Treatment Provider
Jeffrey H. Spiegel, MD
Board Certified Facial Plastic Surgeon, Board Certified in Otolaryngology – Head and Neck Surgery
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I Came To The Best In The World & Was Operated On By A Fellow
"Hey y’all I'm Chloé and I'm from New Hampshire. This is a very long read, and hope it is heard by both the players involved and to girls looking for doctors and practices with their best interest in mind. Thanks in advance for listening.
For the last year I've been trying to make sense of what happened to me at the hands of Doctor Spiegel and The Spiegel Center. I've told my story on FB pages and other review sires. And I've received so much support it’s been humbling.
Well something occurred to me these last 14 months as I've been navigating the physical and emotional fallout from my FFS. Most recently as I've been navigating the patient advocacy department at Boston Medical Center Yes, a claims adjuster is actually speaking to me. Will they help correct a horrible wrong, or will they force me into court? Time will tell.
As we all know the entire medical system was built by doctors and hospitals to protect the interests of doctors and hospitals. What what about the patients? Well it's that underlying narrative that I'd like to speak to. Specifically, "The Hippocratic Oath."
A hippocratic oath may seem to be just an empty narrative used to reach a climactic end in a Lifetime movie, however it's so much more. At its core among other things is, "first do no harm." Do no harm. Famous last words right?
In short it means to do everything in your power as a doctor to heal or otherwise make life better for your patient. Most any doctor anywhere will no doubt go on-and-on about the gravity of this oath and it's importance to their practices. Well what of the doctor's who don't? What of the doctors who lose sight of the patient in front of them because they're already looking ahead to the next patient? The next cash or insurance payout?
How do we as patient's discern what a doctor's motive really is? I mean it's safe to say that an ER surgeons entire life revolves around one thing; saving lives. But what of the Pediatrician, Dentist and of course Plastic Surgeon? These in almost all cases are not "life or death" situations, so where does a non-triage doctor see themselves within the. "first do no harm” narrative?
Well as it relates to my experience at the Spiegel Center, some see themselves above it. Be it from tenure or ego, some become so full of themselves and their own self interests, (like say going on Good Morning America or buying a new building and having spouses anointed "Facial Experts" so he can offer even more services) that they forget the real reason they took that oath so many years before. To help the patient in front of them live a better life. In this case the very vulnerable population of transgender women who seek a doctors help.
One would think that doctor would do everything in their power to provide the highest level of care that today's medicine, technology and technique can provide. Remaining on top of all things within their practicing field of medicine. So that they may offer the most comprehensive medical care to their patients. Things such as X-rays, CT Scans, high resolution photography and computer models.
With some doctors, they're so confident that they decide to become a teacher. And besides opening up another revenue stream, it's a huge boost to the resume. So they role out their years of medicine to up-and-comers to learn their craft. Of course students need to learn and we need teachers to teach them, however what happens when that teacher simply isn't very good at what he does?
What if that doctor has drifted away from his hippocratic oath to further his reputation? As he chooses to leave behind the creative, comprehensive and cutting edge, (in the name of his patients) to focus on more income and publicity. Forging ahead with the, “this is good enough” approach to his field.
So what happens when this doctor teaches this minimalist "one-trick-pony" style of surgery to others? What if this doctor refuses to employ any evolved medical techniques? What if he refuses to invest in technology that could help him build a better more comprehensive surgical plan? What if he’s so above it all that he doesn't even prepare a surgical plan at all? Instead just winging it on OR day?
How effective can that doctor be as a teacher? Moreover how on earth is a student supposed to learn from him? And what happens when he has a student who just isn't ready? Isn't active in their pursuit of the best and newest ways, and instead follow his mediocre "mail-it-in" approach?
After all not all FFS Doctors are like Keojampa. Doc K is at the top of the field and rightfully so. This said, it's worth noting that he trained under Dr Spiegel himself. Yet Keojampa like most of the new class of plastic surgeons employs every manner of tech to ensure the best results possible for each patients unique needs. This said he learned from a doctor who does not. A doctor who’s running on his inflated reputation not actual results. And who applies bare bones approaches based upon antiquated 1980's methods and tools.
As a single example. Sutures. Modern day tech has robotic closing technology which provides hundreds of micro stitches along large entry points. And as you can imagine just how crucial it is to FFS patients specifically to have a clean close with an eye to the aesthetic. What if your teacher could care less about that technology and instead continues with massive Frankenstein suturing? How do you as a student learn?
Well an ambitious fellow like Keojampa would turn to the admitting hospital and find instruction via other means. But what of the fellow who doesn't? The one who's timid and unsure of themselves or even unmotivated? Hey after all if it's good enough for the self proclaimed "best in the world" then it's good enough for them right? No matter the reason, what happens to the patient's needs and outcome? Indeed their expectations of the highest quality care.
Well I can tell you what happens, that patient gets substandard, dare I say malpractice level care. I was a patient of Dr. Spiegel and can speak with truth and conviction that I was handled like cattle. His consult was all of a few polaroids, while poking at my face for all of ten minutes. Letting go a smile, he quickly exited the office and had his team put together a 57K cash quote for 8 procedures.
He never took a single measurement or employed any tech whatsoever. And what now has become the White Whale of my story, is that he never mentioned that he operates a teaching practice and that a fellow may be the one operating on me.
Let me be perfectly clear here. I WAS NEVER TOLD HE RAN A TEACHING PRACTICE AND NEVER ASKED IF A STUDENT COULD OPERATE ON ME. Never a word.
Lacking any of this insight I would come back months later with insurance and commit to surgery with him. Due to that insurance dynamic, I could not get the 8 procedures done, instead I could only get 4. Later learning through Harvard Pilgrim that he charged 56K for half of the work. Lovely isn't it....
So on March 15, 2018 I went under the knife. I had Type III forehead with scalp advancement and brow lift. An open Rhinoplasty. Chin Implant and Tracheal shave. I was under for less than four hours. Less than 4 hours! The Type III alone should have been that. Red Flags much?
As the first days wore on I knew something wasn't right. I had a massive (Xtra-Large) potato size implant in my once V-line jaw which scared me to death. I had what appeared to be a lifted forehead, only to watch the incision open up and turn to massive scarring, skin wrinkling, lumpiness and my brows flatlining. Hair would fall out and never return and my hairline was only advanced on one side. And I now had this trench between my eyebrows. Visible when I smile.
Meanwhile my nose was a mess. I was and continue struggle to breath on one side, it runs off center and the bridge looks like it was ignored completely as its still asymmetrical. Looking at me it has so much berth to it, some have asked me if I’ve had a broken nose before? Can you imagine?! In short it looks like I've been in a fight. Lastly my tracheal shave seemed meh at best with a lumpy pimple like scar emerged.
I was an emotional disaster and reached out to Spiegel's office. They were all manner of supportive. Verbally anyway. So was Spiegel. The marching orders were and remained for months that, "I had to let it heal" and "don't worry we will do whatever it takes to make you happy."
Well it healed alright. And so emerged a complete botch job top to bottom. And that promise to make me happy? Well that was nothing more than lip service as they would kick that can down the road for 6 months. And when it finally came, it came with a 7K price-tag. I balked. They took absolutely no ownership and ignored me outright. So I walked away. My head spinning I fell apart.
So after 14 months, extensive research and new understanding of just how fellowship programs are administered, I have come to the very likely conclusion that Dr Spiegel never even touched me. I was operated on by his fellow Dr. Laura Garcia Rodriguez. And if Spiegel did operate, he was obviously doing so with another patient in mind. Less than 4 hours for what I had done is as impossible as it is inexcusable. Or simply put, maybe he's just not a very good surgeon. In any case....
So what happens when an established plastic surgeon has an ego that far exceeds his talents? The same one who employs antiquated and honestly outdated processes, while also doubling as a teacher to aspiring students? Is he placing his patients needs first, while doing no harm? Or is he actually causing it?
Is it "doing no harm" when you end-round informed consent because you know that nobody's ever going to agree to have a student operate on them when they came to "the best in the world" for their surgery? So by that omission alone, hasn't harm been caused?
It's worthy to note that because teaching doctors are the "attending physician of record" that means that he, not the fellows are on record as having completed any given surgery. They never get public credit. Now in the case of Doc Keojampa his work was no doubt amazing even then. Yet because he was only a fellow, it was Dr Spiegel who took credit for all that work. So on the other end of the spectrum, when a fellow botches a patient, that too is on Spiegel. Which places him in a very uncomfortable position. For his reputation would be at risk if he admitted to error of any kind.
Well I was one of the patients on that end of the spectrum. My post FFS face is a disgusting mess. I can, (and have) dress(ed) as a man since and never once was mis-gendered. In my normal day to day I'm constantly clocked. Adding that I’m horribly scarred, cannot breath, and now have a more masculine lower face because of this disgusting implant.
In so many ways I, (and others like me) represent the perfect storm of how transgender medicine can and does go wrong. I'm the victim of an arrogant and dishonest doctor. And I will testify under oath to that end.
With this I ask you; what's the hippocratic oath worth when your doctor doesn't care about their patients, but rather how much he can charge you for a bare minimum amount of time and investment? Well from this patients perspective, it's worth nothing. Instead you find yourself here looking for answers. I suffered real physical and emotional harm under the care of the Spiegel Center. Thanks.
For the last year I've been trying to make sense of what happened to me at the hands of Doctor Spiegel and The Spiegel Center. I've told my story on FB pages and other review sires. And I've received so much support it’s been humbling.
Well something occurred to me these last 14 months as I've been navigating the physical and emotional fallout from my FFS. Most recently as I've been navigating the patient advocacy department at Boston Medical Center Yes, a claims adjuster is actually speaking to me. Will they help correct a horrible wrong, or will they force me into court? Time will tell.
As we all know the entire medical system was built by doctors and hospitals to protect the interests of doctors and hospitals. What what about the patients? Well it's that underlying narrative that I'd like to speak to. Specifically, "The Hippocratic Oath."
A hippocratic oath may seem to be just an empty narrative used to reach a climactic end in a Lifetime movie, however it's so much more. At its core among other things is, "first do no harm." Do no harm. Famous last words right?
In short it means to do everything in your power as a doctor to heal or otherwise make life better for your patient. Most any doctor anywhere will no doubt go on-and-on about the gravity of this oath and it's importance to their practices. Well what of the doctor's who don't? What of the doctors who lose sight of the patient in front of them because they're already looking ahead to the next patient? The next cash or insurance payout?
How do we as patient's discern what a doctor's motive really is? I mean it's safe to say that an ER surgeons entire life revolves around one thing; saving lives. But what of the Pediatrician, Dentist and of course Plastic Surgeon? These in almost all cases are not "life or death" situations, so where does a non-triage doctor see themselves within the. "first do no harm” narrative?
Well as it relates to my experience at the Spiegel Center, some see themselves above it. Be it from tenure or ego, some become so full of themselves and their own self interests, (like say going on Good Morning America or buying a new building and having spouses anointed "Facial Experts" so he can offer even more services) that they forget the real reason they took that oath so many years before. To help the patient in front of them live a better life. In this case the very vulnerable population of transgender women who seek a doctors help.
One would think that doctor would do everything in their power to provide the highest level of care that today's medicine, technology and technique can provide. Remaining on top of all things within their practicing field of medicine. So that they may offer the most comprehensive medical care to their patients. Things such as X-rays, CT Scans, high resolution photography and computer models.
With some doctors, they're so confident that they decide to become a teacher. And besides opening up another revenue stream, it's a huge boost to the resume. So they role out their years of medicine to up-and-comers to learn their craft. Of course students need to learn and we need teachers to teach them, however what happens when that teacher simply isn't very good at what he does?
What if that doctor has drifted away from his hippocratic oath to further his reputation? As he chooses to leave behind the creative, comprehensive and cutting edge, (in the name of his patients) to focus on more income and publicity. Forging ahead with the, “this is good enough” approach to his field.
So what happens when this doctor teaches this minimalist "one-trick-pony" style of surgery to others? What if this doctor refuses to employ any evolved medical techniques? What if he refuses to invest in technology that could help him build a better more comprehensive surgical plan? What if he’s so above it all that he doesn't even prepare a surgical plan at all? Instead just winging it on OR day?
How effective can that doctor be as a teacher? Moreover how on earth is a student supposed to learn from him? And what happens when he has a student who just isn't ready? Isn't active in their pursuit of the best and newest ways, and instead follow his mediocre "mail-it-in" approach?
After all not all FFS Doctors are like Keojampa. Doc K is at the top of the field and rightfully so. This said, it's worth noting that he trained under Dr Spiegel himself. Yet Keojampa like most of the new class of plastic surgeons employs every manner of tech to ensure the best results possible for each patients unique needs. This said he learned from a doctor who does not. A doctor who’s running on his inflated reputation not actual results. And who applies bare bones approaches based upon antiquated 1980's methods and tools.
As a single example. Sutures. Modern day tech has robotic closing technology which provides hundreds of micro stitches along large entry points. And as you can imagine just how crucial it is to FFS patients specifically to have a clean close with an eye to the aesthetic. What if your teacher could care less about that technology and instead continues with massive Frankenstein suturing? How do you as a student learn?
Well an ambitious fellow like Keojampa would turn to the admitting hospital and find instruction via other means. But what of the fellow who doesn't? The one who's timid and unsure of themselves or even unmotivated? Hey after all if it's good enough for the self proclaimed "best in the world" then it's good enough for them right? No matter the reason, what happens to the patient's needs and outcome? Indeed their expectations of the highest quality care.
Well I can tell you what happens, that patient gets substandard, dare I say malpractice level care. I was a patient of Dr. Spiegel and can speak with truth and conviction that I was handled like cattle. His consult was all of a few polaroids, while poking at my face for all of ten minutes. Letting go a smile, he quickly exited the office and had his team put together a 57K cash quote for 8 procedures.
He never took a single measurement or employed any tech whatsoever. And what now has become the White Whale of my story, is that he never mentioned that he operates a teaching practice and that a fellow may be the one operating on me.
Let me be perfectly clear here. I WAS NEVER TOLD HE RAN A TEACHING PRACTICE AND NEVER ASKED IF A STUDENT COULD OPERATE ON ME. Never a word.
Lacking any of this insight I would come back months later with insurance and commit to surgery with him. Due to that insurance dynamic, I could not get the 8 procedures done, instead I could only get 4. Later learning through Harvard Pilgrim that he charged 56K for half of the work. Lovely isn't it....
So on March 15, 2018 I went under the knife. I had Type III forehead with scalp advancement and brow lift. An open Rhinoplasty. Chin Implant and Tracheal shave. I was under for less than four hours. Less than 4 hours! The Type III alone should have been that. Red Flags much?
As the first days wore on I knew something wasn't right. I had a massive (Xtra-Large) potato size implant in my once V-line jaw which scared me to death. I had what appeared to be a lifted forehead, only to watch the incision open up and turn to massive scarring, skin wrinkling, lumpiness and my brows flatlining. Hair would fall out and never return and my hairline was only advanced on one side. And I now had this trench between my eyebrows. Visible when I smile.
Meanwhile my nose was a mess. I was and continue struggle to breath on one side, it runs off center and the bridge looks like it was ignored completely as its still asymmetrical. Looking at me it has so much berth to it, some have asked me if I’ve had a broken nose before? Can you imagine?! In short it looks like I've been in a fight. Lastly my tracheal shave seemed meh at best with a lumpy pimple like scar emerged.
I was an emotional disaster and reached out to Spiegel's office. They were all manner of supportive. Verbally anyway. So was Spiegel. The marching orders were and remained for months that, "I had to let it heal" and "don't worry we will do whatever it takes to make you happy."
Well it healed alright. And so emerged a complete botch job top to bottom. And that promise to make me happy? Well that was nothing more than lip service as they would kick that can down the road for 6 months. And when it finally came, it came with a 7K price-tag. I balked. They took absolutely no ownership and ignored me outright. So I walked away. My head spinning I fell apart.
So after 14 months, extensive research and new understanding of just how fellowship programs are administered, I have come to the very likely conclusion that Dr Spiegel never even touched me. I was operated on by his fellow Dr. Laura Garcia Rodriguez. And if Spiegel did operate, he was obviously doing so with another patient in mind. Less than 4 hours for what I had done is as impossible as it is inexcusable. Or simply put, maybe he's just not a very good surgeon. In any case....
So what happens when an established plastic surgeon has an ego that far exceeds his talents? The same one who employs antiquated and honestly outdated processes, while also doubling as a teacher to aspiring students? Is he placing his patients needs first, while doing no harm? Or is he actually causing it?
Is it "doing no harm" when you end-round informed consent because you know that nobody's ever going to agree to have a student operate on them when they came to "the best in the world" for their surgery? So by that omission alone, hasn't harm been caused?
It's worthy to note that because teaching doctors are the "attending physician of record" that means that he, not the fellows are on record as having completed any given surgery. They never get public credit. Now in the case of Doc Keojampa his work was no doubt amazing even then. Yet because he was only a fellow, it was Dr Spiegel who took credit for all that work. So on the other end of the spectrum, when a fellow botches a patient, that too is on Spiegel. Which places him in a very uncomfortable position. For his reputation would be at risk if he admitted to error of any kind.
Well I was one of the patients on that end of the spectrum. My post FFS face is a disgusting mess. I can, (and have) dress(ed) as a man since and never once was mis-gendered. In my normal day to day I'm constantly clocked. Adding that I’m horribly scarred, cannot breath, and now have a more masculine lower face because of this disgusting implant.
In so many ways I, (and others like me) represent the perfect storm of how transgender medicine can and does go wrong. I'm the victim of an arrogant and dishonest doctor. And I will testify under oath to that end.
With this I ask you; what's the hippocratic oath worth when your doctor doesn't care about their patients, but rather how much he can charge you for a bare minimum amount of time and investment? Well from this patients perspective, it's worth nothing. Instead you find yourself here looking for answers. I suffered real physical and emotional harm under the care of the Spiegel Center. Thanks.
Provider Review
Board Certified Facial Plastic Surgeon, Board Certified in Otolaryngology – Head and Neck Surgery
335 Boylston St., Newton, Massachusetts