Friday, April 16, 2010

Last minute angsts and crises

Riding so high on Vicodin right now that I'm watching Fox news, so no promises on veracity or consistency. I'm 18 hours post surgery, and think I'm running a little ahead of the curve, but we'll see how things go from here. I'm on a 6-hour medication cycle, and the discomfort definitely spikes up towards the end of that.

Initial first few hours in recovery room were a special hell that will keep for later.

Rewind: I posted a long mail to ffs-support (a facial feminization support yahoo group) late last night, in an attempt to set some order to my thoughts. My plan was just to do the lower face, but after 5 hours of reasonable sleep (and a good chat with Morley), I felt a bit more daring, and told Dr. Zukowski that I was up for doing the whole shebang.

However, I still didn't want to the hairline advance, for two major reasons. Firstly, it leaves a scar along the hairline. This would be acceptable if I were planning an actual gender transition, resolve to wear bangs, and have further hair grafts to cover it.

That, however, is not my near-term plan. I expect to clipper, shave, or just bald down to nothing at least a couple of times in my later life, and I won't want a long scar across my forehead when flashing my scalp. I'd be happier with the endoscopic approach that Dr. Zukowski, which would leave smaller, vertical scars that I could treat as being decorative, but when I stated this position, he flat out refused to do it.

This was a very nasty shock to receive an hour before surgery was due to start, since this had been pretty fundamental to my planning from the time he first presented it as an option two years ago. It felt like a nasty bait and switch. Luckily his attempts to convince me were all around the context of hair grafts, hairstyle, et al - ie, at odds with my goals, so staying resolute wasn't too hard.

Equally lucky, he busted out a ruler, measured me up, and insisted - based on a paper he'd co-authored that identified ideal mid-eye to brow distance of 2.5 cm, and a brow to hairline distance of 5cm, that I was already at 7 cm from brow to hairline. This was a surprise to me - and commentary on ffs-support had also pooh-poohed the need to do the advance - so some time later, I borrowed the ruler, ostensibly to get an idea of the effect of the 2cm advance that he was promising, and confirmed that my total mid-eye to hairline distance was more like 6 cm than the 9.5 that he had claimed.

In fairness, I was measuring to my widow's peak, not a median hairline, and wasn't taking into account the more receded hairline corners, but I've seen similar forehead shapes to mine on both men and women, so while I'm sympathetic to his desire to exercise his show-piece surgical technique, I really wasn't convinced. If it bothers me, I'll come back for it in a year or two.

So back to the original lower-face plan - except that he pointed out that as long as I was going to be going through the recovery anyway, I may as well do the remaining non-forehead pieces anyway. This comes down to cheekbones, blepharoplasty, and lip lift. I have always wanted cheekbones; the droopy eyelids do nothing for me (being asymmetric and a genetic legacy, although I wonder if their reduction will throw more of this into sharp relief); and the lip lift... well, this has always been offered as a delayed option, on an outpatient basis at some point in the future. All of my quotes state the price followed by "now or later". But now, apparently not - "either do it now, or when you come back to the forehead. I'm not going to nickel and dime." This was less of a shock than the forehead, but still a very unpleasant late change. In the end, I agreed to do it now.

In all honesty, had I not already paid an enormous non-refundable deposit to get to this point, I would probably have at least delayed or even outright walked. But after so much stress to get to this point, it seemed like a relatively small incremental change over the lower-face work that I had already made my peace with.

We'll see how it goes.

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