommended was everything I came into the consultation thinking I needed besides the lip lift and cheek implants. I still have reservations about them, mainly the cheeks, but I trust Dr. K and I will review with him my concerns at my pre-op appointment on November 20, 2018. I think FFS may be one, if not the, most important surgery for transwomen. I was always very feminine looking but there are some things about my face that would always be more masculine because of my bone structure being allowed to develop under the effect of testosterone for so long. Hormones can’t fix bone. It is what it is. Ultimately, I want to feel like myself all the time. Not just when I am wearing makeup, or if I have styled my hair just right, or in certain lighting, etc. etc. That anxiety and constant worrying about features that everyone sees, every single day, is draining. I know after my initial surgery, my GD regarding my brow ridge was significantly reduced. It was amazing. However, it was not completely gone and Dr. K believes that he can significantly improve those results and more. I believe he can too. As my surgery is about 2 weeks away, I wanted to share some tips for getting prepped. Things I have learned since last time and more research that I have done leading up this new surgery. First the questions list. I always have tons of questions lol and I think it is important to be able to ask your doctor anything. Especially with a procedure like this. If your doctor is not comfortable answering questions, walk away. Q1: If I am not satisfied what are my options?Q2: Do you charge for revisions? Q3: How will weight loss/weight gain affect my results?Q4: Will there be loose skin/saggy skin from the removal of bones?Q5: Will cheek implants make my under eyes look hollow/sunken?Q6: How is this going to look as I age?I am still coming up with more but these are my main concerns lol. Tips prior to FFS (Disclaimer: I am not a doctor lol, check with your doctor first. These are things that helped me and instructions that were given to me.):T1: Start taking 1000mg of Vitamin C 2-3x daily, 2 weeks prior to surgery. Take the Vitamin C with food!T2: Day before surgery, take standard dose of Bromelain 3x that day. Breakfast, Lunch, and Dinner. T3: After surgery drink pumpkin juice. You can get it from Amazon. T4: Take Arnica Montana/Bromelain after surgery as a natural remedy for swelling and bruising. T5: Stop taking hormones 2 weeks prior to surgery. Resume hormones 2 weeks after. T5: Buy 2 freezable gel facemasks, to keep in rotation for post-op swelling. T6: Buy one of those airplane neck support pillows. T7: Have a blender on deck for fruit and veggie smoothies as you will be on a liquid diet and you want to stay healthy. T8: Have your teeth cleaned about a month prior to surgery, just to reduce infection risk as cheek, chin, and jaw surgery are done through incisions in the mouth. T9: Buy Neosporin with anti-itch properties for incisions. T10: Buy a loose-fitting hat and large sunglasses lol. T11: Buy silicone scar strips/sheets. The gel is okay too but the strips/sheets are better. T12: No ibuprofen or alcohol 2 weeks prior to surgery. Tylenol is okay. T13: Buy some good deep cleaning facial wipes. Okay, I think that is for now. I will do another pre-op update next week sometime. Thanks for reading. I will add pics at a later date. Some of my previous posts include why I had to remove pics previously. Be careful about your privacy folks!