Facial Feminization Surgery: Forehead Contouring

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Please note: this week’s video contains animated diagrams of invasive surgical procedures. These animations may be hard to watch for some viewers. Discretion is advised.

Our first post gave you an introduction to facial feminization surgery. As you may recall, this surgery is not a single procedure, but a collection of procedures, any of which a patient may opt in or out of depending on their needs and desires. This week, we hear Dr. Thomas Satterwhite discuss one of these procedures: forehead contouring.

With forehead contouring, the surgeon addresses two primary areas: the frontal sinus, which is the bone directly above the bridge of the nose, and the supraorbital ridge, which is comprised of the bony structures underneath the eyebrows. Depending on how pronounced these bones are, and whether they are solid or contain air spaces, the surgeon may use one of several different approaches. “The best way of deciding what is the right approach for you is by starting out by getting an X-ray,” says Dr. Satterwhite. He goes on to detail some of the most common approaches to surgically feminize this area of the face.

In a few weeks, Dr. Satterwhite will be telling us about one more procedure that’s commonly performed during FFS on the upper portion of the face, and that is the brow lift. Keep an eye out for that post very soon!

Informing Consent: Empowering Trans Folks through Information

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Five years ago, I was lying in a hospital bed, excited and nervous for my life to change for the better. I was two years into my transition from female to male, and I was about to get top surgery. My mind bubbled with fantasies of shirtless adventures in my near future. I’d lie on the beach with my friends, carefree as the sun beat down on my bare chest. I’d strip off my tank top in a gay bar, tuck it casually into the waist of my pants, and a hot man would buy me a drink, seeing me as my true gender. Life was going to be so much better.

It didn’t turn out so well.

I’d chosen to have the periareolar (more correctly called the “circumareolar”) procedure, a tricky surgery in which a donut of skin is removed, leaving a scar only around the nipple itself. I was drawn in by the surgeon’s promise that I’d maintain nipple sensation and have no noticeable scarring. What I didn’t know was that few trans men are good candidates for this procedure, and my surgeon didn’t know how to correctly judge my candidacy. My chest was too large, and I had too much extra skin. As a result, my incisions split open, became infected, and my chest had a lumpy, strange contour that looked wholly unnatural. It wasn’t at all what I’d imagined.

My original surgeon attempted to revise my result with two follow-up surgeries, neither of which improved things much. Finally, I lost faith in him, and sought the opinion of Dr. Michael Brownstein, a well-known and highly respected top surgeon. From him, I learned that I never should have undergone the peri procedure; double incision was a far better choice for me. He performed this procedure on me, resulting, finally, after more than two years, thousands of dollars, and four surgeries, in the chest I’d dreamed of.

Certainly, part of my bad experience with top surgery was because I didn’t see enough doctors beforehand. I was a student at the time, and although my university insurance covered a large percent of the cost of surgery, I didn’t have the luxury to travel around the country consulting with lots of surgeons. But in this day and age of digital information, there is no reason that I, or any trans person, should have to rely on in-person consultations to glean the necessary information about medical transition.

Transitioning should be easier, in all regards. Our medical options should not be mysterious. We should no longer need to rely on the limited information available from local doctors and our local trans communities. And with more and more doctors implementing the forward-thinking “informed consent” model of care, the onus is on us to educate ourselves. To do that, we need resources. We need reliable sources of information.

And this is the impetus for Informing Consent. We partner with surgeons who are regarded as experts in their fields and asked them to discuss, on video, the medical procedures that are essential (for some of us) to making our lives worth living. Over the next few months, we will release videos weekly, presenting information on Facial Feminization Surgery with Dr. Thomas Satterwhite, Phalloplasty with Dr. Curtis Crane, and FTM Top Surgery with Dr. Scott Mosser. Eventually, we will have information on other procedures as well, including vaginoplasty, metoidioplasty, breast augmentation, hysterectomy, and others.

We also know that surgery is not the only topic trans folks need information on. In addition to surgical videos, we’re working hard on tutorials on changing your name and gender on essential documents such as your driver’s license, passport, birth certificate, and social security card.

This Monday, August 3, 2015, we’ll officially launch with an overview of Facial Feminization Surgery presented by Dr. Thomas Satterwhite. Stay tuned, follow our blog, and keep up with us on Facebook or Twitter.