Here I was at the end of March or the beginning of April 2016. I had met with a number of surgeons looking not only for information on what procedures would benefit me the most, and who I felt had more experience, but also I was trying to read in between the lines. Speaking with the surgeons gave me a sense of who they were as a person. The personal connection was and still is very important for me.

By this time I had quotes from each of the surgeons, and after speaking and getting to know them initially I had decided that FACIALTEAM was my best option.  After all this work it was time to focus on the actual surgery.  Thanks to my interviews with the surgeons and the report and images from Virtual FFS, I had a much better idea of what would work for me, but I still had to decide on the actual procedures. It was also time to put a figure on how much FFS would be.

The decision process was somewhat hard as it was an iterative process, and in between iterations there was lots of waiting time. Ok, maybe not lots of time waiting, but back then it certainly felt like it was long. You’ll see why below.

Stage 1.- The Least Possible

Facialteam quote
The first quote from FACIALTEAM

In my first consultation with Dr. Simon from FACIALTEAM I told him that my objective was to get the least amount of procedures that would give me the best bang for my buck. I had never had surgery of any kind more than my wisdom teeth, so least seemed to be better for me then. After that initial Skype consultation my patient coordinator sent me the first quote with just the basic procedures as suggested by Dr. Simon. Here’s where my waiting started.

It took a few days, which now I understand why, and on top of that, the time difference with Spain made it so that my emails would be read the day after in Marbella. The reason why it took time is because the surgeon takes some notes during the consultation. Then he passes those to the patient coordinator who then in turn sent me a quote based on what the surgeon and I discussed. The quote includes the fee for each of the procedures we discussed plus a few other items.

My first quote only had a rhinoplasty, or “nose job” – I hate that term, I think it’s so pedestrian, a lip lift and a mentoplasty (or chinplasty, AKA genioplasty). The quote also included hospital, meds, operating theatre, 2 nights at the hospital, the cost of the general anaesthesia, and other materials like pre and post CT Scans. I explain this to show that a surgical quote is not only “for FFS” or “for the procedures”.  Rather the total on the quote is a combination of procedures and how these affect other costs. For example, the longer the procedures take or the more procedures you have, the longer in the operating theatre incurring a larger fee. Same goes for the anesthesiologist and the surgical materials. Often we just want to know “the price”. Now I know that the total for a quote depends on the combination of procedures done at once, which also depend on the individual patient.

With that first quote from FACIALTEAM in hand I tried to compared it to those from the other surgeons to see the price differences and see if it would make much of a difference. At the end it was almost impossible to compare the quotes. The other FFS surgeon that I had seen over Skype had quoted me on a much longer list of procedures, making the operating theatre time and anaesthesia also higher. That other surgeon’s quote did not include hospitalization fee, so that would also needed to be calculated.

Stage 2.- Waiting Meant I had More Time to Wonder

This is the part where the waiting was bad news for me. My mind started drifting, thinking and considering or rather fantasizing of all sorts of alternatives.  Specially after comparing the quotes from the FFS surgeons, or rather the list of procedures, my head then switch to a different mindset.

If I was going to go through the whole expenditure of flying to Marbella, pay for my stay at the recovery home and go through general anaesthesia, why not get “everything done”? After a few days of mulling this idea I contacted my patient coordinator at FACIALTEAM and asked for a quote with “everything” that I thought I could get done. Of course this updated wish list was based on what I thought I could get done and not on what I needed. I was asking for what was in mind and not on what made sense.  Again, after a few days between time zone difference and their internal communication process, I got a reply with the surgeons’ recommendation of not going crazy. Their suggestion was to have another Skype consultation to discuss what were my new objectives. This time the waiting would be longer as the date for my next Skype video conference would be all the way in August of 2016.

Throughout this whole process I simply could not make up my mind about getting a hair transplant done in Marbella with FACIALTEAM or with one of the local surgeons I met earlier in March. The question of doing the hair transplant in Spain or at home was the last one I was able to answer. The variables that I was considering had to do with FACIALTEAM’s approach to hair transplant. FACIALTEAM typically harvests hair follicles from the coronal area at the time of a forehead reconstruction rather than the occipital area. Another variable was the fact that the surgery date if I had the hair transplant would be sometime after March 2017 while without a hair transplant it would be in October of 2016 or February 2017. To answer this question I needed to hear from Dr. Simon. That would put the brakes on my own mental speculation of what would be best.

Stage 3.- Final Fine Tuning

During this longer wait period to meet with Dr. Simon again over Skype many ideas came and went and some morphed into other ideas. Finally it was time to see him again and get my updated collection of questions answered. Like on the first Skype consultation I felt a good connection with the surgeon and he answered all my questions. He made a few comments that some of the procedures were not necessary but if I decided to get them done a small improvement would be visible. These were a jaw reduction and trachea shave, which in my case were not too bad. They wouldn’t be as dramatic or beneficial as the rhinoplasty, lip lift and chin, but they would add to the whole “smoothing” of my face, which is what I was looking for in the first place.

One thing that I’ve learnt through my own process is that every little bit counts. We recognize gender on so many attributes that when you come from presenting male to female EVERY detail counts.

Stage 4.- The Actual Shopping List

After a few quotes and Skype calls I felt confident with the following procedures from higher on the face to lower:

Facialteam Final Quote
The quote of procedures I decided upon.
  • No forehead reconstruction and no hair transplant. I was mostly convinced that I didn’t need a forehead reconstruction and that it would be faster if I had the hair transplant done at home 3 month after FFS. Otherwise if I had the hair transplant with FACIALTEAM my surgery date would been sometime late in Q1 or early Q2 2017.
  • Rhinoplasty to reduce the projection and smooth the features of my nose.
  • Lip lift to make the lips/mouth/nose complex smoother and hopefully show more of my teeth.
  • Chinplasty to harmonize the lower third of my face.
  • Jaw shaving to round up the back of my jaw.
  • And trachea shave to reduce my somewhat smallish Adam’s apple.


Although the process was fairly uneventful on one side, on the other it was full of doubts and questions that only I could answer, but not without getting information from the surgeons. It was an iterative process that had a few waiting gaps in the middle. During those waiting gaps my mind would start to complicate things as doubts and questions came about. I wish it would be easier to get access to the surgeons, but now I understood the difficulty in that. They are busy performing lots of surgeries a year, traveling for consultations and presenting at conferences, and of course they’re humans that need holidays and time off.

Back then I was not on Facebook, which I’m so thankful for. Otherwise if I had been there, getting more feedback from other past patients and other prospect patients my mind drifting may have been even worse. The process was mostly me, my thoughts, and the information I received from the surgeons themselves and from their websites. I did get help from my family, specially my aunt, who I bounced my thoughts over to helped me decide.

P.S. I don’t include the quoted prices as I believe that to be a fairly personal thing, but if you really want to know, please use the comments area below and I’ll get in touch with you.


7 thoughts on “4 Stages to Choose my FFS Procedures

  1. Hi Franches,

    First off, thank you for the blogposts you’ve shared about your process and journey. I’ve personally found them very useful as a resource and organized in such a way that it’s grounding to revisit while still in the planning stage. I’m writing because I’m wondering if you’ve written anything on your the experience of getting hair transplants (and if not, if it’s something you’re comfortable with sharing)??

    1. Aw, thank you so much for your feedback! 🙂

      I think the only things I’ve written about my hair transplant are in regards to how I decided on it opposite to getting a scalp advancement. The idea of a scar [from a scalp advancement] that big on my forehead makes me shiver.

      I guess, in general, I can say that the experience was less of an issue than I had anticipated before going through it. I was concerned how I’d look as the hair was growing, specially the first few weeks and months. But I just managed to comb my hair sideways, as I’ve always did to cover my widows’ peaks, and just managed. As a reference my HT surgery was in early January 2017 and by early February of the same year I was at the first USPATH conference in L.A.

  2. Franches, Thank you for providing your blog.

    I find comfort knowing that it is best to keep the multitude of counselors to a minimum to only those who NEED to know.
    At this stage, I foresee five procedure groups – FFS, Voice, Bust, ZDV, Hair removal.

    Thank you again,

    1. You are very welcome Joan!
      At the end it’s up to you and what makes you comfortable. Some people feel more comfortable having more counselors while others like me like to keep a more concise group.
      I wish you the best as you progress through your different steps. 🙂

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