FFS

There are a couple types of FFS surgeons.  Basic makeover surgeons and technical FFS Surgeons.

FFS stands for facial feminization surgery or the feminizing of a male face by using surgical means.

Many surgeons will claim to be "Board-Certified in Plastic Surgery".  They can claim this and that and promise you the world and sell you on a surgery.  This is not a bad thing nor is it a good thing.  It merely depends on the needs of the patient.

If you have a very masculine forehead and pronounced brow bone and male chin, jawline, big nose and will need extensive work and reconstruction...you do not want to go to your run of the mill local board-certified plastic surgeon. Why?  They can't do the extremely technical and invasive procedures necessary to make your face feminized and passable.  You'll be throwing money away.  You'll spend $10,000 and then after the surgery, you'll be unhappy with the results and you'll go spend another $25,000 - $35,000 to pay someone to try and fix it.

This is YOUR face for the rest of your life.  You want to be sure that YOU are going to be happy
with it.

For those types of procedures there's maybe 7-10 surgeons in the entire world TOPS who can do aggressive facial feminization work.

Type 3 Forehead Reconstruction FFS Surgeons

Jordan Deschamps-Braly
San Francisco, CA

Dr. Deschamps-Braly is the understudy of Dr. Douglas Ousterhout, who is the godfather of FFS and he recently retired.

Dr. Marcelo Di Maggio
Buenes Aires, Argentina

Dr. Jeffrey Spiegel
Chestnut Hill, MA

FacialTeam in Spain
Marbella, Spain

Dr. Parag Telang
Mumbai, India

Dr. Eric Bensimon
Montreal, Canada

Dr. Lazaro Cardenas

Guadalajara, Mexico

Dr. Suporn
Thailand

Dr. Chettawut
Bankok, Thailand

Dr. Bart Van de Ven
Antwerpen, Belgium

Dr. Harrison Lee
Beverly Hills, CA
New York City, NY

DR. M.F. NOORMAN VAN DER DUSSEN

Belgium

Dr. Barry Eppley
Carmel, IN


(Note: Currently there are NO surgeons capable of doing type 3 forehead reconstruction surgeons in the state of Colorado).

These surgeons do what is called a Type 3 forehead reconstructive surgery.  It is serious craniofacial and suborbital surgery. Major reconstructive of forehead, brow and eye sockets. Not every transgender woman will need this type of work, but many will.

Susan's Place has an excellent thread on the types of surgeries and the differences in the male and female skulls.
https://www.susans.org/forums/index.php/topic,202486.0.html

http://www.virtualffs.co.uk/Forehead.html


Dr. Deschamps-Braly's website discusses exactly what craniofacial surgery is and consists of.
http://deschamps-braly.com/craniofacial-surgeon-san-francisco/


If you pass very well, you already have soft features, a naturally feminized face and you need a few subtle minor changes such as a little smoothing, some rounding, raising the eye lids, raise the eyebrows and some other light cosmetic surgeries then a board-certified plastic surgeon will do you just fine and there is no need to go find a surgeon capable of type 3 forehead reconstruction.

Denver has two board-certified plastic surgeons that can handle these types of surgeries.

Type 1 Facial Feminization Surgeons (here in Colorado)

Dr. Terrance Murphy
799 E. Hampden Ave.
Suite 540
Englewood, CO 80113
Phone: (303) 788-8400
info@murphyplasticsurgery.com
http://murphyplasticsurgery.com/

Dr. Andrew Wolfe
Golden Complex
725 Heritage Rd #100
Golden, CO 80401

Cherry Creek Facility
501 S Cherry St #900
Denver, CO 80246
Phone: (720) 279-1926
https://www.thecenterforcosmeticsurgery.net/cosmetic-surgeon-wolfe.cfm


There is a type 2 forehead reconstruction surgery as well.  All three types are explained here.
http://www.noormanvanderdussen.com/feminization/forehead-recontouring.html


No one can tell you who the right surgeon is for you.  You have the links and the information above, it is up to you to decide what it is exactly that you need, do several consultations, look at their before and after results, ask questions, do research and figure out what questions you should be asking during your consultations to figure out everything and then you choose the best possibly surgeon for YOUR NEEDS.  All surgeons will have pro's, cons, positive reviews and negative reviews and complaints. It's like buying a car.

This is a pretty good read on the different types of FFS surgeons, how to evaluate their qualifications and abilities and make a sound decision.
http://facialfeminization.surgery/index.php/ffs-history/


This quote comes from a person who had FFS with the wrong surgeon, spent a bunch of money and then had to turn around and spend a bunch more to get it fixed.

"Oh my, where to start with this...

How about the basics?

Your face is the SINGLE MOST VISIBLE PART OF YOUR ENTIRE BODY.  Within a fraction of a second, it's possible for people to determine whether to gender you as male or female just by looking in the area close to your eyes.  Your face will NEVER BE HIDDEN in the same simple way that we can hide other aspects of our bodies or personalities.  Genitals and other parts of our bodies can be hidden under clothes.  Our voices and mannerisms can be altered.  We can hide baldness under wigs.  But none of that matters if WITHIN A FRACTION OF A SECOND SOMEONE HAS ALREADY DECIDED THAT YOU'RE MALE BASED UPON YOUR FACE.

It follows that the face is the most important area of many MTF transitions where accepting anything other than the best surgical results possible is utterly foolish.
Consider my case: I initially went to a local board-certified plastic surgeon for my FFS.  I thought that staying in my home city would make life easier, and I found someone who claimed to have done trans work before and who managed to convince me of his skills during a couple of consultations.  The price was good - about half of what FFS would normally cost - and extra savings were to be had by avoiding travel, time away from home etc.  What's not to like?

In fact, the guy I chose was almost identical in background to Dr Murphy.
Woke up from surgery and was instantly disappointed.  The hairline advance was clumsy.  The brow lift was good, but because the surgeon wasn't able to perform a "type 3" procedure and only did a "type 1", my brows looked stupidly high compared to the prominent brow bone that was still there.  My nose was lovely - he did a great job with that.  And we didn't even touch my lower face, which he thought was feminine enough already.  Be careful about listening to plastic surgeons.  They're very, very, very good at (1) making you feel slightly bad about the way you look, and (2) telling you their services are the best way to fix it.  Salespeople through and through.

My brow ridge was still obvious.  My eyes were still deep-set and very masculine.  But I convinced myself that it was a good result, and told everybody that I was happy with the outcome.  In reality, it was a thorough disappointment and I felt deep down like I'd wasted my time and money.  Within two months of surgery, I was already getting in contact with the actual FFS surgeons in the US to arrange consults to fix what had been done.

And a year later, I had surgery with one of the big name FFS surgeons who could actually do a "type 3" forehead reconstruction, along with correcting/enhancing some of the stuff that the first surgeon didn't do well or didn't do at all.  Lower face, for example.  Lots of bone work that the local board-certified surgeon told me didn't need to be done (probably because he couldn't do it).  Am I pleased with the result?  Yes, most definitely.  Now that I've had a proper "type 3", along with significant reshaping of my orbital rims to get rid of the deep-set look in my eyes, and along with lower face work, I look far more feminine than before.  Removing deep-set eyes requires invasive forehead bone work, not just soft tissue stuff like a brow lift and eyelid work (which most certainly won't solve the problem).  And this is the kind of work that the average plastic surgeon who works on stay-at-home moms (who already look female) just never encounters in his or her surgical career.  FFS is not the work of a generalist.  You need a specialist.

My costs?  The first surgery was about $10,000.  (This was a while ago.)  The corrective real FFS was about $25,000.  So a total spend of about $35,000, including travel and related expenses for the second FFS.  Had I gone to the proper FFS surgeon initially, I'd have spent about $30,000 because my nose had already been done and didn't need correcting the second time.  So a slight extra expense, but two face surgeries SUCKED, as did the year of utter misery while I resented my stupidity for ignoring the common-sense advice of almost everybody in the trans community.

The choice of surgeon is CRITICAL.  A generalist like Dr Murphy can't possibly be experienced and trained in FFS techniques, at least not to the level that the actual FFS surgeons in the US are.  Look at his website.  He spends his days doing mommy makeovers, boobs, liposuction, and mini facelifts.  At a guess, I'd say he does a trans patient maybe once every couple of months - at most - and even then he's not doing actual FFS, but rather applying general, simple, and ineffective soft-tissue procedures to transwomen's faces.  A dedicated FFS surgeon will have done hundreds, if not thousands, of transgender patients, many of which will include significant bone reconstruction.

A typical board certified plastic surgeon making a living from stay-at-home moms WILL NOT DELIVER RESULTS comparable to the likes of Spiegel, Zukowski, Deschamps-Braly, Lee, or FT.

Ok, let me temper that a little.  If all you need is a nose tweak or a brow lift, then yes, a standard board-certified plastic surgeon will probably be good enough.  But if, like the OP in this thread, the issue is BROW BONE and/or JAW BONE, it would be a complete waste of time and money to go to a surgeon who is incapable of performing those procedures!

Take a look at Dr Murphy's results on his website.  They're really not very good at all.  You can clearly see that at best, all he's been able to do are very minor alterations.  The underlying bone structure - particularly the foreheads - are identical in the before's and after's.  His work has had, at most, a rejuvenating effect.  The feminizing effect of his work is non-existent.  This is the same result that I had when I went to a normal plastic surgeon first.  I looked slightly different, but zero percent more feminine than before.  And this is facial FEMINIZATION surgery.  The goal is to look more feminine, and Dr Murphy (and probably almost every other non-FFS surgeon) just can't perform the underlying work necessary to make people look more feminine.  They don't know what they're doing.  In fact, the only feminization I see in Dr Murphy's before's and after's is that he's used the trick of taking before's with no makeup or wigs, and after's with makeup and wigs.  It's as if he hasn't operated on the patients whatsoever, other than raising one woman's eyebrows to a slightly unnatural position.  From an objective standpoint, these results are very poor!  Subjectively, I'd say they're pathetic.

So with FFS, you get what you pay for.  To get good results costs money, it takes time, and it takes the effort of going to where the good surgeons are.  It's a very specialized field, and while the usual arrogance of plastic surgeons might cause them to all claim they can perform FFS, in reality there's only a handful of surgeons worldwide who can actually deliver on their promises on a consistent basis.  Driving distance should NEVER be a factor.  Every city in the US has board-certified plastic surgeons who will claim that they can feminize your face.  The fact that Dr Murphy is seven miles away from where the OP lives shouldn't even enter into the equation.  FFS, like SRS, is probably going to involve almost a couple of weeks away from home and a trip on a plane.  Based upon his results and based upon my own experiences with a very similar surgeon, I'd say that every dollar spent on Dr Murphy will be wasted.

Why did this thread cause me to re-register and dive into what will undoubtedly become a bit of an argument?  Because the suffering that my useless first FFS caused still stings to this day, and I strongly believe that it was unnecessary and caused in part by my own misguided belief that board-certified meant "good enough" and that staying local was important.  And the OP's thought process is frighteningly like my own.  It's an expensive mistake waiting to happen.  And it's well known that there's very few people who are willing to speak ill of their surgeons and admit that they had poor results, so it's no surprise that his patients in Denver are all saying that they love his work.  If I was a patient in one of his before's and after's, I'd be banging on his office door asking for a full refund!

I'm deliberately not mentioning who my first FFS surgeon was, nor who I went to after that to have it all done properly.  I'm not promoting any particular surgeons, and won't divulge this information.  It's not important to the message in this post, which is to take FFS extremely seriously, to realize that it's very specialized and complicated surgery that only a few surgeons can perform competently, and that the face is the number one most important aspect of getting gendered correctly.

Want to avoid getting whispered about in doctor's waiting rooms?  Get proper FFS, not some budget version by a local doc who talks a good game but clearly won't fix the problem."

NOTE: The opinions in the quoted section directly above do not necessarily reflect the views, opinions or beliefs of the author of this blog.  This quote was posted to show the seriousness and criticalness of selecting the proper FFS surgeon.  The views on Dr. Murphy are the author of the quote's and strictly their own.

Furthermore, the author of this blog has no opinion on Dr. Murphy himself as the author of this blog has never received treatment from him and does not wish to engage in any commentary that could be considered slanderous or libelous terminology or be engaged in any defamation of Dr. Murphy's character or business practice.  The only statement the author makes in regards to Dr. Murphy's abilities is that Dr. Murphy DOES NOT do Type 3 Forehead Construction which is a FACT.