Lynn et la Chirurgie de Féminisation du visage (FFS)


Lynn et la

Chirurgie de Féminisation du visage (FFS)

Copyright © 2000-2010, Lynn Conway.

All Rights Reserved [version of 10-20-10]

Traduit par Marie-Noëlle
Révisé par Nathalie

(Anglais)

Post-FFS photo of Lynn: March 29, 2000
Le 10 novembre 1999, Lynn Conway a bénéficié d'une opération de féminisation du visage (FFS). Cette opération de 10 heures a été réalisée par le Dr. Douglas Ousterhout, M.D, sur le site de Davies du California-Pacific Medical Center de San Francisco. Doug Ousterhout est le chirurgien qui a entrepris le premier cette forme de reconstruction très agressive des os du visage pour les femmes transsexuelles. Le but de cette intervention est d'éliminer ou de réduire les nombreuses déformations des os causées par les effets masculinisant de la testostérone après la puberté chez les transsexuelles. Pour vous rendre compte de ce qu'il est maintenant possible de faire, vous pouvez découvrir les expériences et examiner les photos avant/après de personnes comme Andrea James, Becky Allison, Gina, Madeleine, Nicki, Sally et Rachel, qui ont toutes été des patientes du Dr Ousterhout. Vous pouvez aussi examiner Diane's page about FFS surgery with Dr. Ousterhout et la page chirurgicale sur le site www.beginninglife.com où vous découvrirez encore plus de témoignages et de liens au sujet de cette opération.
As increasing numbers of trans women underwent these surgeries during the early 2000's, the benefits of FFS became widely apparent - leading to a call for wider medical availability and support for these procedures, as by Andrea James in her open letter to HBIGDA of June 16, 2006:

"I urge HBIGDA and all helping professionals to place a greater emphasis on voice and face in the Standards of Care, and I especially urge you to consider advocating for the medical necessity of facial feminization procedures for those exposed to androgens during puberty. . ." - Andrea James Ces pages contiennent des informations générales, le journal de Lynn et certaines de ses photographies, dans l'espoir que ces informations seront utiles pour les personnes qui envisagent de recourir à ce traitement.


Informations générales (Fr) Remerciements (Fr) Trucs et astuces

Motivations de Lynn pour cette intervention (Fr) Le journal chirurgical de Lynn Informations sur l'hôpital de Davies

Décision et préparatifs (Fr) Résultats initiaux Cartes et moyens de transport

Note importante au de residence readaptation “Cocoon House” (Fr) Le journal de l'opération de lifting (FLS) Cocoon Guest House

Liens FFS Résultats globaux FFS/FLS Nourriture, Logement et services


Traitement par "Laser Skin Resurfacing surgery" (LSR)



INFORMATIONS GENERALES: Durant les années 80, le Dr Douglas Ousterhout comprit que les effets masculinisant de la testostérone chez les transsexuelles (MtF) peuvent être tout aussi défigurant et handicapant socialement que les effets de défiguration chez les victimes d'accidents et chez les enfants qui sont victimes de déformations génétiques du visage. Disposant d'une très large expérience en matière de chirurgie plastique et reconstructive maxillo-faciale et cranio-faciale, et doté d'une large palette de "trucs chirurgicaux" qu'il pouvait appliquer dans de tels cas, le Dr Ousterhout a commencé à pratiquer de nouvelles méthodes très agressives de reconstruction du visage des femmes transsexuelles. Nombre des techniques chirurgicales utilisées pour réaliser une opération de féminisation du visage sont décrite dans son livre "Aesthetic Contouring of the Craniofacial Skeleton", Douglas K. Ousterhout, Ed., 1991. Ces techniques vont bien au delà de celles utilisées dans le cadre des opérations de chirurgie esthétiques (comme on peut le voir dans les dessins et photos de ce livre qui illustrent l'élimination chirurgicale et la reconstruction d'une large part du front et de l'orbite occulaire afin d'éliminer une arcade sourcilière très masculine). Dans le cas des femmes transsexuelles, le Dr Ousterhout s'efforce d'ajuster les dimensions du visage à celles qui sont usuelles chez les femmes, sur la base de mesures anthropologiques. Les besoins de la survie au cours de l'évolution ont adapté le visage des hommes pour leur permettre de se protéger durant la chasse et les combats, ce qui leur donne des arcades sourcilières protubérantes et une mâchoire et un menton proéminents. D'un autre côté, le visage des femmes a évolué (tout comme celui des enfants) afin d'améliorer leur capacité à se cacher et à fuir et ayant une vision périphérique moins entravée (avec les yeux plus en avant dans la structure du visage, et sans arcade sourcilière). Ces différences en matière de caractères sexuels secondaires sont induites par des hormones sexuelles présentes en proportions différentes dans le corps des garçons et des filles après la puberté. Une masculinisation rapide des traits du visage débute durant la puberté et continue durant la vingtaine sous l'influence de la testostérone, qui provoque également l'apparition d'une pilosité abondante et le changement de timbre de la voix. La suppression des sources de testostérone (les testicules) interrompt ce processus comme on peut le voir sur les profils de deux Hijra dont la photo est publiée sur le site de Takeshi Ishikawa (depuis de nombreux siècles un grand nombre de personnes transsexuelles en Inde ont délibérément entrepris des opérations de castration et d'émasculation complète durant leur adolescence, comme rite d'entrée dans la caste des Hijras; Ils vivent ensuite en tant que femmes dans des "familles" Hijras). Les deux Hijras des photos de Takeshi n'ont pas d'arcade sourcilière proéminente, une petite maxillaire et un petit menton, la jointure entre leur front et leur nez est douce. En l'absence de testostérone, les traits de leur visage sont restés ceux qu'ils avaient durant l'enfance et ressemblent bien plus à ceux des autres jeunes femmes (quand bien même les Hijras n'ont d'habitude pas d'accès aux hormones féminines). Mais qu'est-ce qu'on peut faire pour aider des femmes transsexuelles qui, par la forces des circonstances ont dû grandir dans un corps masculin et ont dû endurer la masculinisation de leur visage? Une féminisation par voie chirurgicale peut être entreprise. Elle redessine le contour du front, elle réduit ou élimine l'arcade sourcilière, elle reconstruit le nez et la liaison avec le front, elle rend plus étroit et réduit la maxillaire et le menton (et le repositionne dans un autre angle), elle redessine la trachée en éliminant la "pomme d'Adam". Cependant, comme pour la chirurgie reconstructive des personnes victimes d'accidents et pour les enfants qui ont des difformités du visage ou un palais fendu, cette chirurgie est extrêmement agressive.


Madeleine - avant, pendant et après son opération de féminisation du visage par le Dr Douglas Ousterhout

La transformation est profonde, et Madeleine est maintenant une belle femme:

On n'entreprend pas une intervention chirurgicale aussi brutale pour des raisons "cosmétiques". La patiente doit être très motivée, prête à prendre le risque de souffrir sérieusement ainsi que celui de faire face à des complications. La période de récupération postopératoire est douloureuse et difficile à vivre. Nombre de traces de l'opération perdurent longtemps après: des os enflés qui peuvent prendre des mois avant de revenir à l'état normal, il peut y avoir un engourdissement au niveau du menton, qui lui aussi ne disparaît que lentement et des zones du scalp où toute sensation disparaît pour une année ou plus, voire en permanence.
Cependant, dans le cas de personnes transsexuelles pour qui l'arcade sourcilière et la maxillaire sont très protubérantes, l'opération effectuée par le Dr. Ousterhout peut faire la différence entre une vie décente et une mort sociale, c'est à dire entre une acceptation aisée de la personne en tant que femme ou être l'objet d'une stigmatisation massive pour son apparence. Dans de nombreux cas, cette opération remplace un visage qui a toutes les apparences d'un travesti, par des contours féminins et attirants.

Par exemple, considérez le cas de Sally, tel qu'on peut le voir dans les trois photos ci-dessous. La première photo, sur la gauche, la montre alors qu'elle avait encore l'apparence d'un garçon, et d'un beau garçon. La seconde la montre après deux années de traitement hormonal et d'épilation électrique. Nombre de femmes transsexuelles seraient déjà très heureuses d'avoir réussi une pareille transition. Par contraste, nombre de personnes peuvent penser que "maintenant, elle est vraiment bien".

Mais, bien que les traits de son visage soient assez féminins sur cette photo, vous remarquerez qu'elle a encore l'apparence d'un travesti. L'arcade sourcilière protubérante, le grand menton et la maxillaire très évasée qui en faisait un bel homme ruinent son visage en tant que femme. La troisième photo la montre après son opération de reconstruction du visage, par le Dr. Doug Ousterhout. Cette photo met en lumière ce qui ne va pas dans la deuxième et pourquoi elle n'était pas si jolie que ça. La transformation due à l'opération de féminisation du visage est à la fois subtile et profonde. Elle est maintenant une très belle femme, même sans maquillage. C'est un très beau résultat. Toutes les opérations ne seront pas aussi réussies. Cependant, elles permettent souvent de changer la vie, en ce qui concerne la capacité de passer et de l'image que les personnes ont d'elles-mêmes.

Photos de Sally:
Avant la transition; après deux années d'hormones et d'épilation; après l'opération de féminisation du visage par le Dr. Ousterhout


Mais que ce passe-t-il ici? Qu'est-ce qui a fait que son apparence a changé à ce point? On trouve la réponse en examinant ce même changement de PROFIL. Bien que nous ne nous regardions presque jamais de profil, c'est souvent dans cette orientation que les autres nous voient. Et c'est la structure de notre visage de profil qui détermine le plus l'apparence de notre visage et le genre qu'on attribue à notre visage, y compris de face. De ce fait, c'est notre profil qui le plus souvent nous donne l'apparence de travestis et nous empêche d'être belles. Les deux photos qui suivent montrent Sally de profil avant et après sa chirurgie d'opération du visage. Les changements sont vraiment ahurissants. Son profil était vraiment ingrat pour une femme, alors même qu'elle semblait "OK" de face. Après l'opération, son arcade sourcilière proéminente a disparu, et elle a été remplacée par un contour arrondi et féminin. Son nez a été resculpté de manière à se fondre dans le reste du visage. La hauteur et l'angle de son menton ont été radicalement modifiés. La largeur et l'évasement de son maxillaire ont aussi été fortement réduits.

Vues de profil de Sally avant et après la chirurgie du visage:



C'est dans ces vues de PROFIL que nous voyons clairement les changements dramatiques qui sont faits sur l'ossature du visage durant une opération de féminisation du visage. Ces changements dans la structure osseuse sous-jacente peuvent réparer l'essentiel des dégâts causés par la testostérone durant la puberté. Sally a enfin des traits du visage comme ils auraient dû être dès le début si elle avait pu vivre son adolescence en tant que jeune femme: sous l'influence des oestrogènes et sans testostérone (avec un niveau faible mais non nul de testostérone (cf. "sexing the body", Ann Fausto-sterling, Basic Books, 2000) ndt). Le résultat final est superbe et a vraiment changé sa vie, comme on le voit dans les photos ci-dessous. Ces résultats montrent aussi combien il est important d'aider les transsexuelles dans leur adolescence, de manière à ce qu'elles puissent éviter de développer des traits physiques masculins qui nécessitent après des opérations douloureuses pour les corriger.


Sally – maintenant une belle femme



De nombreuses manières, l'arrivée de la chirurgie de féminisation du visage a eu un profond impact sur la vie des femmes transsexuelles, sur leurs chances de trouver le bonheur, dans la même dynamique que celle créée par l'invention des opérations de réattribution de sexe. Les femmes qui peuvent ainsi corriger la masculinisation de leur visage vivent quelque chose de bien plus important qu'un simple exercice de vanité qui résulterait d'un "lifting" conventionnel. Cette opération, bien qu'extrêmement agressive concerne la guérison de leur souffrance, leur capacité de s'accepter elles-mêmes et, en fin de compte leur aisance à trouver leur place dans la société. Pour un aperçu de ce processus, consultez le texte de Rebecca Kastl intitulé "To Pass or Not to Pass". Vous pouvez aussi écouter ce qu'en dit mon amie Emily Hobbie: "Quand je sortais avant cette opération, quoi que je fasse, quelque soit la joie que j'exprimais, j'étais perçue bizarrement par certains. Je ne parle pas de 'passer' là. Je parle de comment, en tant qu'être humain les gens me voyaient. Je veux très clairement que les gens me voient *moi* sans qu'ils puissent douter de qui je suis. Aussi optimiste et entraînante que je sois avant l'opération du Dr Ousterhout, les lignes et les courbes de mon visage qui n'avaient rien à y faire érodaient ma confiance, étaient aussi déplacés qu'une boucle de cheveux qui se tenait en l'air et que rien n'arrive à ramener sur la tête. Je suis sûre que si la procédure du Dr. Ousterhout n'existait pas, j'aurais fait au mieux, mais je crains que quelque soit la joie que j'aie amené dans ma vie, la différence entre qui je suis et ce que mon visage disait que j'étais m'aurait consumée. Qui sait. Le résultat de cette opération ne me permet pas simplement de me déplacer dans le monde et dans la société – ce que j'aurais pu espérer de mieux avant – mais il me permet de l'embrasser, de trouver la paix en moi, ou la possibilité d'y arriver, et les autres le voient et le sentent. C'est un cycle de résonance très précieux en ce sens que mon plus grand confort et ma plus grande relaxation se sentent et que les autres peuvent à leur tour me la refléter." La réputation du travail du Dr Ousterhout avec les femmes transsexuelles a grandi rapidement depuis le milieu des années 90, quand a été connu le résultat de ces remarquables transformations par ces dernières et par leurs counsellors. L'information s'est répandue encore plus vite à partir du moment où des photos "avant – après" sont apparues sur des sites de personnes transsexuelles, en même temps que des informations sur la manière de se préparer à faire face à cette intervention radicale. Andrea James a été la première femme transsexuelle à publier de telles photos sur son site. Ces dernières ont permis à Nicky, Sally, Lynn et de nombreuses autres femmes de visualiser le principe de cette opération, ce qui les a amenées à décider d'entreprendre cette intervention pour elles-mêmes. En mai 2001, le Dr Ousterhout avait entrepris cette reconstruction majeure du visage sur environ 525 – 550 patientes transsexuelles. De nombreuses personnes en transition MtF entreprennent maintenant cette intervention juste avant de commencer leur "expérience de la vrai vie". Cette intervention peut grandement augmenter leurs chances de succès durant cette dernière, car elles paraissent encore plus féminines qu'avant. Par exemple, Andrea, Gina, Madeleine, Nicki, Sally and Rachel étaient toutes dans ce cas. Une meilleure acceptation des personnes durant leur "expérience de la vraie vie" leur permet maintenant de faire leur transition sans changer de place de travail, ce qui les aide aussi à conserver leurs revenus au moment où elles se préparent à leur opération de réattribution de sexe. Bien qu'une intervention de féminisation du visage soit coûteuse, le fait d'éviter de perdre son revenu peut largement compenser cette charge. De plus, nous savons maintenant que ces coûts peuvent être déduits des impôts (aux USA, ndt) car ils sont maintenant considérés comme faisant partie de l'ensemble de l'intervention de réattribution de sexe et non comme une intervention cosmétique. Les bureaux du Dr Ousterhout se trouvent sur le campus de Davies du California-Pacific Medical Center. Son adresse est la suivante: Douglas Ousterhout, M.D., D.D.S., 45 Castro Street, Suite 150, San Francisco, CA 94114; telephone: (415) 626-2888; e-mail link. Si vous souhaitez fixer un rendez-vous avec le Dr Ousterhout, téléphonez à son bureau et demandez à parler à son assistante Mira Coluccio. Pour plus d'informations sur le Dr Ousterhout et sur ses méthodes chirurgicales, veuillez consulter la référence suivante: http://www.drdouglasousterhout.com/


POURQUOI LYNN A ENTREPRIS CETTE OPERATION:

Lynn est une femme de plus de 55 ans qui a entrepris son intervention de réattribution de sexe en 1968. Elle a eu la chance d'avoir toujours bien passé en tant que femme. Et elle a eu une superbe carrière. Cependant, elle n'a jamais oublié les effets terrifiants de masculinisation de son visage qui se sont produits à la fin de son adolescence, alors même qu'ils étaient bien moindres dans son cas que ceux que subissent nombre de transsexuelles. L'opération moderne de féminisation du visage lui a permis de remonter le temps et d'effacer l'essentiel des conséquences de cette horrible expérience. Elle a donc entrepris cette intervention pour pouvoir vivre encore mieux et pour un plus de confort et de bonheur alors qu'elle prend de l'âge. L'intervention de féminisation du visage de Lynn comprend un avancement de la naissance des cheveux, un changement de la forme du front, l'élimination de l'arcade sourcilière, un changement de position des sourcils, une reconstruction du nez, une reconstruction du menton et de la maxillaire et une réduction de la trachée, le tout en une seule intervention universellement connue sous le nom de "les travaux" parmi les patients du Dr Ousterhout. Les résultats sont à la fois subtils et effarants. Lynn "ressemble toujours à Lynn", en particulier de face. Mais il y a tout une transformation, en particulier quand on la voit de profil. Lynn ressemble maintenant beaucoup plus à ce qu'aurait été sa s?ur jumelle si elle en avait eu une. Lynn espère que les informations et les expériences décrites ici pourront aider celles qui désirent entreprendre cette intervention. Si c'est votre cas et que vous avez d'autres questions, vous pouvez contacter Lynn par courriel à son adresse ou depuis sa page d'accueil. Elle espère également maintenir cette page aussi à jour que possible. Si vous souhaitez lui faire un feedback, apporter des corrections ou des suggestions, s'il vous plaît, contactez là. Pour plus d'informations au sujet de Lynn, y compris nombre de photos plus anciennes, consultez sa page d'accueil à: http://www.lynnconway.com, Ce dernier inclut des articles des médias au sujet de sa vie et de sa carrière à: http://ai.eecs.umich.edu/people/conway/Media/Media.html
Il contient aussi une rétrospective personnelle détaillée à: http://ai.eecs.umich.edu/people/conway/RetrospectiveT.html


DECISION ET PREPARATIFS:

J'ai toujours aimé la nature et, avec les années, j'ai fait beaucoup de randonnées, d'alpinisme, de course, de canoë, de motocross, etc. Toutes ces années à l'extérieur, combinées avec l'âge ont gravé quelques rides sur mon visage et sur mon cou. Au début de l'année 1999, j'ai commencé à m'informer des possibilités de réparation de mon visage et des méthodes qui me permettraient de rajeunir mon apparence. J'ai aussi cherché des informations concernant les opérations du visage dans les sites web d'autres transsexuelles et je suis tombée sur les photos stupéfiantes du site d'Andrea. En examinant les photos avant/après d'Andrea et de quelques autres, en particulier de profil, j'ai commencé à comprendre combien les caractéristiques de l'arcade sourcilière, de la maxillaire et du menton affectent le genre attribué à une personne, et en particulier aux femmes transsexuelles. En un instant, j'ai compris l'idée d'une chirurgie de féminisation du visage et combien la nouvelle procédure du Dr Ousterhot était performante. Lors d'un voyage en Californie, en juin 1999, j'ai rendu visite au Dr Ousterhout pour une consultation et pour savoir ce qu'il pourrait faire pour moi. J'avais suivi les instructions de Mira et j'avais fait faire des photos aux rayons X de mon visage la veille, dans un laboratoire de San Francisco. Le Dr Ousterhot les a alors examinées en même temps que mon visage, en même temps que nous discutions des possibilités. J'ai écouté attentivement ses recommandations initiales, pendant lesquelles il fait une esquisse sur les photos aux rayons X pour me montrer ce qui pouvait être fait avec mon front, mon nez, mon arcade sourcilière et mon maxillaire. Quand j'ai compris à quel point il pouvait les améliorer, j'ai commencé à envisager sérieusement d'entreprendre cette intervention. Après être rentrée à la maison, j'ai contacté plusieurs patientes par e-mail pour connaître leur expérience et les résultats de leurs interventions. Au milieu du mois de juillet, j'étais décidée à entreprendre cette intervention. J'avais de toute manière besoin d'un lifting et il était maintenant tout à fait clair pour moi que ce serait une immense erreur de le faire sans procéder à une reconstruction de ma structure osseuse en premier. Sans cela, les bénéfices de l'intervention seraient annulés si je devais pratiquer l'intervention de féminisation du visage plus tard. Avec les années, j'ai subi de nombreuses interventions et il était clair après avoir lu les témoignages des autres patientes que cette opération serait une vraie épreuve comparée aux autres expériences. Elle allait être clairement plus difficile qu'une intervention typique de réattribution de sexe. Mais j'avais aussi appris que tant que vous êtes prêtes à faire face à la douleur et au traumatisme, et pas démolie intérieurement par eux, les mauvais souvenirs s'effacent rapidement. Dans ce cas, les bénéfices dépassent largement le prix à payer. Je suis retournée chez le Dr Ousterhot en août 1999 pour une consultation détaillée. Nous avons décidé de faire l'ensemble du "travail", c'est à dire l'ensemble des interventions en une seule opération. Il l'a planifiée pour le 10 novembre de la même année. J'ai payé mon dépôt, ce qui confirmait ma décision. Entre août et octobre, j'ai eu la chance de rencontrer Sally et Nicki, deux femmes qui avaient déjà bénéficié de la même opération avec le Dr Ousterhot. J'étais stupéfaite de la différence que cette intervention avait produite et j'ai appris beaucoup de choses d'elles au sujet de l'intervention et de la récupération. Cela incluait nombre de trucs pratiques au sujet des préparatifs, ce qu'il fallait prendre, les problèmes logistiques, les questions pratiques concernant l'hôpital et le voisinage et de nombreuses informations au sujet de ce qui se passe durant la phase postopératoire. Par exemple, sur la base des informations que j'avais collectées sur le web et de mes entretiens avec Sally et Nicky et d'autres patientes, j'ai commencé à me préoccuper de la claustrophobie due au fait que je devais porter un bandage sur mon visage pendant cinq jours à cause de mon nez. Je me suis rassurée en m'entraînant un peu à l'avance: j'ai mangé un repas et dormi pendant une nuit en portant des clips qui bouchent le nez pour la nage. Manger et boire furent difficiles, c'était aussi difficile d'avaler et mes oreilles bourdonnaient tout le temps. Mais je m'y suis progressivement habituée, même si c'est resté problématique. J'ai commencé à sentir que les bandages ne seraient pas insupportables. Au moment où je préparais mes bagages, pensé à ce qu'il fallait prendre et planifié tous les aspects pratiques du voyage et de la récupération, je consultais intensivement les sites d'autres patientes. Il y avait de nombreuses petites questions dont je ne connaissais pas la réponse et d'autres dont je ne savais pas qu'elles devaient être posées. J'ai donc décidé de faire un journal et de prendre des notes à partager avec les autres. [Note: certaines des photos ci-dessous sont assez spectaculaires. Je les ai inclues de manière à ce que des patients potentiels puissent bien voir à quoi ils vont ressembler peu après l'opération. J'espère que cela va réduire le choc initial du premier regard dans le miroir]

NOTE IMPORTANTE AU SUJET DE LA RESIDENCE DE READAPTATION "COCOON HOUSE":

Quand j'ai entrepris mon opération et que je suis sortie de l'unité de soins intensifs de l'hôpital de Davies deux jours plus tard, j'avais plusieurs options pour la suite de mon séjour et ma récupération. Il y avait des motels dans les environs (cf. ci-dessous) et aussi les "chambres d'hôtes" de l'hôpital de Davies. Il s'agissait de chambres d'hôpital sur un étage, qui n'étaient plus utilisées. Pour $60 par jour, vous pouvez séjourner ici et obtenir trois repas par jour préparés par l'hôpital.
Les chambres d'hôtes étaient pratiques et proches du cabinet du Dr Ousterhot. Il y avait cependant des inconvénients – certaines patientes s'y sentaient très seules. D'autre part, la nourriture hospitalière n'était pas du goût de tout le monde. En décembre 2000, les chambres d'hôte ont été récupérées par l'hôpital et les collaborateurs du Dr Ousterhot ont trouvé une solution pour la récupération et le séjour des personnes opérées. Cette solution est mise en ?uvre par deux infirmières de l'hôpital de Davies. Voici le courriel envoyé par Marie-Lou, l'une des tenancières de la "Cocoon House", pour annoncer sa création:

"Lynn, je me présente (Mary-Lou) ainsi que ma partenaire Tricia. Nous sommes des infirmières qui travaillons dans le bloc opératoire de l'hôpital de Davies. Après avoir appris la fermeture des chambres d'hôte, nous avons décidé de transformer nos deux unités en lieu d'accueil pour les patientes du Dr Ousterhot. Notre but à toutes les deux est de mettre à disposition un environnement non fumeur, confortable, sûr et accueillant. Nous ne fournissons pas de soin infirmier! Mais nous sommes des infirmières qui se soucient de leurs patients! (*) Nous fournissons des repas qui conviennent à des patients qui récupèrent d'une opération de féminisation du visage, c'est à dire des jus, de l'eau, des gélatines, des puddings, des coupes de fruits, des soupes, des popcicles. Chaque chambre est équipée avec une télévision, une vidéo, une stéréo et un lecteur CD, un téléphone (pour des appels locaux uniquement), un réchaud à gaz, un frigo, un four microonde, une machine à café, un sèche-cheveux et un coffre fort pour les objets importants. Nous avons une belle cour avec des citronniers! Notre maison d'hôtes est éloignée d'environ 1 mile de l'hôpital, le système de transports publics est pratique (coût $1.00). Le voisinage (Noe Valley) contient de nombreuses communautés et il est culturellement varié. Contrairement à l'essentiel de la zone de San Francisco, notre environnement est plat! Des restaurants, des épiceries et la plupart des facilités sont très proches de notre résidence. Meilleures salutations, Mary-Lou"

((*) jeu de mots intraduisible: "We do not provide any nursing care!!! We are nurses who care!!!")

Pour environ $125 par jour, la nouvelle "Cocoon House" est une superbe résidence, les repas et la disponibilité du personnel est très précieuse durant la phase de récupération. C'est une très bonne solution. Contactez Mira dans les bureaux du Dr Ousterhot pour plus d'informations et pour réserver une place pour votre séjour.

Dans le journal ci-dessous, je décris mon expérience, qui inclut un séjour dans l'ancienne maison d'hôtes de l'hôpital de Davies. Ceux qui entreprendront cette même opération à l'avenir ne devraient pas oublier que le séjour à la Cocoon House (ou dans un motel) sera différent. Pour plus d'informations à ce sujet, veuillez consulter le site web de Cocoon House.

LINKS TO FURTHER FFS INFORMATION:

Since this page was first posted in 2000, ever-increasing numbers of trans women have been undergoing FFS in order to more smoothly and successfully complete their gender transitions. As a result, a number of prominent plastic surgeons around the world have begun doing the type of facial surgery pioneered by Douglas Ousterhout, and are becoming experienced in these surgeries. More and more women are posting their stories and photos of FFS results as each year goes by, thus helping other transitioners better understand the cost/risk/reward tradeoffs involved in undergoing these surgeries. All this activity has led to ever-more information about FFS being posted on the internet. The following links will help you begin to explore all that information:

Andrea James' FFS information page, with links to many FFS information resources.

Beginning Life FFS page, with many links to patients' stories and photos and to prominent FFS surgeons' websites.

Diane's page about her FFS surgery with Dr. Ousterhout.

European TS information site: This site provides information on FFS (and SRS) surgeons in many countries (and in many languages).

Facial Feminization Information.

Yahoo FFS Support Group.

Vicki Estrada's photo-diary video about her Facial Feminization Surgery with Dr. Spiegel in Boston NEW

Victoria Escher's page about her FFS with Dr. Ousterhout (including before/after photos) NEW
Prominent FFS surgeons' websites:

Douglas Ousterhout, M.D., San Francisco, CA

Jeffrey Spiegel, M.D., Boston, MA (link to FFS page, also see many photos at this link)

Mark L. Zukowski, M.D., Chicago, IL

Frans Noorman van der Dussen, M.D., Antwerp, Belgium

Suporn Watanyusakul, M.D., Chonburi, Thailand

Bart van de Ven, M.D., Ghent, Belgium (procedures, before/after photos,) NEW

Marcelo Di Maggio, M.D., Buenos Aires, Argentina (more, more, more, more, more, more) NEW
REMERCIEMENTS:

Tous mes remerciements au Dr Douglas Ousterhout pour sa compréhension et son souci quant aux conséquences de la défiguration du visage des femmes transsexuelles, pour appliquer ses capacités d'innovation et de création à la résolution de ce problème et pour faire bénéficier son habileté chirurgicale sans pareil à la féminisation des visages de tant et tant de femmes transsexuelles.
Merci à sa gestionnaire et assistante, Mira Coluccio, qui entre en relation étroite avec toutes les patientes pour les aider à se préparer et qui les aide à faire face aux difficultés de la récupération, et qui se charge de faire en sorte que l'entreprise chirurgicale du Dr Ousterhout fonctionne sans heurt. J'aimerais également remercier Andre James, Sally, Nicki, Jessica et Carolyn pour toute l'aide qu'elles m'ont donnée personnellement et alors que je préparais ce site web.


Douglas Ousterhout, M.D., D.D.S. L'assistante de Doug, Mira Coluccio

Note: ici se termine la traduction partielle de cette page. Elle inclut une description de l'opération de féminisation du visage. Le reste de la page (l'agenda et les informations au sujet de l'hôpital et des facilités de logement) est, pour l'instant, uniquement en anglais.

DIARY OF MY FFS SURGERY AND RECOVERY:

11-8-99: I flew to San Francisco one day early to avoid any possible problems with flight delays. Stayed one night in the Metro Hotel (see locator maps) near Davies Hospital. It was beautiful weather today. I enjoyed a nice walk and scouted all the neighborhoods around the hospital to locate the Safeway grocery store and drug stores store, the Muni light-rail-transit stops, and various other services and restaurants, as useful info for my boyfriend Charlie when he arrives.Went downtown and had dinner with my friend Rom and her partner.


11-9-99: Went to Davies Admitting shortly after noon, and checked into my hospital "Guest Room" where I'll stay tonite.Checked in with Dr. O's office at 3:00 pm for final surgical planning, taking of the "before photos", some lab work, paying of fees, etc. Filled some last minute prescriptions at a nearby pharmacy on the way to dinner. Then walked over to have dinner at Chow with Dr. O's recent patient Carolyn, who had just had the same surgery a month ago. Got some good tips and hints from her. Called Charlie. Went to bed early.


11-10-99. Surgery Day: Went down to Admitting at 6 am. Signed in and then am wheeled downstairs to prep for surgery. I'm calm, rested and ready; I guess all those work-outs at the Y are paying off. My last physical checkup showed BP of 110/60 and pulse of 72. Now a lot begins to happen. It's all very smoothly efficient, and everything is kind of a blur from here on. The IV line goes in. I remember being rolled into the operating room, and talking with Dr. O for a little while. Then, the lights go out.

The next photo shows me after just awakening the evening in the ACU after 10 hours on the operating table today. I have a full face bandage on, and drain tubes are being used to drain blood and ooze from down within the jaw/chin wound. I'm alert and don't feel too badly. Of course I realize that this is just a temporary respite before my body starts reacting to what has happened to it!




11-11-99: Here I am in the ACU the day after the surgery. Dr. O has removed the full face bandages. My body has begun to notice that something extraordinary has happened, and is reacting accordingly. My face is very swollen now, and I've slowed down and am settling into grinding my way through the next week or so.



This next photo is late in the afternoon of of the 11th. My Charlie flew into SF midday, and arrived just after my full-face bandages had been removed. I was a bit groggy here, but was I ever so glad to see him and hug him. My face is now very swollen, but I'm very aware that there are no major problems so far. I'm not vomiting, my voice sort-of works, my throat isn't sore, I can see straight and I don't feel particularly weak. Wow, I think I got lucky - - .



Evening of the 11th. Here I am with my morphine pump handy. It's keeping me pretty happy. Luckily I have a hearty appetite, and the pureed food tastes great right now. I'm feeling awake and am not in much pain now. However, I'm not totally in contact with reality either.

The facial swelling continues to increase, puffing my cheeks way out. My hair is a soggy, bloody matted-down mess. Hmm, the next few days are going to be interesting. Let's get some food down while the getting's good.



I learned right away that eating was going to be a chore, because of the nose-packing interfering with swallowing and also the very limited amount that I could open my mouth.

Then, sometime this afternoon my IV must have backed out of its vein, because my arm started hurting. I looked at it and saw that the forearm was all puffed up from fluid being pumped into it. I realized what was wrong right away and called a nurse, and she replaced the IV into my other forearm. No harm done, but I've learned from many past surgeries that it's a good idea to stay alert for such things, and to buzz for help right away.

I'm also learning lots of wierd things, such as how wonderful the "suction tube" is. Like the thing at the dentist's office that sucks spit from your mouth. The problem now is huge gooey blood clots and ooze up in behind my nose and up into my sinuses. What makes it worse is every time you swallow anything with the nose packing in place, some of that wants to go up in there too! All that aggravates the psychological impact of the darn nose packing.

At first I tried to snucker that stuff down into the back of my mouth. It was tough to do, because it was so slimy and stuck up there. Then I accidently discovered what happened if I stuck the suction tube back in there and caught the end of some stuff with it. Wow, it would instantly pull a whole octopus-like gorpy bunch of it out of there. What relief! Way cool! By the time I left the ACU on the 12th, I'd half-filled a quart reservoir with "stuff".

Charlie stayed over at the Metro Hotel on Divisadero tonight, the 11th. It's just a few blocks away and an easy walk to Davies. Tomorrow when I move from the ACU into my Guest Room, Charlie will move in with me too.

The Guest Rooms are on the third floor of Davies, and although without nursing care they are provided with hospital food services, and are a short elevator ride and walk from Dr. O's offices. These rooms provide comfortable, convenient, inexpensive accomodations once ACU nursing care isn't needed.

[Note: Patients (and partners) would now move to Cocoon House, the new post-FFS recovery facility that has replaced the Guest Rooms]

11-12/13-99: Moved from the ACU into my Guest Room midday on the 12th. It was great to unpack a bit and get more of my things within arms reach. What's especially wonderful is that Charlie can now stay with me all night, sleeping in the second bed in this room. I encouraged him to play tourist in SF for 6 to 8 hours each day, so he'd have some fun too. But having him return each afternoon or evening and spend the night was wonderful.

Any patient's spouse, S.O., or friend could do the same - - you can get two keys, and the keyrings are passes through the Davies Emergency Room area at any time, day or night.

I also met JoAnne, another of Dr. O's patients today. She's in a guest room just a couple of doors away. We were now able to keep each other company for a while each day.

The next photo shows Charlie and me in our Guest Room. The flowers behind my head were sent by my friend Nicki. On the shelf to the left of Charlie you'll see two "good luck" photos that I brought with me. One is of Charlie holding one of our cats. The other is one of my friend Sally bravely showing two "thumbs up" while in her full-face bandage during her surgery here.




11-14-99: The very worst seems to be over now, and I've settled into the grind of day-to-day coping with heavy dull pain. Also, my nights have been pretty fitfull and I haven't been able to sleep but for a couple of hours at a time. The bruising on the upper face doesn't look too bad now, and the swelling now is mainly a problem in the jaw, chin and trach areas. I've taken on the "chipmunk" look as my friend Sally calls it. My swollen cheeks make me look like I'm an expressionless chipmunk with a mouthful of stuff in her cheeks - - .

I've taken to walking around on the 3rd floor (the Guest Room floor). It's 150 yards around, and is a nice, quiet relaxing walk. You can circulate for a mile or so without seeing anyone else, since it's almost unoccupied except for other patients of Dr. O. You can tell how many are here by looking for food trays outside the rooms before/after meals.

I almost always left my door open, so I'd see people once in a while. One of the food servers, undoubtedly new, once brought my dinner into my room and said "I'm not sure what's going on on this floor. I bring food up here and leave it outside rooms, but never see anyone here". I said "This is the Twilight Zone" in a very solemn voice. That seemed to reassure him a lot.

It was also very, very comforting to have a number of close friends visiting me now. My friends Jorge and Susan visited me yesterday; I'll be staying with them one night before flying home on the 19th. Today Rom and her partner Luccia visited, as did my friend Terri Wanke. I've also received lots and lots of phone calls which, along with the visitors, have really cheered me up.

I've now begun to get into a very excited state, because as of today I can see how amazingly this surgery is going to affect my forehead and browridge. Along with the Vicodin pain pills, all this has made me extremely hyperactive when on the phone and with visitors. The nose packing and the associated breathing and drinking difficulties are a continual nuisance, but they didn't make me crazy or claustrophobic like I'd worried they'd do. I'd brought a few Valiums just in case, but didn't need to use them after all - - - .

Brief description of the overall operation: Dr. Ousterhout had made a large initial incision that accessed Lynn's forehead and brow area. This 19 inch incision ran vertically up from the top of each ear for about four inches, and then horizontally circled the forward part of Lynn's scalp (the photo below shows staples reinforcing stitches that hold together a part of this incision). Pulling this large flap of skin downwards exposed the forehead and browridge, part of which which Dr. Ousterhout then sawed out and worked on outside of Lynn's head.

Those forehead and browridge bones were sawed into sections, and then reassembled with Titanium wires into a flatter form. Dr. O then ground the surface to a smooth, convex form. After he reshaped and resized the forehead/browridge, he wired it back in place using Titanium wires and dissolving screws. For more details on this unique browridge procedure, see some details and photos from Dr. Ousterhout's textbook.

Dr. O then exploited the initial incision to advance Lynn's hairline: He removed a section of skin and then stretched the scalp aft of the incision forward to meet the original incision line. Most of the incision within the hair-covered areas was reinforced with staples after being stitched.



In addition, Dr. O had reshaped my nose, in particular the bone and cartilage of the nose ridge-line, so that it contoured nicely into the new brow and forehead contours. He then made some detailed refinements of the nose tip. In the process, he straightened out my nose, which had been badly broken years ago and was quite out-of-alignment left to right. In the photo above, the nose is shown protected with internal and external splints, internal packing and an external bandaging.

The jaw and chin area is covered by a bandage compressing the area where the jawbone has been sectioned both horizontally and vertically. During the "double-sliding genioplasty", pieces were taken out of the jawbone to reduce its height and width and to change the angle of the bone underneath the chin area. The reduced pieces were then put back together with Titanium plates, screws and wires. Before reattachment, the jawbone was then slid forward into a position that will yield a nice, small, properly-positioned female chin, and then wired into place.

The jaw and chin work is accomplished through a large incision all around the base of the gums on the inside of the mouth between the teeth and cheeks. This wound area will be quite painful for at least two weeks after surgery, and will remain very swollen for many more weeks after that. It's a nuisance to clean your teeth after meals, but they have to be kept very clean to avoid post-op infections. I'm sure glad I brought a child's tooth brush that could easily slip down into the wound area without stretching things too much. I think that Mira provides these toothbrushes to most patients now.

Finally, Dr. Ousterhout opened a small incision up under my chin, through which he removed sections of tracheal cartilage to eliminate my "adam's apple". Although mine was a modest one and hadn't been a problem before, we knew that it would be visibly quite obvious after my later face-lift surgery. The trachea reduction area is also bruised and swollen in the photo, but not too painful, yet. I didn't lose my voice during early recovery as some have reported, although I had to keep it rather low and soft to avoid pain from the tracheal wound area.

Even though my whole face is swollen, bruised and discolored in the above photo, those who know me can already visualize how much Dr. Ousterhout set my forehead back and recontoured it to remove my browridge. Notice the higher eyebrow position, and how much less my eyes appear to be set back into my face than in earlier photos of me.


Some comments on my surgical recovery so far: I was very lucky with this surgery: I didn't step on any of the land mines that some of the other patients have previously encountered (extended periods of vomiting, severe sore throat from the 10 hours of intubation with a breathing tube, anxiety reaction to the nose packing and mouth-opening restrictions, double vision for extended periods, high-fever reaction to the surgery, loss of voice for extended period, weight loss due to lack of appetite, extreme tiredness for many days, etc.). Thus my appearance and attitude returned towards normalcy fairly rapidly.

However, the FFS was a major shock to my system. It was a real grind to deal with the heavy dull pain from day to day. You should expect major difficulties in sleeping for the first few days, and you probably won't sleep all the night through for the first week to ten days. My bowel movements stopped for three days (effects of surgery and antibiotics). I'd worried about constipation, but on the fourth day post-op I had a large full movement without trouble (probably thanks to taking Metamucil in some water at my morning meals each day, and a couple of Ex-Lax's on the 3rd and 4th days).

The basic activities surrounding eating are made quite difficult due to the effects of the nose packing, the pain and swelling in your lower gums, and the very limited amount you can open your mouth ( I could just barely fit my thumb's smaller dimension between my upper and lower teeth).

For the first four or five days, you'll probably really need to take a Vicodin pill once every four to six hours. You'll know when you need to take one. After that, I reduced the dosage to a half-tablet every six hours and then tailed that dosage off as the days went by.

Anyone contemplating this serious surgery should prepare very thoroughly and get in good shape physically. By learning what to expect day to day from web sites and discussions with previous patients, one can take things to help cope with possible problems, and one can also avoid becoming unnecessarily frightened by and anxious about the ongoing wierd things that occur during recovery. Visitors and phone calls are good distractions from the daily grind while in the hospital.


11-15-99: Still spent a very fitfull night. Woke up in pain, and took a Vicodin. Then got some more sleep. Felt OK by breakfast. Sort of tired and dazed, but not too bad either. Stomach a bit upset by a too-full feeling, since still not eliminating quite enough to keep up with intake.

Finally washed my hair for the first time this morning. Did this by sitting and leaning back at the sink, using lots of towels, and care not to get any of the facial bandages wet. Took a long time even for a crude shampooing to get most of the blood and goop out, but I felt ever so much better afterwards.

Mira called and said to come to Dr. O's offices at 4pm for first bandage/stitch removals. Charlie came with me (and watched) as Mira removed the nose-packing, some of the inside nose stitches, some of the trachea stiches, and the jaw/chin bandage. Dr. O came by and he removed my forehead stiches. I'd worried about pain from some of these procedures, but all were done very quickly and with only minor, quite tolerable pain. I must say though that the packing removal procedure was scary, as length after length kept coming out. I kept wondering when it would end, and if there would be pain somewhere along the way - - . It turned out that the anticipation about these procedures, especially about the removal of the nose-packing removal, was worse than the reality.

I was feeling well enough by now that Charlie and I decided to get out of the hospital for a while. We walked from Davies down to the N-Line Muni light-rail stop just a block away from the hospital, and took the Muni downtown to the Powell Street Station. We explored the San Francisco Shopping Centre, which you can enter from that Muni subway station without going outside. It's a neat place to shop, and you can get there from Davies via the N-Line with little walking or exposure to the weather (or from Cocoon House via the J-Line).

We also walked around for a while in the Market Street and Union Square area, and browsed in some of the department stores there. I reminisced about the time 31-33 years ago during my transition when I drove up the Peninsula from Palo Alto each week to undergo long electrolysis sessions in an office just off Union Square.

We took the L-line Muni subway back towards Davies, and got off at Market and Church near the Safeway store. We bought a bunch of deli goodies at Safeway, and walked back to our room for a nice evening meal. I had to squash my sandwiches down flat so that I could fit them into the side of my mouth. But it was great to be able to eat with the darn nose-packing out!

Slept better that night. Went to bed at 10pm; woke once at 12:30 to go pee; then slept all the way thru to 6:30am the next morning. Ah that felt nice!


11-16-99:

Felt better after the good nite's rest. Charlie packed, and we talked a lot. He had to get back to Michigan and his work. Went down to the lobby at 10am. His "Super-Shuttle" arrived right on time at 10:30 to get him to the airport plenty early for his 12:50 flight. I was sad to see him go; he'd been wonderful through all this, and it had been quite an ordeal for him too - - .

I got a nice sandwich and some fruit at the corner mart near Davies. Also checked out the cafeteria down on "B" level of the hospital, and started bringing tasty items up from there too, helping to improve my appetite again, which had finally languished after 5 days on the hospital food.

The rest of that day I spent lots of time on the phone with friends - - and I called Charlie that eve when he got home - - our three kitties had been lonely for us, so he gave them hugs for me too - - .


11-17-99:

Awoke early. Started organizing my stuff a bit, since I'll be leaving tomorrow. About 9am, Dr. O called and asked if I could come down early today to have him remove my nose splints (a day early). I took a Vicodin and went down to his offices.

Dr. O first removed the remaining "X" nose bandages, and it was then time to remove the internal plastic "splints" from way back inside of each nostril. I was quite apprehensive, since I'd read that others had experienced great pain during this procedure. However, although it seemed like he was pulling large "bones" from deep inside my face out through my nose, it didn't hurt all that much. As with the packing, the anticipation was worse than the event. However, I was sure glad to get that over with - - - .

Dr. O then handed me a mirror, and I got my first look at my new face. Albeit with a lot of swelling and bruising still remaining, I was amazed at how much improvement was already visible. The new noseridge contoured very gracefully down from the new female browline to create a wonderful new impression. We chatted for a while, and he carefully went over various aftercare information: wash face with fingers (no washcloth) for a while, since the nose is numb and you want to put even pressure of each side while the cartilage is still soft; NO EYEGLASSES for six weeks, until the nose cartilage firms up; no activities that would raise blood pressure for another two weeks, after which I can resume normal exercising; no wearing of hats that would put pressure on the forehead bones for six weeks (bony softness must firm up first); etc. With all the bandages finally off, I was OK'ed to take a full shower that day (although the hospital showers are so strong that I was still very careful not to have it directly spray on my face and head).

That evening I got really cleaned up and dressed nicely for the first time since the operation. I put on a skirt and sweater instead of the khaki's I'd been living in the past week. By now, my normal make-up covered most of the bruising, and made me look and feel better too. My friends Dick and Peggy came to visit me, and we walked over to the Thai House, a few blocks away on Noe Street for a great Thai dinner and a wonderful evening of conversation. I was still very swollen and in some pain, but it was really nice to get out to dinner with my good friends.


11-18-99:

This morning I packed, and then went to Dr. O's offices to have Mira remove the staples from my scalp, and to have her take some initial "after" photos. We went over some planning and logistics for my next trip out for the face-lift on 2-24-00.

Left Davies at 11am; my friend Jorge picked me up; I'll stay with Jorge and his wife Susan down in San Carlos tonite, and they'll drive me to the airport tomorrow for my flight home.


11-19-99:

After a nice evening and meal and a good night's sleep at my friends' place, they drove me to the airport for my flight home. It was great to get back to Michigan, and see Charlie at the arrival gate at the airport. The trip was tiring, and I was so glad to get home, see our kitties again, and to be able to sleep in our own bed there. Before going to bed I weighed myself. Amazingly, I still weighed 155#, which was my set-point prior to deliberately gaining 5# during the two weeks before surgery. I'd thought that I might lose more weight as, others have reported. But that didn't happen. Now I need to work a bit to take my set-point down to 150# , where I've wanted it to be before (and long-term after) the face-lift surgery in February.


11-24-99 (2 weeks post-op)

My first week home I took it very easy. I was still very swollen in the jaw/chin area, and in some pain. I also tired very easily. So it was a time to just relax, eat well, and get a lot of sleep.


12-1-99 (3 weeks post-op)

Although the swelling hadn't really gone down much, I felt much better this week. By late in the week I resumed light work activity, and also resumed moderate workouts at our local Y every few days.


12-8-99 (4-weeks post-op)

Although everything was healing well, and I was set to return to normal activities, I hit a problem this week. On Dec. 6th a small lump appeared at the lower right corner of my chin. By the 7th it was quite swollen. I called Mira, and Dr. O prescribed CIPRO.

This localized infection wasn't under control by the10th, and my face looked a little wierd due to the swollen lump under the right side of my chin. On the 11th Doug prescribed Augmentin, a different antibiotic. About 48 hours later the infection eased and the swelling began to go down. Then late that day, it came right back again! Doug reassured me that at the worst the local infection might need to be drained to help the antibiotics work, and that this minor procedure could be done in Ann Arbor, by a plastic surgeon at UM Hospital who is a friend and colleague of his.

The swelling, pain and appearance effects messed up this week for me. I mostly hunkered-down and stayed at home. So, do not count on being "fully effective" even this long after such major surgery. Minor complications can happen. Don't get your activities too tightly scheduled. Be prepared to deal with contingencies.


12-15-99 (5-weeks post-op)

During the next week I continued on the Augmentin. Late this week the swelling eased. Dr. O prescribed some more Augmentin for me to take for another week, to be completely sure of clearing the infection.


12-22-99 (6-weeks post-op)

All signs of infection went away this week. I went off the Augmentin mid-week and finally began to resume all normal activities. The bony swelling in the jaw and chin is now down quite a bit, although it is irregular and lumpy in places. Almost all the bony pain is gone now. My chin was still quite numb, but my lower lip was more sensitive again so that I didn't "drool" as much when I eat. I still couldn't open my mouth very wide (only 20mm), so eating still involved cutting things into small pieces and inserting things into the side of my mouth.

My appearance when made up, happy and smiling was very nicely feminine now. Even given the limitations due to healing and recovery, and how funny and sore my face felt to me, many people at gatherings felt compelled to comment on "how well I look!" Folks clearly noticed nice changes, but weren't able to interpret them and figure out what happened. They're thinking maybe I've lost weight since they saw me last? Or perhaps I've been doing a lot of exercising? I also caught glimpses of acquaintances staring at me in profile in a state of slight confusion. They were probably trying to figure out why their recollections were so far off-base. It was fun to experience these reactions, which helped to keep the smile on too!

12-29-99 (7 weeks post-op)

The jaw and chin swelling dropped off rapidly this week. There were still a few random bumps of swelling left, but I'm finally seeing what the jaw and chin will eventually look like. It's wonderful! I couldn't be more pleased. The reduction is far more than I'd originally thought could be done, and the appearance of the chin is really very cute. Also, the banding and swelling from the tracheal wound went down a lot, and I could now also see how much Doug reduced my tracheal "bump". It's gone completely, and there will be nothing but a nice smooth neck contour showing once the face-lift is done. Wow, I ever so thrilled with the results now! I should post some photo updates sometime soon - - .

1-10-00 (2 months post-op)

Back to near normalcy now. There is still some lingering jaw swelling and numbness in my chin and left cheek, and some "banding" in my neck tissues where the trach incision was made. The swelling is down enough now to get me worrying again about needing the face-lift.

2-10-00 (3 months post-op)

Almost time to go back to Davies for the face lift on Feb. 24th. And it's a good thing: As the FFS swelling went down further, the need for a face-lift became ever more obvious. A lot of new wrinkles and sags are showing now, unless I keep a big smile on my face!

On the other hand, I'm finally able to open my mouth much wider ( 30mm ), and can thus eat things more normally, including eating sandwiches without flattening them first!



LYNN'S INITIAL FFS SURGICAL RESULTS:

This section provides some photos of and comments on the results of my FFS surgery as the results become increasingly evident during longer-term recovery.

First we'll see some initial "after photos" taken of me on Nov. 26th, when just 2-weeks and 2-days post-op. It's amazing how fast I'd been healing just the prior few days. I'm still quite weakened at this point, and have to take it easy. But, almost all bruising and discoloration have disappeared over the last couple of days. What's left can be easily covered by regular make-up.

Of course, there is still very heavy, hard swelling underneath the jaw and chin, which shows up as large lumps in the following photos. There is still quite a bit of numbness in the lower lip, lower jaw and chin, and also in the forehead and brow area. As the numbness gradually recedes it is replaced by dull heavy pain and a wierd tinglyness as the nerves begin to recover their functions. As of this point, I can't yet control my lower lip movements or my chin's facial muscles, making the effects of the swelling much more noticeable in person than in photos.

However, I am thrilled at the results we're seeing, even now at this very early stage with LOTS of swelling and pain remaining (mainly in the jaw/chin area). My friends will immediately see the huge difference in my appearance in profile. I've never ever shown photos of me before in profile, or even front-on photos without my hair down over my forehead. The elimination of my old browridge, recontouring of forehead and nose-ridge, and reduction in size and narrowing of the chin changes all that.

I can't wait to see how it's all going to look when the jaw and chin swelling goes down completely. Dr. Ousterhout really performs miracles with his FFS surgeries. Time will tell, but I think he's done it again - - for me.

Nov. 26, 1999: Lynn at 16 days post-FFS (still with LOTS of jaw/chin swelling)


Also, I noticed a very interesting side-effect of the noseridge and browridge reduction: My peripheral vision has been greatly extended up, to the sides, and (in binocular vision) across the nose, because those bony areas are no longer blocking so much of the view. It's like shifting from an older car into a newer one that has a much wider, higher windshield.

As an update, here are some snapshots, including one of Charlie and me at Christmas dinner while visiting with my brother and his wife in Wisconsin, and another taken in San Francisco in February. Even though these photos are limited in resolution, my new facial contours are quite noticeable in the semi-profile views taken at 6-1/2 weeks post-op and 3-1/2 months postop:

Charlie and Lynn, December 25, 1999
February 22, 2000

Of course, there's still some more to do to complete my FFS project. It takes several months for the bony swelling to shrink back to where it's not noticeable. With that shrinkage, all the bone removal means that I must get a face lift, because at my age my skin will not shrink back all the way as the swelling goes away. You can see the loose skin down in the front of my neck and around my eyes in the detailed 2 weeks + 2 days "after photos" above. For a while, in late January and February of '00, I'll actually look lots older because of all that loosened skin. However, that problem will be solved by Dr. Ousterhout on Feb. 24, 2000, when he works on me for another 6 hours on the operating table to do my face-lift and some skin-tightening around my eyes.



LYNN'S FACE-LIFT SURGERY (FLS) DIARY:

In many older patients, face-lift surgery may be necessary as a follow-up to FFS. Some patients may have already needed a face-lift prior to FFS, and/or their facial skin may not adequately shrink and tighten up after the FFS's reduction of facial skeletal dimensions. In such patients, a face-lift can produce dramatic overall results, making them not only look more feminine, but much younger too.

Dr. Ousterhout requires a wait of at least a 3 months after FFS before doing the face-lift surgery, in order to insure adequate reduction in bony swelling after FFS. During the final month or so of that wait, you will not look your best due to all the wrinkles and sags. By then you'll be highly motivated to get on with the face-lift!

On February 24, 2000, Lynn underwent face-lift surgery and blepheroplasty (upper and lower eyelid surgery) by Dr. Ousterhout at Davies Hospital in San Francisco. For a detailed diary regarding this surgery, including photos and tips and hints, see the following subpage:

LYNN'S FACE-LIFT SURGERY (FLS) DIARY

The physical impact of face-lift surgery was far less severe than was FFS. Readers can see the difference for themselves by comparing the photos of me during early recovery at that face-lift site, with those of me during early FFS recovery. The first four days or so after FFS were quite an ordeal. The photos taken during early FFS recovery show me in great pain, with an extremely swollen face, grimly hanging on and sweating-out the passage of time. In contrast, the photos at the Face Lift page show me bouncing back pretty quickly during early recovery. While there was pain, bruising and swelling after the face-lift surgery, it was quite tolerable and nothing in comparison with trauma of the initial FFS.

Here we go again! Lynn shortly after face-lift surgery, February 24, 2000

Five days after her face-lift surgery, Lynn is feeling just fine.

February 29, 2000

The face-lift and eye-lid surgery put the "frosting on the cake", and a few weeks later the amazing overall results of the FFS and FLS surgeries were finally revealed.



LYNN'S OVERALL FFS/FLS SURGICAL RESULTS:

Following are digital camera snapshots of my FFS/FLS results, taken March 29, 2000. My facial skin is still very tight, and there's still some minor bruising and some swelling remaining in my cheeks at 5 weeks postop from the face-lift surgery. Although I'm having a little trouble smiling and making facial expressions, the overall results of the surgeries are now becoming clear.

I'm very thrilled with these results, which not only make me look very female but also much younger than my actual age. The effect of FFS on feminizing my profile seems almost unbelieveable to me. Then the face lift removed the jowls in my cheeks and large wrinkles in my face, and also the "turkey neck" folds of skin under my chin. The blepheroplasty removed the large bags of skin over and under my eyes. I'll probably undergo laser resurfacing to reduce the finer facial wrinkles too, but that will wait for another year or so. Doug has worked his miracle for me, and it's truly wonderful!

March 29, 2000: Lynn at 4-1/2 months post-op from FFS, and 5 weeks postop from face-lift surgery
[Lynn's skin is very tight, and she's having trouble smiling, but the results look great already]


Following is a photo taken two months later, on May 29, 2000. My skin isn't so tight now, and I've been getting used to how my new face "works". I've been exercising my facial muscles a lot, and I can make more relaxed, natural smiles and a normal range of nice facial expressions again. Now the result looks really wonderful to me!


September 2000: Lynn after FFS and FLS (with no make-up on)


Note: Lynn enhanced the results of her earlier FFS and FLS surgeries by undergoing Laser Skin Resurfacing (LSR) surgery by Jeffrey Dover, M.D. in Chestnut Hill, MA (near Boston) in early 2002. This surgery was done to rejuvenate the final appearance of the facial skin by removing many fine wrinkles, age-spots and other sun accumulated damage (compare photo above with the one below). The results are subtle but powerful in "4-D", i.e., when seeing the skin close-up and in motion (as when speaking and making various expressions). When performed by a top laser surgeon such as Dr. Dover, LSR surgery can greatly improve skin tone, not just by removing defects but also by making the skin much softer, smoother, "plumper" and generally younger-looking. For additional information about laser skin resurfacing see:

LASER SKIN RESURFACING (LSR)


Lynn on her honeymoon in August 2002 - post FFS, FLS and LSR
click on photo for more detailed view

What did people notice?

It's was a lot of fun encountering friends and colleagues after FFS/FLS. While at several important functions at Univ. of Michigan, many folks who hadn't seen me for a while seemed strongly compelled to say something, usually something like "Gee Lynn, you look GREAT! What've you been doing? Lose some weight?". I'd usually reply "yep, been working out and lost some weight. I'm also really having fun and enjoying retirement too!"

But I noticed something else too. At cocktail parties and at gatherings at UM, I noticed out of the corner of my eye that someone is staring blankly at my profile. If I turned smoothly and looked up at them, I'd catch a puzzled look on their face. It didn't occur to them that someone can be physically "morphed" in this way, so they were probably wondering "why their memory is failing them so badly"! Such observations raise all sorts of interesting questions about appearance and identity, and the resulting effects on one's social role and the expectations of others.

This reminds me of the effects on others of the dramatic physical morphing that occurred during my hormonal and social transition years ago. Many acquaintances suddenly "caught onto the paradigm shift" at some point, and "perceived the new identity". But a few family members clung to their memories of the "old me" and could never quite "see the new person", even after so much morphing had occurred that I was unquestionably a woman to strangers and to new friends. The better someone knew you before transition, the longer it took for them to realize that the old you was dead and gone, and that your now-female body was inhabited by a newly visible spirit who had fully taken it over.

Seems like people look you over very closely when first getting to know you, in order to establish who/what you are. Later on they rely on those first impressions, taking them for granted and not easily noticing important changes. Fascinating stuff, eh!

In the end, what counts is the inner effect on oneself, and the potential of medical procedures such as FFS for enhancing healing, self-acceptance and inner comfort. Recall the words of Emily:

" - - - Results aside, it allows me to not simply move through the world and society -- the best I could hope for beforehand -- but to actively embrace it, to find a peace within myself, or the possibility for it, that others see and perceive. It is a wonderful resonant cycle as the relaxed comfort in my own skin radiates from me to others, who in turn sense my centeredness and reflect happiness back at me - - - . "

Doug Ousterhout and Lynn at the "Be-All" convention in Chicago, June 2004


VARIOUS TIPS AND HINTS:

My first recommendation for anyone considering this surgery is that you thoroughly check out the other FFS websites, especially Andrea's, Becky's, Madeleine's, Nicki's, Randi's and Sally's. Those sites contains lots of useful information, to which I'm adding some further tips and hints in this site.

Be sure to be psychologically prepared for what you are getting into:

It is very important to realize that FFS is not a typical cosmetic surgery procedure. The level of pain and trauma is going to be very high. While a few patients breeze through FFS with little difficulty, an equal number are highly traumatized by the experience. Also remember that nursing and hospital care in general "ain't what it used to be". Davies is an excellent facility, but to some extent you are "on your own" when recovering there as in most modern hospitals, and you need to be psychologically prepared for that and able to keep a positive outlook in spite of any difficulties during recovery.

For most patients FFS is a very gritty, tough ordeal. By being well prepared, you can help make the best of it, and reduce the psychological impact of pain and trauma during recovery. Knowing what to expect during recovery, and knowing in advance a lot about the hospital and the local neighborhood and services, will enable you to retain a feeling of control. You'll find ways to do many things for yourself, instead of having to go without or rely too much on others for help.

If possible, arrange in advance to have visitors, phone contacts, companionship:

Visitors and phone contacts with friends can really help to ease discomfort and pass the time during the initial recovery phase. I recommend if at all possible that you have a family member, friend or spouse stay with you, especially the first four/five difficult days of recovery.

There are usually several of Doug's patients recovering in Cocoon House at the same time, and by getting to know these patients you'll find additional companionship and mutual support during recovery.

I got to know one other patient while I was recovering from FFS at Davies in Nov 99, and met three more while there for my face-lift in Feb/Mar '00. My friend Anneliese met four other patients while she was there: two from the U.K., one from Italy, and one from Illinois. Anneliese benefited from their help when her luggage was misplaced over a weekend following her surgery, and she needed to borrow pain meds and other basic items.

Some helpful drugstore items:

Be sure to take one essential item: A child's toothbrush for cleaning down in the painful, swollen gap between your lower teeth and cheeks. You'll have to clean food particles out of there to avoid infections, and also to avoid painful irritations. Another very helpful item: one of the new mild, soothing lip balms such as Vaseline "Lip Therapy" or ChapStick " LipMoisturizer". My lower lip was very swollen and numb for many weeks. The lip balm helped me avoid drying, chapping and painful peeling of the lips.

If your eyes tend to drying, take something like Allergan "Liquid Tears" or "Refresh Tears" - - - I used Oxygene toothpaste and mouthwash, available from dentists who often recommend them for patients undergoing gum surgeries. These are gentle-tasting, non-irritating but very effective antibacterial agents - - - There is soap provided in the guest rooms, but you need to take our own shampoo - - Also, I used Metamucil every day - - and then took some Ex-Lax on the fourth and fifth days to help restart full digestion, thus avoiding constipation from the effect of all the antibiotics.

Some info about food:

For the first two days or so, you'll be on pureed foods. I had a good appetite and that stuff tasted great. Still tasted great as I shifted to "ground foods" the next day. Those not having jaw/chin surgery may transition quickly onto "regular foods", which are a nice treat compared to pureed and ground foods. I was on the regular foods during my later face-lift recovery and found those meals quite good.

Although the hospital meals seemed great for a few days, all of a sudden my appetite declined (I'd had no bowel movements from the 9th to 13th). By the 13th, the ground food didn't seem so appetizing anymore. Finally the Metamucil and Ex-Lax worked, but then I began to really hunger for other more normal foods. Charlie brought back some nice sandwiches, bananas, etc., from the produce/sandwich store on the corner of Castro and 14th, just one easy block away (I'd found that I could flatten the sandwiches with my hand, and then could nibble them into the side of my mouth). During the rest of my stay, we often walked over there to get nice food items. We also made some meals by walking down to the Safeway store and getting some real treats in the Deli there.

[Note: Those staying in Cocoon House have new options for food and local services - see the Cocoon House webpage]

I also discovered the cafeteria on the lower "B" level of the main Hospital building. They serve breakfast and lunch there, and have lots of produce, sandwiches and other stuff available throughout the morning and afternoon hours. This is a nice source of food variety, especially on rainy days when you may not want to go outside.

The Cafeteria's hours are as follows (see Schedule sheet posted on wall-board in corridor leading into cafeteria for any updates; don't pay attention to the large, older sign out in front of that corridor):

Hospital Cafeteria Schedule:
Breakfast 7:00-9:30 M-F
Lunch 11:30-1:30 M-F and S-S*
Dinner 4:30-6:30 M-F and S-S*
*Selection may be limited on S-S.

By the 15th, I ended up usually mixing some nice foods from outside the hospital, or from the cafeteria, in with my regularly served Guest Room meals. There were always things on the hospital meals that were tasty, but other things that occasionally weren't once my appetite was back to normal.

By the 5th day post-op you may begin to feel like eating a meal out once in a while. There are many nice restaurants nearby Davies to chose among, including Chow, the Bagdad Cafe, the Thai House, etc., all within easy walking distance (except that you need to take it easy on the last hill-climbing block back to the Hospital). Since the N-line light-rail/subway station is only one block from the Hospital, you could also easily make trips to downtown for dinner.
[For info about restaurants near Cocoon House see the Cocoon House information pages]

Some notes about San Francisco's weather:

For a month-to-month profile of the weather in San Francisco, and access to the current five-day forcast, see URL: http://www.sfvisitor.org/visitorinfo/html/WeatherForecast.html

That site says: "San Francisco is blessed with a temperate marine climate and enjoys mild weather year-round. Temperatures seldom rise above 70°F (21°C) or fall below 40°F (5°C). Morning and evening fogs roll in during the summer months, but rarely persist. Visitors are most comfortable with a light jacket or coat handy, or in a suit. An all-weather coat will take the chill off cool evenings. Lightweight summer clothes are seldom practical in San Francisco."

Translate this as follows: There are two seasons in San Francisco, the dry season from late April till late October when it hardly ever rains, and the rainy season from late October till late April when it frequently is rainy and blustery. In summer, the City is frequently covered by fog, due to on-shore ocean breezes during the day, and although the temps may be in the 60's it can seem very damp and very cold. The best weather occurs in early fall when it is sunny but not foggy, and then intermittently during sunny day breaks between the winter rainstorms.

Be sure to take a good windbreaker and lightweight but warm insulation, any time of year. I always take a GoreTex parka and light fleece jacket when going to San Francisco, even in the summer, to be used separately or together depending on the situation.

Some notes about "appearances":

Charlie and I went downtown on the evening of the 15th (5 days post-op) when I still had the "X" nose bandages on and while my face was still very black and blue. During that whole trip, including buying a few things in some stores, and metro rides to and from downtown, no one ever stared at me or even seemed to notice my messed-up face. Now that's San Francisco! People there are very nice, and try to avoid making other folks feel uncomfortable regarding their appearances. So don't let all the bandages keep you from getting out and around town, if you really do feel up to it (but see note below re "passing").

By the time I left the hospital on the 18th, my bruising was down enough that I could cover it almost completely with regular daytime make-up. I had taken some Clinique "Continuous Coverage" (in 08 Creamy Glow color), a concealer often used by plastic surgery patients. I didn't need to use it after my FFS surgery, because my bruising went down so quickly and regular day-time makeup was adequate for concealment. Others might find such a concealer useful if they have persistant very dark bruises after FFS, in locations such as under the eyes.

[ Note: I definitely needed concealer after my later Face-lift/Blepheroplasty surgery. I felt well enough to want to get out and do things within a few days of surgery, but my eye and face bruising were worse than with the FFS. I was very glad to have concealer with me then. If you are especially concerned about the visibility of bruises or if you have a tendency towards excessive bruising, I recommend using "Covermark" concealer and powder. Covermark is an amazing concealer system originally designed for people who have facial birthmarks, etc., and provides total coverage of any discoloration.]

Interestingly, I found that I was most self-conscious about my appearance not while bruised and bandaged out in SF, but during my first week back home. My bruising was almost gone, and could be completely concealed by regular daytime make-up. So now there was no obvious "reason for" the still very apparant, large, lumpy swelling beneath my chin, nor for the difficult time I was having making normal facial movements in the area of my lower lip and chin. For the first time I began to notice people occasionally staring at my face. Of course, this was in Michigan, and not San Francisco.

Some comments for those concerned about "passing" during recovery:

Many of Doug's patients are TS's in early transition. Some will be concerned about issues of passing. You're not going to look your best after surgery, and this adds to the passing difficulties that some will face. You needn't be worried about such issues while in Doug's area, or in the recovery area, the ACU hospital rooms or in Cocoon House. Sure, there might be pronoun problems with nurses or staff who don't know you, but those will just be accidents and not intentional, and you shouldn't be concerned. One nice thing about Cocoon House in contrast to a motel is that your stay there can be very private until you are healed up enough and well enough to make yourself presentable again to the outside world.

Then too, while in Cocoon House you'll very likely be able to meet and chat with T-girls staying there at the same time. You can always do this on a first name basis if you'd like to remain in stealth. This is a nice way to find more companionship during recovery without passing being an issue.

However, you shouldn't have the impression that "anything goes" without attracting public comments or insults just because Davies is in San Francisco and the Castro District. There are mean-spirited bullies in every city. For example, one incident was reported in the Davies main hospital lobby where a recently operated TS with facial bandages and in great pain was verbally harassed and brought to tears by workmen/deliverymen from outside the hospital. Of course, one of the reasons many transsexuals go to Doug is because his work can help them get beyond all such harassment.

Some early-transition patients go thru FFS in "guy mode" or androgynous mode, just to make the whole thing simpler and less stressful from the passing point of view. As a result of Doug's work, they may find themselves being "ma'am-ed" while travelling home, even if they are still in guy's clothes. Of course that's such a nice result, it usually feels good. For many patients a selection of very comfortable and somewhat androgynous clothing may be the best choice.

Getting back to the office and to work:

In my case, I felt up to doing some light office work by 2 weeks post-op, but was still in a lot of pain and tired easily. I could only do a 1/2 day here and there. By 3 weeks post-op I was able to resume "quiet, normal activities", but still felt in some pain and didn't want to handle any real stress, since I still tired rather easily. A reasonable bet for resumption of full, normal-stress work activities might be somewhere between 3 and 4 weeks post-op for most patients who get "the works".

Getting back to regular exercise:

Regular exercise is important to me. I think that being in good physical condition helped carry me strongly through the difficult early stages of recovery. But by 2 weeks post-op I began to feel "exercise withdrawel", a lousy messed-up feeling from the forced inactivity. However, after this surgery one must be careful not to raise your blood pressure until you are fully healed, for fear of hematomas or edemas in the wound areas. Dr. Ousterhout advised that I could resume my regular exercise regimen (jogging, aerobics, strength machines) at 3 weeks postop, but he also said to carefully "listen to your body" for any signs that it wanted you to slow down a bit.

I returned to most normal activities, including some moderate exercise, during the 4th week post-op. I hit a complication (infection) during the 5th week post-op that threw me back into relative inactivity again for a couple of weeks, but after that I was very active.



INFORMATION ON DAVIES HOSPITAL:

Here's some info on the Davies Campus of the California-Pacific Medical Center, also known locally as "Davies Hospital". The Davies address is: California Pacific Medical Center, 45 Castro Street, San Francisco, CA 94114. Main telephone: 415-565-6000.

In order to get oriented, let's look at a photograph of a model of the Davies complex of buildings. In the following photo we are looking from WSW towards ENE, i.e., looking over the hospital towards downtown San Francisco. The 5 story building in the upper left is the main hospital building and is called the "North Tower". The main entrance drive from Duboce Avenue enters from the left and heads towards the Garage entrance (the covered Garage is the building on the lower right, you can see parking spaces on its roof).



The main hospital entrance into the North Tower is just off the main entrance drive. You can see a dark blue car parked in pull-out area, with someone walking towards the entrance. A helpful information assistant is located just inside the entrance. Admitting is just inside the entrance to your left.

The ACU hospital rooms where you'll spend the first two nights are on the second and fourth floors of the North Tower building (the old "Guest Rooms" were on the third floor). There is a cafeteria used by staff, but available to ambulatory patients, down on "B" level, two levels below the lobby. There is also a small gift shop just off the main Lobby.

The North Tower hospital building is connected on its "A" level (one floor below the lobby) with another building (the South Tower) to its south (the one in the upper right in the photo). You'll note a circular drive in front of that connector, with a grey car parked in front of it. The covered entrance into A level just behind that car takes you into the corridor where Dr. Ousterhout's offices are located, just a short distance to the right of that entrance.

The other covered entrance off the circular drive, underneath the North Tower hospital (towards the left), is the Emergency Room entrance. Ambulances usually enter from Castro Street (from the bottom of the photo, and go down the drive from Castro into and around the circle to the ER Entrance. The ER Entrance is open 24 hours a day.

Note that there is a large, park-like veranda stretching from the main hospital entrance area on the Lobby level all the way around to and over the Connector building. If you feel like getting out and taking a short walk on a nice day, be sure to explore this veranda. Davies is located up on the slopes of a hill, and the views towards the East from the Connector overlook much of San Francisco, stretching all the way to downtown. There are some benches out on top of the Connector, and it's a great place to relax on a nice day.

Note that Davies is contained within a block bounded by Duboce Avenue on the North (towards the left in the photo), Noe Street on the East (top), 14th Street on the South (right), and Castro Street on the West (bottom). There's quite an elevation gain as you climb from Noe to Castro on either Duboce or 14th when walking to the hospital. Be sure to take that hill climb into account on your walks to/from the hospital. You may be in a weakened state, tire very quickly and have difficulty returning. The hill is also steep enough in places to cause walking difficulties if you're on meds and are unsteady on your feet.



MAPS, DIRECTIONS AND TRANSPORTATION:

For general maps of San Francisco, see http://www.sfvisitor.org/. For information on all types of public transportation in San Francisco and the Bay Area, see http://www.sfvisitor.org/visitorinfo/html/PublicTransit.html

Directions to Davies Hospital:

The map below shows central San Francisco, stretching from the Castro district in the lower left, thru the Civic Center district in the middle of the map, up towards the Union Square and Financial District in the upper right.

The hospital is located in the Castro District, about 2 miles southwest of downtown San Francisco. It's easy to reach by automobile or public transportation.When driving north from the peninsula, take Route 101 all the way to its end as it swings out towards the west. Route 101 exits directly onto Fell Street, heading west. Take Fell Street west about 6 blocks to Scott Street; turn left on Scott, and go south about 5 blocks until it ends at Duboce Street. The entrance drive of the Davies Campus is just a short distance across Duboce and slightly to your right. The entrance drive ends at a covered parking garage.



The Muni N-line light-rail public transit passes within one block of Davies on Duboce Street. This line travels out from downtown via Market Street and Duboce. You can connect to the N-line at any of the main downtown BART stations, such as at Powell Street.

San Francisco's Muni system includes buses, trolley cars, cable cars and light-rail/subway transit. Muni maintains an excellent overall system map that is "zoomable" on the web. This map will help you find ways to interconnect among the various types of public transit in San Francisco.

Access to Davies from San Francisco Airport is easy: Take a "Super-Shuttle" van, which stops just outside all arriving terminal areas. The cost is about $12 to $15. The Super-Shuttle can be scheduled to pick you up at Davies when it's time to return to the airport.

I often save money when travelling to the Bay Area by flying into Oakland Airport over in the East Bay. Air fares there are often only 1/2 to1/3rd of what they'd be when flying into San Francisco. Then too, Oakland Airport seldom suffers the flight delays so common at SFO during stormy, rainy winter weather. From Oakland Airport you simply take an AirBART shuttle ($2.00) to connect to the Bay Area Rapid Transit (BART) system at the Oakland Coloseum Station, and then ride BART to the Powell Street Station in San Francisco ($2.75). From there take the N-line Muni subway to Davies Hospital ($1.00).


Davies Hospital Neighborhood:

Following is a map of the neighborhood surrounding the Davies hospital campus, including pointers to some useful services (North is "up"). Some key items to identify are the Safeway grocery store (open 24 hrs) and the Rite-Aid drug store, located on the corner Duboce Avenue and Church Street, about 1/3 mile east of Davies. [Update: The Rite-Aid pharmacy is no longer there - however, there is a pharmacy in the Safeway grocery store right across the street from the old Rite-Aid location]. There is a laundromat on Duboce (hours are 7-9pm, 7-days). There is a new Walgreen's drug store on Market Street close to Davies.




There is a Muni N-Line stop on Duboce Avenue just outside of Davies Hospital. This fast light-rail line will get you downtown easily and quickly. Note that the N-Line has the added advantage of continuing on to the Caltrain Station at 4th and King Streets. The Caltrain line provides rail service up and down the peninsula side of the Bay Area.

N-Line light-rail stop at Duboce Park, 1 block from Davies:


There is a station for the Muni K, L and M light-rail subway lines located near the intersection of Market and Church. All these lines run into downtown San Francisco. The K, L, M and N Muni lines connect to the Bay Area Rapid Transit (BART) system at the downtown Muni stations, with Powell Street Station being the main connection point. BART provides very rapid service across to the cities in the East Bay area, including to Oakland Airport (using the Coloseum BART stations and then the AirBART shuttle into the airport).

The F-Line surface trolley cars run along Market Street, stopping at every major intersection. The colorful vintage F-Line trolleys will take you all the way downtown, and although slower than the Muni light-rail subways, the F-Line now continues on all the way around the Embarcadero to Fisherman's Wharf, a major tourist attraction with all its shops and restaurants.

F-Line vintage trolley car on Market Street:


Note that for $10.00 you can get "3-day passes" and for $15.00 you can get 7 day passes at the info booth at the main Powell Street Muni Subway Station downtown (and also at the Cable Car info booth just above that station). These passes enable you to ride all San Francisco public transit (except BART) as much as you want for three/seven days, and are a real bargain if you and/or someone staying with you want to play tourist for a while.



LODGING, FOOD & SERVICES DURING RECOVERY:

Most of Dr. Ousterhout's patients move to the Cocoon House residence for recovery after being released from the Davies ACU several days after FFS. By staying at Cocoon House when several other patients are recovering there, you can feel more at ease about many practical recovery needs. This is especially valuable if you don't have someone staying with you during your recovery after FFS.

The Inn on Castro is a wonderfully luxurious Bed and Breakfast Inn near the corner of Market and Castro. The Inn is a great place to stay for any trips to the area. It is also an excellent alternative as a place to stay while recovering after FFS, especially if you have someone coming with you who can help with practical things during your recovery.

Beck's Motor Lodge, on Market Street near the intersection with Sanchez St. (2/5 of a mile from Davies), and the Metro Hotel, on Divisadero Street between Oak and Page Streets (about 1/2 mile from Davies) are inexpensive, convenient places to stay for those wanting to stay in the area a while before surgery or after recovering in Cocoon House. These places are also excellent alternatives to the expensive downtown hotels for vacation trips to San Francisco.

All these lodgings are described below, along with some listings of restaurants and services near Davies hospital.



COCOON HOUSE - A Recovery Residence for Dr. Ousterhout's Patients:

This is a recovery residence for Dr. Ousterhout's patients, located at 3877 Cesar Chavez Street about 1-3/4 miles SSE of Davies Hospital. Many restaurants, grocery stores and most conveniences are located within walking distance of the guest house. Local taxi companies are providing prompt service, and public transportation to the hospital is also very convenient. Anyone can bring a partner or a friend to stay with them at Cocoon House during recovery. A single is $125 per day (including soft foods), and double occupancy is $175 per day.

Cocoon house is operated by Mary-Lou and Tricia, who work as nurses at the Davies Campus in the Operating Room. Upon hearing of the closure of the hospital's "guest rooms" they felt they could turn two rental units in their home into a environment suitable for healing. Mary-Lou and Tricia are wonderful people, and they provide a very safe, comfortable and supportive environment for FFS recovery. Although they do not provide nursing care of any kind at Cocoon House, help with hair washing is offered, and they've also consulted Dr. Ousterhout and Mira on specific guests needs when healing from FFS surgery, i.e. foam wedges, etc. Mary Lou and Tricia reside in the house and can be reached by cell phone.

A comprehensive description of this new facility is now posted on the web (see the Cocoon House website). Included in that description are details of nearby restaurants and services. Most of Dr. Ousterhout's patients now stay at Cocoon House during their recovery after release from the Davies Hospital ACU. Contact Mira for for more details and to make arrangements to stay at Cocoon House.


Cocoon House



Cocoon House (lower right) is about 1-3/4 miles from
the Davies Medical Center (upper left)

There are many shops and restaurants along Market St. in the Castro District near Davies, and along 24th St. in Noe Valley near Cocoon House (blue strips in map below)




THE INN ON CASTRO:

The "Inn on Castro" is located at 321 Castro Street, San Francisco, CA. 94114 (phone: 415-861-0321). It is about one block from the corner of Market and Castro as you go uphill on Castro towards Davies Hospital. Thus it is a short uphill walk from there to Davies and Dr. Ousterhout's office (about 1/3 mile).

The Inn's owner, Jan (pronounced "Yan"), is a gem to match Mary-Lou and Tricia, and the accommodations are even more spacious than the Cocoon House (as such, it's a bit more costly too - with rates for rooms with baths from $135 to $185 per night). It's a Bed & Breakfast and the breakfast is amazing, the atmosphere international and friendly.

Stunningly decorated with contemporary furnishings, the Inn is a restored Edwardian building. The individual bedrooms are warm and inviting and brightly accented with original paintings. They have large bay windows for bright, cheery lighting. Large bouquets of fresh flowers are abundant throughout the Inn. The cozy living room, with its fireplace and deeply tufted Italian module seating, is a marvelous place to unwind in -- just great to curl up with a good book and enjoy a brandy, compliments of your hosts. The Inn serves a full breakfast each morning in the adjacent dining room.

Jan has hosted many of Dr. Ousterhout's patient's and he and his staff are supportive and understanding regardless of where one finds themselves with regards to transition or life afterwards. The Inn's extensive website at URL http://www.innoncastro.com/ contains lots of useful information, including photos of the rooms, and also some information and photos of the Castro District too. The Inn on Castro is conveniently close to the K, L, and M line subway station at Market & Castro, and also to the Market Street F-line trolley cars.


The Inn on Castro



Note that Jan also has three very nice apartments near the Inn that are also available for short term rentals. Apartment 1 costs only $115 per night for two people staying four days or longer (Apts. 2 and 3 are $160 a night for two people for four days or longer). Apartment 1 is an excellent modest-cost option for someone who has a companion coming with them to help take care of them. Here is a report from "Kathryn" about her stay at Apartment 1:

"Mira recommended the Inn and I found out that not only do they offer rooms in the Inn proper, but Jan has 3 apartments in the Castro district also. I rented the cheapest one which was $100/night for 4 days or longer. This apartment is at 88 Caselli and is the lower level apartment of Jan's building. The apartment was beautiful with a private entrance, spacious living and dining room, and a separate bedroom. I took the bedroom of course and there was plenty of room for my friend to set up her queen sized air mattress. There is a full kitchen, TV (with cable), stereo, and a spacious shower with a really nice adjustable shower head. The apartment has sliding glass doors that open into a small garden/courtyard. I never saw or heard anyone else during my 7 days there. It was a nice, quiet relaxing place to recover. It is about 0.9 miles from the hospital and I had no problem walking there the morning of surgery. It's pretty close to the Cala Foods & Walgreens on 18th St. Jan is a sweetheart, he just told me to leave my bags and groceries in the room when I went to hospital and he would store them and have them waiting for me when I returned a few days later. My friend drove from LA and had little trouble parking in the area. Parking was quite plentiful in front of the building but there are restrictions during the weekdays. She either had to move it once or twice during the day or just park a block or so away where there are no parking restrictions. Anyways, that's my experience and I would highly recommend the apartment especially for anyone who has a friend coming to stay with them." - Kathryn


For current information on room rates at the Inn on Castro, and for rates for the apartments too, see the Inn's Reservations Page. The Inn on Castro is highly recommended as a place to stay if you have someone coming with you for your FFS. It is also a wonderful place to stay for later vacation trips to San Francisco too!



Beck's Motor Lodge:

Beck's Motor Lodge is located at 2222 Market Street, San Francisco, CA 94114 (phone: 415-621-8212; toll free reservation line: 800-227-4360). It is located near the intersection of Market and Sanchez Streets [see the Davies Neighborhood Map above]. This location is in the heart of the Castro District, which is San Francisco's largest primarily gay residential area (the majority of folks staying at this motel are rather manly gay men). The neighborhood is an upbeat, safe and friendly area, full of nice townhouses, neat restaurants, interesting clubs and bars, and many small shops.

This AAA 2-star rated motel is comfortable, moderately priced, has convenient free parking, and is within easy walking distance of Davies Hospital. Thus this motel is a particularly convenient one for short advance-visit trips for consultations with Dr. Ousterhout. The distance is about 2/5 mile of a mile (if you use the short-cut shown on the map), and the route is along fairly narrow streets somewhat sheltered from wind/rain. Rooms with a queen-sized bed are about $85-$95 per night plus taxes. The Lodge offers a 15% discount for referrals from Davies (check with Mira on this), so your actual cost may probably be around $80 per night, which is quite reasonable.

Television sets in Beck's are hooked up to a full Cable-TV system with lots of channels. All rooms have a small refrigerator (convenient for multi-day recovery stays), and the Lodge is close to the many restaurants and stores along Market Street between Castro to Church Streets. Thai House, Chow, Bagdad Cafe are all within just a couple of blocks. The Safeway, Walgreens and Rite-Aid stores are also nearby, as are the K, L, and M line subway stations at Market & Church and at Market & Castro. The Market Street F-line trolley cars pass right outside the Lodge on Market Street, and stop at all major intersections including those near the Lodge.

For the quietest rooms, ask for the third floor. There is elevator access in the rear of the motel. There is an outdoor patio in between the 2nd and 3rd floors. The patio overlooks Market Street, and is a nice place to sit and relax outdoors in good weather. Because of its central location in the Castro District, Beck's Motor Lodge fills up virtually every weekend. Be sure to make confirmed reservations well in advance if you'd like to stay there.

Beck's Motor Lodge




The Metro Hotel:

The Metro Hotel is located at 319 Divisadero Street, San Francisco, CA 94117 (phone: 415-861-5364). The Metro has long been used by Dr. Ousterhout's patients, and the staff there are familiar with the situation of TG/TS gals recovering from facial surgery, as are many of the small nearby restaurants and services on divisadero. The Metro offers Dr. Ousterhout's patients a 10% discount off the already reasonable rates, so you'll be able to stay here for only $53 to $55 a night.

This is a small "european style" hotel that is comfortable, inexpensive, and within fairly easy walking distance of Davies Hospital (about 1/2 mile). The Metro is not as close to Muni light-rail and trolley lines as Beck's Motor Lodge. However, the #24 Bus Line on Divisadero Street just outside the Metro Hotel goes south over onto Castro Street and can take you directly from the hotel to/from Davies Hospital with very little walking. In that respect it is even more convenient to get to Davies from there than is Beck's.

The Metro's location is just outside the Castro District. It isn't as close to good restaurants and other services Beck's Motor Lodge. However, the Metro Cafe located in the same building offers nice breakfasts and lunches, and there are numerous small produce/grocery marts and ethnic restaurants nearby.

The Metro's interior rooms are quiet, but have windows opening out to blank walls of adjacent buildings. I like the front rooms that look out over Divisadero; they aren't as quiet, but it's pleasant fun to relax in their big bay window and watch the street scene below. Television sets in the Metro are hooked up to a full Cable-TV system with lots of channels. The hotel seems quite secure; the lobby is locked after 10pm (you'll need your key to get back into the lobby).

This hotel is an even less expensive alternative to Beck's Motor Lodge for a place to stay during consultation trips, or if you arrive a few days early for your surgery, and/or as an alternative to Cocoon House for the latter part of your recovery period.


Photo and locator map for the Metro Hotel


Davies Area (Castro District) Restaurants and other services:

There are many neat little restaurants and cafe's in the Castro District near Davies, and many other services such as drug stores, laundries, etc. (See the Davies Neighborhood map above).

The "Bagdad Cafe" at Noe and Market is open 24 hours a day, and has a wonderful friendly atmosphere. You'll get generous helpings of good food here at reasonable prices. It's also a great spot to just drop in, get a cup of coffee, and people-watch the passersby on Market Street for a while, any hour, day or nite.

Another neat restaurant for lunch or dinner is "Chow", located near the corner of Market and Church. There is always a happy, warm atmosphere at Chow. The food is good and the prices moderate. It can get crowded on weekends and even during the week by 6:30, so our best bet is to go a bit early. The Thai House (hours are 5-10), at Henry and Noe just two blocks from Davies is another nice restaurant, with excellent Thai food and an intimate atmosphere. There is also a very nice produce and sandwich shop at 14th and Castro (Courtney's Produce, hours 6am-8pm 7 days), a very short walk from Davies.





Reset on 3-03-06 MN translation of 12-05-05 LC update of 1-15-06


[Lynn's homepage] (Fr)

Informations générales (Fr)	Remerciements (Fr)	Trucs et astuces
Motivations de Lynn pour cette intervention (Fr)	Le journal chirurgical de Lynn	Informations sur l'hôpital de Davies
Décision et préparatifs (Fr)	Résultats initiaux	Cartes et moyens de transport
Note importante au de residence readaptation “Cocoon House” (Fr)	Le journal de l'opération de lifting (FLS)	Cocoon Guest House
Liens FFS	Résultats globaux FFS/FLS	Nourriture, Logement et services

Douglas Ousterhout, M.D., D.D.S.	L'assistante de Doug, Mira Coluccio

Charlie and Lynn, December 25, 1999	February 22, 2000

Cocoon House (lower right) is about 1-3/4 miles from the Davies Medical Center (upper left)	There are many shops and restaurants along Market St. in the Castro District near Davies, and along 24th St. in Noe Valley near Cocoon House (blue strips in map below)

Madeleine - avant, pendant et après son opération de féminisation du visage par le Dr Douglas Ousterhout La transformation est profonde, et Madeleine est maintenant une belle femme:

Nov. 26, 1999: Lynn at 16 days post-FFS (still with LOTS of jaw/chin swelling)

March 29, 2000: Lynn at 4-1/2 months post-op from FFS, and 5 weeks postop from face-lift surgery [Lynn's skin is very tight, and she's having trouble smiling, but the results look great already]

Photo and locator map for the Metro Hotel