Plastic Surgery

And there comes a time in all our journeys when we look in the mirror and go YUCK!! Mine occurred about the age of 6 when I realized that that thing in the middle of my face, called a nose, was ugly. And as I grew, it also grew - uglier. You see, my nose has a hump in it. Straight on it looks fine but I have an awful profile. I inherited it from my father's side of the family and no offense Dad it was not the perfect gift for a daughter. So I have been very self conscious of my nose, and I even believe that it might be the reason that I am read so often. So last year I decided that I was going to do something about it. Plastic surgery.

So how does one find a surgeon? I mean there are a lot of plastic surgeons advertising in all the media but how do you find one that is sensitive to our needs and in the art of feminizing a face. I do not want to come out looking like Charles Bronson with a face that looks like it has dug 17 tunnels. Not being an expert in field, I set about to educate myself. I first began with the archives here in the TGForum. I read about the personal experiences of others and Dr. Sheila Kirk’s informative articles. I pretty much had an idea in mind of what I wanted. I wanted my nose fixed and to also have a trachea shave; but I was also open to suggestions.

Now I live in North Carolina, and all the locations that specialize in TG surgeries appear to be across country or too far away to make a casual visit. I did take advantage of a free (that always gets my attention along with clearance and 70% off) consultation with Dr. Ousterhout while he visited Southern Comfort last year. "Dr. O" as many of his girls call him, is probably the premier bone surgeon for facial reconstruction for feminizing a masculine face. He went through a long list of things he would do for me including breaking my jaws and replacing them with titanium. Now I immediately had visions of a James Bond villain being stopped by airport metal detectors, and that was way too much too soon too fast for me. Besides I do not look good in heavy metal.

I began to think why do I have to go to one of these famous locations half way across country when there ought to be talented surgeons a lot closer to me. I mean all I wanted was a nose job and a trachea shave which should be fairly common items in the plastic surgery menu. So I began to concentrate my search in state. A friend of mine was also looking for a surgeon and so we were able to compare notes and prices of the ones that we visited. Now I will say up front, that most surgeons charge for a consultation because it does take their time so make sure you do all the research on a doctor prior to the consultation because it can get rather expensive. Most will credit you the fee if you elect for them to perform surgery. Now the best research is a recommendation from someone who has been to that doctor. They can tell you how the doctor and staff are about follow-up visits and do they offer any guarantees. Now there really are not any guarantees but some will do follow-up and corrective work free if needed within a year (normal healing time). It is also great to be able to see their work and the quality. If someone comes out looking like the stitching on the cat woman costume then I would look somewhere else. Also ask about the doctor's "bedside manner". There was one doctor who spent most of the consultation telling what he would not do so he was not interested in me but himself so he did not get a good rating. Also compare cost, time away from the job to heal (usually a minimum of two weeks) and if hospitalization is required. If not you will need someone with you to care for you for a few days. Also find out how many other procedures like the ones you want, they have performed. I mean do you really want to be the first? And find out what all the procedures that they can do because often there are price breaks to do multiple procedures at the same time. But also remember that some procedures work against other procedures and should not be done at the same time. Again the key is to shop and to ask a lot of questions. Remember that this is your face and will be forever changed by this doctor's skills so make sure that you are comfortable and confident with him before you go under his knife.

Well as I said, a personal recommendation is a great start; and I did get one from a post-op that goes to my electrologist. I got the name and number for her plastic surgeon. This doctor is about 90 miles away so I then did something that most people do not do. I went to the local library and got the phone book for that city and looked at their yellow page advertisement. Now I do not know about you but some yellow page advertisements have a "feeling" about them. Some leave me cold and some actually speak to me. This doctor's advertisement shouted to me. "Aesthetic plastic surgery with a woman's touch" SOLD!!!

Well not really but it told me that I needed to call this one and make an appointment for a consultation. So in February of this year, I had my face to face meeting with the doctor. Now here is the key point that I can not stress strongly enough. How comfortable are you with the doctor and confident in his skills? This doctor put me at ease immediately. It was great to find a woman doctor who I could relate to and who could understand my needs. She has had other TS patients so she was aware of our special conditions that warrant different methods. She first wanted to know what I wanted and I told her that I was a TS woman and that I wanted to look more feminine. She agreed that both the nose and trachea needed to be done. I also asked her for her recommendations because she has a more objective slant than I do. She did recommend cheek implants which in her opinion would fill out my hollows under my eyes and would soften my overall appearance and give me the "biggest bang for my buck." None of the other doctors ever suggested this. All during the consultation she made sketches of my face. She even was able to tell me that I had had electrolysis the day before and for two hours. I liked her go slow approach instead of the throw the face out with the bath water that some other surgeons had endorsed. We talked about the scarring if any and the do's and don't for while healing.

My consultation lasted well over one and half hours and I feel that I got my money's worth even if I did not have the work done. I learned more about the how’s and why’s than I ever knew before. I walked away from her office convinced that I had found my surgeon. One very big factor was the she is local. Okay 90 miles local but that is a lot better than having to fly across country so I can go back to see her if I need to. Also, she is economical. She does all the procedures in her office. She has anesthetist on staff so there are no hospital stay which is a big savings. I now needed to figure out how to finance it and when. My only real vacation window would be in November and that would give me the time needed to raise the money.

I told my friends who all knew what I was doing. And in the matter of a month, three of them had gone to see her and all three had surgery dates set. Now this gave me a great chance to see the quality of her work because I would see these girls before and after surgery. In every case her work was fabulous. Her technique is subtle changes and not one that shouts to the world that you have had any work done which fits my plans exactly. You see I am not out at work yet, and the thought of having to explain this when I get back is going to be interesting to say the least. I also got to take a friend to surgery so I got to see the prep work and then pick her up after surgery. She has a major face lift so when I returned her head was swollen. It was round. I mean Charlie Brown round (if her head was that round would my nose be the size of W.C. Fields’). Plus she had a brow lift and had blood draining from her eyes which I was told was normal (glad they told me). So I got to play nurse for her, and she will be doing the same for me. I also got to see how long the swelling and healing takes. In these procedures they go at a rate of 2 weeks, 6 weeks, 3 months and 1 year. So it will take a complete year to totally heal but most will occur in the first two weeks and more within the first 6 weeks. This is important to me because I have two and a half weeks set aside before I have to return to work.

I did go ahead a confirm my date and pay my deposit. By October and my final consultation, I had had a lot of time to think about this step and which items I would have done. I had decided to stick with my original two and hold off on the cheeks until next year. The savings on the cheeks will cover most of my planned lasik surgery on my eyes in the Spring.

So I am all set. I have my date and time to report. I have my list of things not to take two weeks prior (I can still take my hormones - whew do not need PMS now). And I have my transportation and lodging all arranged. So now I wait and wonder and worry. I fantasize about my new nose. But I can not get this image of W. C. Fields out of my head. Ah yes, I will let you know how it all turns out My Little Chic-a-dee's...

Part 2

And my search for a plastic surgeon was with that same Fieldsian philosophy. I was not going to take any chances when it comes to someone with a knife cutting me. I returned home after my final consultation, and a few thousand dollars poorer (yes my friends they like there money in advance since it is difficult to repo your face). I had a long list of things that I was required to do both before and after the operation. For two weeks prior and after the procedure, I could not take anything that promotes blood flow; therefore, no aspirin products at all. Other things like vitamin E, cayenne, garlic, ginger, St. John's wort (there goes my depressions) and gingko biloba (and there goes my memory) were on the list. Well at least I can continue on my hormones (nothing worse that scared patient with PMS.

Did I say scared? Well to be very honest with you I was, because I have been blessed to have never been hospitalized and I have never been sedated. As much as I have been looking forward to making another positive step in my transition, this one scared me a lot. Of course all my steps forward scared me in some ways; but in the past, I could always get up and walk out if I had to if things got bad. This time there is no way to do that. I knew that this was really routine surgery with little risk but still I would be lying if I said that I was not scared. I did have the benefit of having so many friends who were supportive and encouraging. Some said that I was brave. I will tell you what brave is. Brave is doing this by yourself alone. A friend of mine was scheduled the week prior to me for surgery and she back out. In my mind, she did not have the support structure that I did and when she began to have doubts there was no one there to reassure her.

I packed for a week long visit with my friend who would be acting as my nurse. I had been her nurse back in the summer so it was repayment time. Normally I would have packed steamer trunks full of things for a stay of that length (image the safari scenes from those old Tarzan movies) but this time I packed very light. I mean I would be able to spend the week en femme but for some reason the image of ball gowns and gauze was not to be. I packed for comfort and did not expect to be wear any makeup. I was told that I would not be able to wash my hair or face for a week so the grunge look would be in style.

I arrived at my friend's home Monday evening. We had a light supper. I did not want much to eat since I am not suppose to have anything after midnight; no juice, candy, gum and just barely enough water to swallow my pills, and my nervousness took my appetite. We went over my check list of things to do and take and then it was off to bed for very little rest.

The next morning I arose and cleaned up in silence. I wore loose clothes so that they would be easy to get me in and out of and ones that I did not mind if they got bloody. The drive to the clinic was long and every fear imagined visited my mind (the problem with having a good imagination is that it can take over at times like these so visions of Lon Chaney and noses on the floor and loosing my voice all came to call). When we got there, I took my three Valiums as directed. I put on my hospital gown and sat down in a cold vinyl chair and faded out..........

...........my next memory is being back at my friend's house and taking off my clothes to crawl into bed and that was some 8 hours later. What happened in between is anyone's guess. I did look in the mirror. I can say with gladness that W. C. Fields was not looking back at me; Rudolph was. Only the tip of my nose showed and it was the prettiest cherry red (if I could only find the lipstick to match it). There was a bandage on my throat where my adams apple used to be. Plus there were some small extras done that my insurance was actually going to cover (thank goodness for small wonders). I crawled into bed with ice compresses for the swelling and a glass of water. I was not in pain but just uncomfortable. My biggest complaint was that I could not breathe through my nose so I had the worse case of cotton month ever. It felt like the whole French Foreign Legion had walked across my tongue with their dirty sock feet.

The next day was really more bed rest. The top of my head felt half asleep from the anesthesia so I did get some soup into me later that day and kept the cold compresses on.

The following day was Thanksgiving. Even though it was not a traditional Thanksgiving dinner I did have so much to be thankful for this year. There are times when the value of friends become very apparent, and I know that I could not have gotten to this point without them. We just have to remind ourselves to tell them just how much they do mean to us. I was up for most of the day but I did get tired very quickly. At one point I went outside and walked around the house, and I came back in exhausted. I had been very surprised at how much this little surgery had taken out of me.

Oh did I tell you that I had the loveliest set of black eyes imagined. They range from a very warm yellow to a dark purple (which my friends know is my favorite color). And today they began to move. The first two days the color was below my eyes but today the color had moved to my eyelids which means I did not have to wear any shadow (ah the wonders of modern medicine). I also felt a lot better. The effects of the anesthesia were gone and I almost felt good enough to go out and face the after Thanksgiving Day Sales. (I said felt good enough not CRAZY enough). So I guess I was healing okay, and my cherry red nose become more pink. I was surprised that I was in no pain. I had this big bottle of pain pills which I never touched.

Saturday was our Thanksgiving dinner. We had invited a few friends over to share dinner with us and to look me over since two of them had expressed an interest in doing this same thing in the near future. It turned out to a most enjoyable day even if I was hard to look at me.

On Monday, bandages came off. There was a lot of swelling from fluid build up that the doctor showed me how to message and work it out of the areas. She said to continue with the cold compresses. She was very pleased with her work, and I was too even if the eyes were still black.

Now here is the kicker. I went with my friend to the mall where she wants to pick up a few items and to a restaurant for lunch. I was sort of dressed androgynously with no makeup, my hair not styled, no polish, and looking like I had been in an accident; and I got ma'amed everywhere. So the key to passing is to look like you are the victim of spousal abuse.

The following week was one of doing light work around the house since I was not suppose to be bending over any and still working on the swelling. I did get brave and go out to dinner on Wednesday with Renée who was in town on business. The cover up did not completely hide my black eyes which were decreasing slowly but still went out.

Two weeks after my surgery, I was back for a follow-up visit. The doctor was very happy with her work on my nose and brought other in to view it (is there any money in nose modeling?) I still have to work on messaging both areas to get the fluid to dissipate and the swelling down. I have several follow up visits planned and that again speaks highly for finding a doctor that is local. A friend spent almost $1,200.00 on one follow-up visit across country.

Okay the bottomline is this. The ugly hump in nose is gone and so is my trachea but you can not tell it from the swelling. I am only disappointed that swelling has not gone down quicker. I have been told that I can expect up to two months before there is a noticeable decrease. Until then it will be turtle necks and ski mask (good thing I timed this for winter). I will continue to message both areas in hope that I am aiding the recovery process. Would I do it again? Well I have already discuss some new options for next year. And as I walked out of her office, those immortal words on Fields came rushing to me. "Never give a sucker an even break."

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