Facial Feminization Surgery – Day 4

Day 4 post-surgery for round 1 (eye lift, cheek , jaw reshaping, under neck lipo, cheek lipo, neck and face lift — required when one does jaw work).

Swelling is starting to go down, and a lot of it has “fallen” down to my jaw and under jaw. Getting more visible bruising down there now, from the fluids that are collecting there.

Eyes are improving, although I’ll definitely continue to have shiners for awhile.

Getting easier to open my mouth (e.g. to speak or eat) now that the skin isn’t stretched so tight.

Finished up today’s follow up exam. Doctors think I’m healing well. In what I assume is a good sign, they decided to move forward the next follow up — the one where they’ll remove the stitches from my eyelids — from Thursday to Wednesday.

In addition to continuing to use cold packs, they want me to also start massaging the swollen areas to help get out the accumulated fluids. Not looking forward to that.

Round 2 of surgery (brow reduction, brow lift, opening up the orbitals around the eyes, nose reduction and reshaping, and lip lift) is a go for a week from today.

Someone asked again why I went all the way to Argentina for my surgeries. Here’s why:

The tr:dr version is you go where the best surgeons are, especially when it’s your face.

There’s only about half-dozen surgeons in the world who are truly excellent at facial feminization surgery (FFS) — in particular reducing the male brow ridge is a extremely specialized skill. The orbital bones you can grind down, but the bone over the sinuses is only about 1 mm thick. So they actually cut it out and then reset it at a different angle.

There’s also the aesthetic judgement, which is probably equally important. Some of it is just “regular” plastic surgery, e.g. a nose job as far as technical skills, but getting things just right — and it literally can be a case of a millimeter one way or the other — is huge. Most plastic surgeons aren’t familiar with the subtle differences needed when trying to feminize a male face, compared to just doing a nose job on someone who was born female. My surgeon is also a craniofacial surgeon, which most plastic surgeons aren’t, so he’s especially versed in the subtle differences between male/female facial anatomy. (Things like there’s a difference in the average length between the upper lip and the bottom of the nose, male jaws flange outwards more, and have a sharper corner at the back, etc.)

My surgeon also has a reputation for very natural looking results — and you still look like you. There’s another famous surgeon in the field (now retired) who had a reputation for turning out Barbie dolls, i.e. everyone looked kind of alike. Which was good if you wanted to look like Barbie, but not my thing.

I know a friend and someone else who had the same procedures done with the same surgeon. So I had first-hand knowledge of the kind of results were realistic,* what it was like dealing with him, and other stuff to expects.

* Far, far too many plastic surgeons cheat a bit on their before/after photos, with differences in lighting, head positioning, how the hair is placed, etc. Di Maggio says he doesn’t, and I believe him, but shopping for plastic surgeons is really difficult. And especially when it’s your face…

Finally, this wasn’t the deciding factor, but it’s definitely a huge plus that with the differences in the exchange rate, the cost of doing this work is less than half of what it would cost in the States, even with the cost of travel and renting an apartment for a month.

Especially because trans-related surgeries are still rarely covered by insurance — in fact my particular insurance policy explicitly prohibits trans-related coverage for any of the procedures I’m having because they’re consider merely “cosmetic surgery.” Some insurers, like Kaiser, are starting to be more progressive, but I have a nasty feeling we’re going to see things move backwards during the next few years.

Also, ain’t technology grand… Just got off the phone with HR at my company to coordinate details of my medical leave, after calling my healthcare provider to verify some info about the short-term disability application that’s being sent to EDD.

‘Course it costs $10/day whenever I activate cellular service in Argentina, but in this case, it was worth it. Might as well make a few more calls to other folks today, since the day is already paid for.

(And yes, I know about WhatsApp and have it installed, but that wasn’t practical for these calls.)