Transition process

[emmicd]

As part of the transition process from male to female how important is facial feminization surgery(FFS)?

How can you find a price that is reasonable without having to travel overseas?

How has it made a difference for you who have done it?

Has anyone consulted with Dr. Jeffrey Spiegel in Boston Massachusetts?

http://www.drspiegel.com/facial-feminization-ffs/

[Aprilrain]

How important FFS is depends on how masculine your face is. I went to Spiegel and am very pleased with my results. He is expensive but I think worth it.

[Stephanie-L]

I have seen this question here and on other forums. The answer is, it depends. For some, FFS is more important, for others GRS. It all depends on a number of factors. Do you want to physically be a woman, or look and be treated as a woman? Is your face very masculine? What do hormones do for you, some do get a bit of facial feminization from hormones, some don't. Only you can answer those questions, hopefully with help from a therapist. One thing I will advise, start facial hair removal now, it is the longest and slowest process, and often the most expensive over time.
As to finding a good surgeon, again, it depends. How much work do you need, and do you need bone work? If you do, be prepared to pay, because all the surgeons who do extensive bone work are either expensive or require overseas travel, or both. You can do what I did, and contact several by email, sending them photos for an evaluation. I contacted 10, and got pretty much the same recomendations from most of them, so I pretty much know what I need. I do not need a lot of bone work, and have seen good results from my prefered surgeon, though he is out of the country, so I will have to travel a bit. Another thing you can do if you have the time and money is go to SCC in Atlanta, many of the top surgeons will be there and doing quick consultations, so you can check out several and talk to them in person. One thing I suggest is to get before and after photos that are not on the surgeon's website, i.e. either directly from a patient or on one of the surgery help forums. Also research the surgeon's reputation, again, mine has a good rep, with only one unfounded negative report I have seen. Others have several, even the big names have a few.
I have not started researching GRS yet as FFS is more important for me, YMMV. Good luck to you...............Stephanie

[ColleenA]

Another thing you can do if you have the time and money is go to SCC in Atlanta, many of the top surgeons will be there and doing quick consultations, so you can check out several and talk to them in person.

Good suggestion. If you can't make it to Atlanta Sept. 23-24, though, you may want to go to First Event in Boston, which is closer to your home, on Jan. 20-21 (unless that conflicts with plans to be in DC for the next presidential inauguration lol).

[Kerigirl2009]

I have not transitioned but if I was to begin the process, I would most definately want FFS because I have a male jawline and could use a brow reduction plus maybe some cheek inplants maybe some plumper lips and an adjustment of the distance from the lip to the nose, But I do like my nose just the way it is.
I think its a matter of personal wants and needs to help those who do transition of how well they want to pass and get rid of all traces of maleness that they can afford.
If and when I do, all of the work would be done here in the states.

[abby39]

How important FFS is depends on how masculine your face is. I went to Spiegel and am very pleased with my results. He is expensive but I think worth it.


What SHE said! And just for the record. WOW!

[noeleena]

Hi,

For my self its about accepting what i look like or if this refers to how i should look . then really it has no base's for myself in being accepted for who i am . im accepted reguardless of my facial looks & people dont give a damm.

Those who know me & thats in the 1000's dont have any issues so ether i look like a woman or a male or they are so over it its a none issue,

The truth is being intersexed gives me something that many trans would like yet would have major issues with my looks .

im 65 what the hell would i need surgery for to look like a woman maybe against being accepted anyway. so no surgerys, no point im long past it & so are my many friends, & the other 1000 people im involved with.

Im not trying to prove im a woman i allready am one i dont need to pass or blend in fact is i dont & wont.
Yet i have had women say to me when they saw me thought i was a woman any way. many women do have male facial features so it begs the ? is it needed, not in my case .

There are so many other things or atributes about my self that says i can be accepted as a normal woman . so some of us dont have that ....look .... yet pass as women in other ways that confirm i am a woman.

Now im not saying others should not have surgerys its a very individule thing,

It comes down to confindence being selfassured & knowing who you are, & accepting what you are.

Im content & happy in being myself & for who i am. what more do i need.
okay just one miner little detail ,

((((((( ....... For >>>> Jos <<<< to be with me at some stage ........ ))))))).

...noeleena...

[morgan51]

It will be the first surgery I've thought that from the start. I am totally a male in the face dept. Thinking strongly I will go to mexico and Cardenas

[Inna]

The question can be approached from many facets, but if you want the brutal honesty from not so brutal girl then here it is (TS section is just that way hon, truth hurts, [-]sometime[/-]most of the time :eek: )

FFS for most if not all TS males who transition after 30 is as necessary for absolute assimilation as the air you breath to see another day!
Of course there are those who can go about their day with pointing fingers, derogatory comments, laughs, and occasional sexual slurs, for the rest of us(* using US under creative license I have bought for 0.02 cents) FFS provides peace of mind and assimilation into the real world, being looked at as a genuine woman, interacted with, addressed, helped and befriended as one.

However said all that, FFS does not solve your life but you do, on the other hand, solving your life with true face is way less difficult and way more, how WE* say "phenomenally gratifying immenseness, PGI for short"

Warning:
FFS procedures are a combination of intervention with varied degree of re-sculpting, from my own experience and knowledge of few who have gone into the realm of FFS, healing process is long, effects take time and follow up procedures will most likely be necessary to achieve absolute feminine presentation!

Disclaimer:
If you or any one near, behind, or in front of you doesn't like, agree, or look kindly upon what I have expressed in the above article, please contact my legal department at INNAS corporate headquarters, 0001 rabbithole st n, alicetown, KY, 33666

[StephanieC]

If you or any one near, behind, or in front of you doesn't like, agree, or look kindly upon what I have expressed in the above article, please contact my legal department at INNAS corporate headquarters, 0001 rabbithole st n, alicetown, KY, 33666

Too cute!

For me, it's the trachea shave

[Frances]

I transitioned in my early forties (I am turning 46 next week). My features are very neotenous (pedomorphic), and I can get by just fine without FFS. Some people absolutely do need it if they ever want to stop sticking out. I know someone, however, who passed just fine and got FFS anyway because she "thought" she did not. It took her a long time to accept her new face.

Whether FFS is necessary or not has not much to do with age, but with how neotenous you are. Women usually retain their juvenile features, while men do not. I would love some work if I had the money, not to help me look more female, but to be prettier.

http://i916.photobucket.com/albums/ad9/CGaronMTL/Pix_2011_09_08_B.gif

http://i916.photobucket.com/albums/ad9/CGaronMTL/Nol2010_B.jpg

http://i916.photobucket.com/albums/ad9/CGaronMTL/Pix_2011_09_08_A.gif

[Inna]

I transitioned in my early forties (I am turning 46 next week). My features are very neotenous (pedomorphic), and I can get by just fine without FFS. Some people absolutely need it if they ever want to stop sticking out. I know someone who passed just fine and got FFS anyway because she "thought" she did not. It took her a long time to accept her new face.

Whether FFS is necessay or not has not much to do with age, but with how neotenous you are. Women usually retain their juvenile features while men do not. I would love some work if I had the money, not to help me look more female, but to be prettier.

How does it feel to be a member of the 1% of Genuinely feminine features Club from the get go, I would say I am envious and you are lucky but I know better, even though you got it babe I know that transition is still painful and sorrowful regardless.
Hot Mamma though, thanks for sharing!

[StephanieC]

Frances, IMHO you don't need a thing. However, I think you have a good point: sometimes we are our worst enemies in assessing appearance. The other benefit for women: makeup. Even a little bit really helps....it doesn't have to disguise, it can "enhance". How many people, male or female, roll out of bed looking like a million bucks?

-stephani

[Cheryl T]

You're very pretty...you don't need to have anything done.

[Frances]

How does it feel to be a member of the 1% of Genuinely feminine features Club from the get go, I would say I am envious and you are lucky but I know better, even though you got it babe I know that transition is still painful and sorrowful regardless.

^This is a very important point.

Because I blend in easily and men find my face attractive does not change everything else. Transitioning on the job was hard. My relatives are incredibly uncomfortable around me. My old friends will not communicate with me. My ex blocked me on Facebook. I had to file for bankruptcy because of the costs related to transition. I went on 6 interviews since January and have been discriminated just about every time.* I used to be in the music business (as a player and a sales rep.), and a lot of people know me. I cannot walk into a music store unoticed (and having to deal with my past), and I fear getting heckled if I play live again.

So yes, pretty face or not, transition still sucks. I would have to move far away to have any anonymity.

*I don't talk about my transition during interviews. My industry sector (translation) in very incestuous and ex-collegues are everywhere, but no one asks me questions. I may be perceived as a tranvestite. I wish they looked at my ID to see that my transition is done.

[Pamela Kay]

Frances,

I'm sorry your work situation has been so tough and unaccepting. I think your situation illustrates why many of us chose to do FFS. I am out at work and leave to have FFS on Oct 1st then I'm off until I return to work as Pam on Nov 13th. Since I'm transitioning in place and have been there nearly 5 years, everyone has seen me or knows who I am. Being an instructor and trainer has put me out in front of them more than most everyone in the organization. I also have to travel around and do seminars in other states across the country.

My main reason for doing FFS first was for myself and not wanting to see him so much staring back at me in the mirror every day. Secondly for work and those around me so they will see a new face to put with the new name. I realize they, and I will always see parts of my old self but I look forward to being seen differently. At least enough that everyone will be able to see the new person and not so much of the old one.

Including me.

[Kathryn Martin]

Frances, so beautiful, live even more so than in pictures........

Emmi I went to Spiegel and he told me to wait. He said I don't need facial work but maybe a face lift when I get to look like a hound.




How does it feel to be a member of the 1% of Genuinely feminine features Club from the get go, I would say I am envious and you are lucky but I know better, even though you got it babe I know that transition is still painful and sorrowful regardless.
Hot Mamma though, thanks for sharing!

[Badtranny]

So yes, pretty face or not, transition still sucks. I would have to move far away to have any anonymity..

Good heavens Mrs Yamamoto, you're beautiful!

I love how honest you are about your situation. Very inspirational.

[ReineD]

Emmi are there any FFS docs that you are considering other than Spiegel?

Frances, no one looking at you would ever even guess your past and I don't understand why it is difficult obtaining employment. How do they know? And more importantly, why do they care?

[Frances]

Frances, no one looking at you would ever even guess your past and I don't understand why it is difficult obtaining employment. How do they know? And more importantly, why do they care?

There is a limited number of translation firms and linguistics departments within private companies. There was a huge turn-over in my company (I left six weeks ago), and ex-collegues from before and after my transition have found work in these others companies. I test well and get to the interview, but things go bad when the supervisor and the HR person make go around the office and see my former collegues. Jaws drop as I am paraded through the office.

I don't talk about my transition during the interview, so they only information they get about is from these people who did not know that I had transitioned. They don't know that I have had SRS, either.

I tried revealing my transsexual past to one company where there would not be ex-collegues, but where they performed intensive background checks (Loto-Quebec). The result was the same.

Why do they care? I don't know, but it's become clear to me that no one wants a tranny around, even if she's good-looking, petite and sounds like a female. I will probably have to freelance and work from home. Transition sucks and is hard for everyone, regardless of superficial advantages.

[Badtranny]

How do they know? And more importantly, why do they care?

RD, they know because she's in a place where they remember "him". This is why I would always get fired up at the "keep your mouth shut" brigade, because for many of us it doesn't matter. Our past didn't magically disappear after transition and some of us make our living in fairly small industries where there is no escaping it.

We should all remember that advice given from the benefit of our own experience is sometimes worth less than nothing to someone else.

[StephanieC]

We should all remember that advice given from the benefit of our own experience is sometimes worth less than nothing to someone else.

I agree. We who have not been through these experiences (yet) don't really understand or know. We can empathize. But the words can be quite inadequate.

[Frances]

RD, they know because she's in a place where they remember "him". This is why I would always get fired up at the "keep your mouth shut" brigade, because for many of us it doesn't matter. Our past didn't magically disappear after transition and some of us make our living in fairly small industries where there is no escaping it.

We should all remember that advice given from the benefit of our own experience is sometimes worth less than nothing to someone else.

To be fair, I keep my mouth shut with people who did not know me. It is the only way to be sure that I am perceived as a woman. It is very hard, however, to be perceived as a woman if everyone used to know me (like in the music scene). So, I am stealth when I can, like in my appartment building (which has 210 appartments; I don't want the janitors and tenants to talk about me and my past).

In my field and during job interviews, it's a connundrum. If I talk about it, they may get scared that I will be "all about it." If I don't talk about it, and someone recognizes me, then the information passed along may be incorrect ("I don't want a man in my bathroom!").

Not to be conceited, but the fact that I pass so well and that I am fairly attractive is even worse. Male bosses who may find me attractive are even more weirded out when they find out (homophobia), and some women are angry that a "man" can look better then them (jealousy).

I try not to be a "tranny," but as soon as I leave my appartment, there are always situations where my transsexual past can catch up with me. If I left Montreal, I would keep my mouth shut at all times for sure, though.

[Badtranny]

I agree. We who have not been through these experiences (yet) don't really understand or know. We can empathize. But the words can be quite inadequate.

That's not what I meant. I have indeed been through the "experiences" and in regard to Frances, we are both transitioning right where we live and work. There is no secret, our past and our present overlap to the extent that virtually everyone who knew us then, also knows us now. My comment was for people who may have also done it, but have completely different circumstances and thus a completely different experience.


If I left Montreal, I would keep my mouth shut at all times for sure, though.

Well that's an entirely different bag of nuts then isn't it.

[EnglishRose]

What others have said - it really does depend on your features, how they react to hormones etc.

For me I would like rhinoplasty at the very least (a "nose job") - check out that huge schnozz on my avatar. :)

[Inna]

I suppose my own perspective aside from good close friends who had been there all along with support and love, I had disappeared from earth to all my colleges, acquaintances and occasional folks I would deal with during my 12 years of Dealership operations.
I have proven just week ago how far removed I was from the scene when I went back to see if I could change my first name on the dealer card at the local auctions which I am entertaining to visit in the near future.
Mind you the staff of 25 girls in the open area of main office floor knew me, joked with me, facilitated my purchases, some were on the first name basis and we always had a very pleasant time.
One of the dealer registration girls was one of the few closer associated.
I walked into the office and stood at the counter at dealer reg. she approached the counter, "Hi sweetie how can I help you" I looked at her and gazed into her eyes, but she was simply not recognizing the iota, expecting that some recognition would be rather inescapable, I simply giggled inside and said "hi, I'll like to find out if I can change users first name to show different on the badge", she asked for the dealership which by now is under different corporate name and ownership, and then for the name of the individual I was referring to.
At that moment I simply expected the spark of curiosity and perhaps slight hmmmm, I spelled the name, in very obvious male spelling, she typed it in and asked "what should be the new name", "Inna" I spelled and by this time I was waiting for her to shout "OMG, wait........YOU???!!!" But NOOOOOOOOO, she typed it in and looked back at me and asked if there are any furter changes to be made.

I was dumb found but also extremely satisfied that this just happened. Because next time if I decide to pursue this field once again, I will stroll into the auction and will be perceived as a new girl amongst those whom i have seen at least once a week for 12 long years.

So I am grateful for the OPPORTUNITY of loosing everything and resorting to living, surviving in the deep dark corner of a warehouse in the middle of nowhere, despite the loss of everything but truly NOTHING, I have gained freedom to be the girl I was yet newborn into the reality of my new life!

[Frances]

I was dumb found but also extremely satisfied that this just happened. Because next time if I decide to pursue this field once again, I will stroll into the auction and will be perceived as a new girl amongst those whom i have seen at least once a week for 12 long years.

So I am grateful for the OPPORTUNITY of loosing everything and resorting to living, surviving in the deep dark corner of a warehouse in the middle of nowhere, despite the loss of everything but truly NOTHING, I have gained freedom to be the girl I was yet newborn into the reality of my new life!

That's interesting. I guess could look for a job as my new self in a different field, but I am a translator. I can't not mention my work history, and prospective employers can look into my past. If my cost of living were not so high (rent, car expenses and bankruptcy settlement payments), I could change my career once again, but I went back to university for five years in my thirties for this. I can't lose myself, unless I give up on my career.

One translation firm owner appears to be so freaked out that even freelancing for them seems to be out of the question. And he would never see me or interact with me in person.

Honestly, I understand why so many are driven to prostitution.

[Stephenie S]

The prospect of employment discrimination is only too real for many TG women. And to think, many natal women are faced with this very situation their entire lives.

Stephie

And yes, many natal women are driven into prostitution also.

[ReineD]

Not to be conceited, but the fact that I pass so well and that I am fairly attractive is even worse. Male bosses who may find me attractive are even more weirded out when they find out (homophobia), and some women are angry that a "man" can look better then them (jealousy).

I never thought about that, but it makes sense, especially when you're pretty. Men can become pretty violent (at least in the news), when they've found themselves attracted to someone who "used to be a man". I so wish that people could understand about transsexuality, that TSs were never men to begin with, despite their sexual characteristics.

I'm not sure about the jealousy among women though. Young women who are looking for boyfriends may intensely dislike the competition if she is prettier or if she threatens to take her man away, but this is not the case in the workforce, especially among emotionally mature women. You would be working with women who are there to do their job, just like you, and who are not looking for office relationships? I have friends who are beautiful, and the only time I feel threatened is if I feel they have designs on my SO. lol

[Aprilrain]

I never thought about that, but it makes sense, especially when you're pretty. Men can become pretty violent (at least in the news), when they've found themselves attracted to someone who "used to be a man". I so wish that people could understand about transsexuality, that TSs were never men to begin with, despite their sexual characteristics.

I'm not sure about the jealousy among women though. Young women who are looking for boyfriends may intensely dislike the competition if she is prettier or if she threatens to take her man away, but this is not the case in the workforce, especially among emotionally mature women. You would be working with women who are there to do their job, just like you, and who are not looking for office relationships? I have friends who are beautiful, and the only time I feel threatened is if I feel they have designs on my SO. lol

OK, but there are GGs who are very unaccepting of TSes so what is it if not homophobia or jealousy? perhaps religion but that aside then what?

[Frances]

The prospect of employment discrimination is only too real for many TG women. And to think, many natal women are faced with this very situation their entire lives.

Stephie

And yes, many natal women are driven into prostitution also.

Woah Steph! I am not saying that I have it tough in a man's world now that I am a woman. My profession is dominated by women, including most supervisory position. Female translators have no problem getting work. As a matter of fact, there is reverse sexism in the profession. It is men who have a problem getting work, because according to stereotypes, women are more naturally gifted when it comes to languages. Male translators are kind of viewed like male nurses. I am having problems getting work because of my transsexual past, not because of my current gender. This has nothing to do with feminism and patriarchy.

[Frances]

I'm not sure about the jealousy among women though. Young women who are looking for boyfriends may intensely dislike the competition if she is prettier or if she threatens to take her man away, but this is not the case in the workforce, especially among emotionally mature women. You would be working with women who are there to do their job, just like you, and who are not looking for office relationships? I have friends who are beautiful, and the only time I feel threatened is if I feel they have designs on my SO. lol

Because transphobic women (and men) are comforted by the (false) idea that the line between the sexes cannot be crossed. It makes them feel more secure in their own gender identity. That is why old school drag queen performers will make it very clear that they are really men after their act. A trans woman who does not pass well is not threatening, but one who does is disturbing. People are often transphobic or homophobic because of their insecurities. This can take the form of cis-sexism, of which I have been the recipient many times in my office (I have been subjected to many comments in the bathroom for fixing my make-up; while GG's never received such comments), and it can take the form of jealousy.

[ReineD]

OK, but there are GGs who are very unaccepting of TSes so what is it if not homophobia or jealousy? perhaps religion but that aside then what?

You mean ALL the reasons that might cause non-acceptance of TSs? Gosh, there must be dozens, anywhere from religious beliefs, to a belief in the dozens of different types of movie stereotypes (think Silence of The Lambs or other horrible portrayals), to plain ignorance, to having been raised in biased families, on top of the particular brand of homophobia that many men experience (where they feel their masculinity is threatened if they believe themselves to be attracted to "another man").

Here's an interesting study in PDF format about the extent of the bias in our society and it's impact on TGs: "Injustice at Every Turn: A Report of the National Transgender Discrimination Survey (http://www.thetaskforce.org/downloads/reports/reports/ntds_full.pdf)".

Frances, if there are GGs who feel that their femininity is threatened by a beautiful TS (as long as she is not after her boyfriend ... in which case it would make sense :p), then honestly I just don't get it because I don't feel that way and I can't see another emotionally mature woman feeling that way. Not saying there mustn't be GGs who feel that way, I just don't understand them.

[Kathryn Martin]

It would be useful to find out why you are not offered a position. Once they have given the position to someone else it might be useful to have a conversation and find out what is behind this. While few would come and say they didn't hire you because you used to be a man, maybe some would talk given the right circumstances. If there is something else at work you need to know and if what you say is indeed so, then that would be important to know.

I also find that subtle undercurrents come from both men and women. Whether it's jealousy or an attraction that feels misguided after the fact to the attractee, I have had situations where I got the impression that men felt guilty because they found me attractive and then react with gratuitous behavioral violence. I was once told by a friend to whom I had confided that I would like bigger boobs to balance my appearance that: "you can't have it all" whatever that means.

While I have not been employed, I have "employment interviews" every time I am meeting with a new client. Now in my case it might be that most people likely know before I meet them that I used to be a man, and so there is a filter ahead of time.

I also find that we tend to face the same patriarchal behaviors as any woman.

Reine, that is an amazing piece of work, I reviewed some months ago.


Woah Steph! I am not saying that I have it tough in a man's world now that I am a woman. My profession is dominated by women, including most supervisory position. Female translators have no problem getting work. As a matter of fact, there is reverse sexism in the profession. It is men who have a problem getting work, because according to stereotypes, women are more naturally gifted when it comes to languages. Male translators are kind of viewed like male nurses. I am having problems getting work because of my transsexual past, not because of my current gender. This has nothing to do with feminism and patriarchy.

[Stephenie S]

Woah Steph! I am not saying that I have it tough in a man's world now that I am a woman. My profession is dominated by women, including most supervisory position. Female translators have no problem getting work. As a matter of fact, there is reverse sexism in the profession. It is men who have a problem getting work, because according to stereotypes, women are more naturally gifted when it comes to languages. Male translators are kind of viewed like male nurses. I am having problems getting work because of my transsexual past, not because of my current gender. This has nothing to do with feminism and patriarchy.

You misunderstand.

There is no question but that women are subject to discrimination in the workforce. I was not being specific to the field of translators. I was being far more general. There are, of course, female dominated fields. Nursing is one. SA is another. Hairdressers are mostly female also.

I am willing to bet that it's men, not women at the top in all these fields.

S

[LisaMallon]

This is a tricky one since it is so individual. Sorting out the masculine features of your face are key things to being accepted as female (for all the reasons everyone else has stated here).

From my (limited) research to date there seems to be 3 levels to this.

On the physical side how is your bone structure? If it is good then you are really just looking into face lift like things (ie soft tissue work).
This especially so if you are older and your face has all the various lines and sagging, etc. Male facial fat tends to congregate in slightly different places to to females (as it does on the body).
If you are young then it should redistribute over time on HRT. But if you're older then basically some of it could be permanent. Plus the lines it has created are there for all time.
So a 'tidy' up is needed, fortunately this should not be too major a process since it is purely skin and fat.

If your bone structure is more male'ish, then you are into more serious (and more expensive) things. Lots can be done nowadays on jaw shape (etc).
But it can be just one feature of your face that is the issue, e.g. a very square jaw. So getting 'everything' done may not be an issue.
If you are unlucky then you have several structural points that are predominantly male looking, then you are definitely up for some serious work.

One way to help you work it out is to look at yourself in the mirror and pull all the facial skin back (or use tape) so it is very tight and then just the bone structure is predominant. Now it does look funny but it helps you gauge how your bone structure really is. If by doing it your face looks much more feminine (albeit all tight and stretched) then you might be ok in that dimension.

In either case you need to wait a while until you get an idea of the full impacts of HRT on your face first.

The psychological factor is far more complex. Obviously there are the confidence and 'self image' issues.
The problem we all have is that when we look in the mirror we have all those memories of what we looked like and it distorts our perception. However we actually look we still see 'that face'.

So even if your face is pretty good naturally, you may end up wanting some sort of FFS just to help your own perceptions and hence your confidence (etc).

This is about my position at the moment.
As you know I see an image consultant who has worked with a lot of TS girls. This helps because she sees me as I am, not how I think I am.
And I think that it is very important to try and get some objective feedback. We are all our own worst critics.
Now I have a very fine bone structure and she assures me that when the hormones soften my face a bit I should be ok. There are all sorts of tricks with hair, (in my case) spectacles and makeup.
But, being 55 I have some deep lines and a bit of sagging and some fat distribution around my chin (which makes it look larger than the actual bones would make it). Will these change .. maybe. If I had been younger when I started then that would might have done it.
But my feeling is that at some point in the next couple of years I'll need some 'nip and tuck' work to reverse all those decades of T, if for no other reason but to increase my confidence in presenting myself.

There are 2 other options of course.
One is if you are as short sighted as me, always take your specs off when you look in the mirror ... one fuzzy blob looks just like another. And if you keep them off when off going out you never notice anyone looking at you strangely (especially if you have put your mascara on your lips)... though walking into lamp posts all the time really hurts. The other is to a get a pair of enormous implants and always wear low cut tops .. I mean no one will look at your face anyway ... lol.

Joking apart, I think we are in the same place at the moment. Waiting to gauge the impacts of HRT (etc) and doing research.
But try and get some objective feedback from someone to help you work it out. But not a surgeon of course, since they do have a slightly vested interest.

[Pexetta]

The prospect of employment discrimination is only too real for many TG women. And to think, many natal women are faced with this very situation their entire lives.

If only natal women had had the sense to have FFS...

[ReineD]

If only natal women had had the sense to have FFS...

Lol. I wish I could afford it, not bone shaving or sculpting or anything, but all the "lifts". :p

[LisaMallon]

Lol. I wish I could afford it, not bone shaving or sculpting or anything, but all the "lifts". :p

I agree, which is why I'm taking the 'slow' path. This not a whim it is serious money and serious risk management.
Every time you go under the knife there is a risk.
Worse if you have general anaesthetic. The risk are obviously .. well death. Dying under anaesthetic does happen.
The infections, god help you if you get one of the 'super bugs'.
Then the risk of loss of feeling, even just a 'face lift' can cut nerves and you lose feeling, worse even function .. 'my face looks good .. except for the drool'.

So, my way is slowly, slowly. See what HRT does. Work on makeup, hair, (etc). Review in a year.
You can get so desperate to be a woman that you can really screw things up if you are not careful.

As I always say, I want to transition to being a woman .. not a corpse.
Take a simple example: if you are on HRT and you are 50+ ( probably even 40+) and you are not taking daily aspirin then you are being a bit silly.

Caution, take it slow and steady (Emmi I am talking to you).. you will get there. I will get there.
Be careful of the knife, hair & makeup can cover a lot of sins .. as most GG women know.