FFS Surgery Consult

Back on December 4, 2018 the hubby and I went down to Phoenix to see Dr. Ley for a Facial Feminization Surgery Consult. We have been through this type of thing two other times. The first for hubby’s top surgery then for his metoidioplasty, that last was with Dr. Ley and Meltzer so we were familiar with how it would go.

She was polite, and a good surgeon with the hubby. Her bedside manner was a bit abrupt (as it was also during his surgery as well). That being said we knew we would at least get a straight estimate. We had gone to a local Seattle doctor and he had quoted more then $60,000 for procedures that didn’t include as much bone work as I wanted (he is more of a specialist in soft FFS, such as muscles, not so much on the bone).

We went in having already done that 15 minute consult last August and assumed 20k minimum. After the quote from the Seattle doc I was expecting more like 50+k because Dr. Ley had mentioned doing a lot more invasive stuff, I was prepared to not be able to get enough credit to get it all.

We arrived and got the facial/cranial x-rays which was a lot easier than expected. The people at that dental office that did the x-rays evidently do it for a lot of transgender patients and they were completely professional and friendly enough.

Then we arrived at the appointment and only had to wait a little while, it was nice compared to last time.

Once we went back the first thing we noticed was that Dr. Ley was incredibly friendly with us. She was open and warmed up the room verbally before going into the questions. She had no problem interacting with me physically, touching my face and giving me a very intense look over and comparing what she saw, to what the x-rays showed.

The first thing I noticed is she said unless I absolutely wanted it, she wouldn’t recommend a rhinoplasty (nose job). She showed me the x-rays and evidently my nose is already at a feminine angle (angling up slightly). She was clear that for a face to be seen as feminine has a very broad spectrum and my nose was already comfortably in that place. This was a relief as my experience at other consults pushed a nose job. It meant she wasn’t in this just for money.

She went over the rest of me and it came out mostly like I expected. She is going to try and lower my hairline slightly. She was honest, she doesn’t think it will go more than half an inch (maybe a little bit more if she can push it). I have a good hairline, but contrary to what other docs say, she was clear it would help, but wouldn’t be as far forward as some try to quote.

The next part was raising my brows. She can do that easily at least half an inch, that will also help with the lower hairline because between the two my forehead will be at least an inch less than it is now.

Also dealing with my forehead is she will be doing some work on my brow ridge, basically sanding it down to be less masculine, while basically filling and shaping the forehead so it doesn’t just become flat. Her experience as a facial/cranial plastic surgeon with infants reassured me she has the skills.

In addition she will be adjust the orbital area of my eyes (I believe this is the facial cranialplasty level 3, intense but it should open my eyes up a lot. It will make them look bigger, and give me more real estate to use makeup on above my eye. She thinks this will also be a big help with feminizing my face.

We got down to my cheeks and recommended cheek implants. I wasn’t so sure on this, we hadn’t considered it but she was right. My 100lb+ of weight loss has gotten rid of any cheeks, they have sunken in a bit and implants wouldn’t go away, they would give a feminine cast. I talked with hubby and we decided that is good. So it is now going to be more surgery then expected so the cost went up.

Then she went to my jaw and surprisingly enough she recommended that she doesn’t shave it down. The angle is good, it isn’t super masculine or thick and unless I really wanted it she would leave it alone. I was surprised, and happy that once again she recommended against a procedure she could charge a lot of money for.

Then we got to my lips, I wanted a lip implant to lift my lip from its typically flat masculine look to a feminine look. She said that is easy and while she was there she could reduce the space between my lip and my nose giving it even more feminine look. The hours added on to the rest of the surgery (including chin below) was too much for one day so she recommended I do that as a second trip down. That would be an ‘in office’ procedure and I could go home the next day. We agreed, I am getting it, but probably not until three months after rest of surgery.

Finally we got down to my chin, and she fully agreed that it needs to be reduced (thinned/shaved down). She goes in through the mouth for that part so it won’t leave a scar on my neck. She was skeptical of plastic surgeons who would go up and under the neck, leaving a big scar since you didn’t need to do that. This is nice, considering when they due the brow ridge they will have to pull the skin back from my skull and do the bone work underneath, at least it won’t be pulling skin off my full face, just my upper half… ya that is a gross image.

The final result, about $39,000 quote. It is a good chunk more than I originally thought, but still more than $20,000 less than Seattle with more of the procedures I want. Here is the breakdown:

Procedure                                       Fee    
FSCP w/ Brow Burring (6.5 hours)
Genioplasty (2 hours)
Malar Aug with Implants (1.5 hours)
Lip Lift w/implants 7025 (in office)
2 Nights Hospital                                     
$19,878.00
8,319.00
6,038.00
3,500.00
1,248.00                                    
Total $38,983.00 (still 20k less than Seattle)

I am very fortunate, we cannot afford to pay this but my credit is good enough to cover this with Care Credit and regular Visa. It means we are deferring student loans as we can, and we are going to be “going to school” broke but we can make the payments if necessary.

I am even more fortunate that my husband loves me enough to do this. When I saw the bill, even at 20k less than the other doc my initial response was to not do it. I didn’t want to tank his finances. He made it very clear he wants this for me, it is something that is going to help me in the future. I don’t care about passing in theory, but it will be easier to get the level of jobs I have the education for if I am not stuck in the middle according to society. So we are going to do it. Surgery is April 26, 2019 and the lip portion will be probably by August of 2019 depending on how my face will heal.

I will have a lot of future posts about this going into a lot more detail of the procedures and what we are going to do. I just wanted to get this out there as the basic what happened and how much. I will post examples of the procedures later as well.

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