Deschamps-Braly Clinic of Plastic & Craniofacial Surgery

I wanted to update my review to help others see how much Dr. Deschamps-Braly can change your life. I went into surgery not knowing exactly what to expect, but I trusted him because of his reputation. I really felt at ease after the consultation. I still was not sure what I would look like, but I had high expectations. My results exceeded all my expectations. The masculine aspects of my face were immediately gone when the bandages came off, but over the next six months, my results just kept getting better and better, especially my chin and jaw.

In the years since, everything about my life is better. I am more confident, I am immeasurably happier, and I am frequently complimented by strangers. It has made everything in my life easier, from walking down the street to job and school interviews. It's especially been amazing to get into dating after FFS. To be considered attractive in the way I have always wanted can't be described until you experience it, too. Dr. Deschamps-Braly gave me the life I dreamed of having.

I hope this update helps you make the same decision I did. Choosing Dr. Deschamps-Braly is the smartest decision I've ever made !

I consulted with two surgeons before selecting Dr. D. The other doctor was fine. Dr. D and his staff have all been absolutely incredible.

He's effortlessly charming but doesn't misuse the charm; he is clear about potential complications, where people have been unhappy, etc. He has the strongly held professional opinion that one should go a bit past the female average when doing facial feminization surgery, so he makes his recommendations accordingly, but ultimately listens to the patients' wishes. He was careful to ask me what I wanted before sharing his own recommendations, and particularly touched on whether I was going for androgyny or femininity.

Ultimately, I picked Dr. D for his aesthetic sense. You can see it in every detail in the office architecture, in the experience he and his wonderful staff gives their patients, and in the after photos of the many people he's worked on. I hear it all the time from the dozens of his patients that I personally know. I wanted a doctor I could trust with my face, the thing that everyone sees first when they look at me, and I feel incredibly confident about the surgery I'll be getting a week from day.

One area where Dr. D could do a bit better is mock-ups. He acknowledges that his are not the best. I ended up hiring a friend, also trans and an artist, who photoshopped me some mock-ups of what I might look like. I took those mock-ups with me to the pre-op and they were really helpful in showing Dr. D what I wanted for my nose.

You meet every member of your surgical team beforehand. This is so important. Some doctors will have students work on you. The only team member I met day-of was the anesthesiologist, who Dr. D works with a lot.

I expected to be basically in bed for the first several days. I got home, slept for several hours, and then was ready to go for a walk (they want you to walk two hours a day for recovery). I expected pain but there really wasn't any -- just discomfort and some strange nerve sensations and some numb spots (my chin, the top of my head, part of my nose). Most bandages came off five days later, and the nose cast came off a week after surgery. It was exactly the nose I'd asked for in the pre-op (the femme version of my original nose).

Recovery went so smoothly and so quickly with limited exceptions. I remember that Dylan Mulvaney got her surgery just a few weeks before me from a different doctor. She was as swollen at three weeks as I was at one. I credit this to the pre- and post-surgical diet the team required, which was low sodium, low carbohydrate, low blood thinner. Anecdotally, this diet makes a huge difference in swelling for other plastic surgeries as well.

I'm two days short of six weeks as I write this, and so happy about the outcome. Dr. Dr promised me I'd look feminine but couldn't promise me I'd be pretty, but now I'm definitely both, with still a lot of healing to go. I expected facial surgery to eliminate a lot of dysphoria, but I didn't expect it to eliminate most of it. Before if I saw myself doing a pull-up in the mirror, the muscle gave me dysphoria. Now, I see a pretty girl doing a pull-up in the mirror, and she's strong!

Of course, nothing is perfect. Here are some caveats and downsides you might want to know about.

* Firstly, if you are a vocalist, you might have an extremely distressing time with the trachea shave. At six weeks my range is severely limited, I have dysphonia, I can't do falsetto. Everyone assures me that these things will come back in the next two months because Dr. D has a flawless track record with trachea shaves, but it's been by far the hardest part of surgery recovery for me. Even for speaking, I'm stuck in Chad voice right now and it's really hard. I think the clinic could have done a better job of providing guidance -- perhaps arranging a consult with an otolaryngologist with a vocal specialty to make sure everything is healing okay.

* The clinic could do a better job of dealing with people who might have GERD / silent reflux. These can complicate laryngitis. If you have this, consider taking a course of prilosec.

* They give you a scopolamine patch behind the ear in recovery. For some people, scop makes it difficult or impossible to pass urine, which can cause you to be re-catheterized.

* Your face will be asymmetrical in different ways than it was before, and this might bother you.

* Don't expect to eat solid foods for a while. I had to order soylent, and then order more soylent, and more, and more, and more again. Even now that I'm eating mostly solid food, I still drink a lot of soylent, because my jaw is healing still.

* The hairline scar will be bad for a while.

* Talk to your doctor about low-dose oral minoxidil to reduce shock loss. The topical only works for some people.

* Find an existing patient and get an invite to the surgery discord. I don't know what I'd have done without that community. What an amazing group.

I was standing, pigeon-toed and awkward, in the corridor outside of Dr. Deschamps-Braly's office, holding my x-rays. I heard a voice behind me saying, "You wouldn't happen to be going in here, would you?" It's the doctor himself, radiating kindness, competence, and looking just casual enough, with a nice suit and an open shirt collar. He shook my hand, let me in, introduced me to the staff, and disappeared into the back to prep for the appointment.

It was nuts, at that time, to be treated and addressed appropriately (and warmly) without so much as a batted eyelash by the entire staff. The whole clinical experience is very luxurious and a little intimidating if you've never thought of yourself as "the type of person who gets plastic surgery," but trust me, they see the person inside, too; they're all wonderful people who went above and beyond before and after the surgical experience.

I knew from the beginning that I wanted someone extremely experienced with doing facial feminization surgery, and especially someone who could do the type of extreme brow reconstruction that can turn a "chad" brow into an authentically feminine appearance. Dr. Deschamps-Braly impressed me with his extreme level of technical depth in that area. It's all very mathematical. I just said, "Give me the face I would've had if I'd started hormones when I was a kid," and he devised a plan of how much he wanted to take off, and where, on the spot. I initially wanted to hold onto a little nose character, but he convinced me quickly to get a "ski jump" nose to seal the deal in terms of a feminine apperance.

It was also really charming that he accurately pegged me as a goth and delved gleefully into pictures of how the brow reconstruction looks while it's in-progress. You aren't going to find those pictures on the internet; it looks far more grisly than it actually is.

The surgical experience went as well as it possibly could've. I woke up after dark. The nurse who monitored my recovery was really fun to hang out with, and, like the rest of the staff, saw the person inside.

I enthusiastically followed his post-op instructions, and recovered rapidly. Walking is extremely important for healing and drainage, and at the time (six months prior to CoViD) walking around looking like a potato woman wasn't too dodgy. As for pain - well, it was discomforting. There was a lot of swelling and it felt like I'd hit pavement or been in a fistfight the previous day, but I wouldn't call it "painful." Ibuprofen and acetaminophen, were enough to deal with the pain and inflammation as long as I took them on-time.

As for the results: I found it hard to process at first. Similar to what Natalie Wynn (Contrapoints) said in her review of a similar procedure, I woke up and I was like... okay? This is good, I guess? And then, especially as I hit week 6 and beyond, people started staring at me in astonishment and gushing about how beautiful I was. I'm skeptical of the entire concept of beauty, and I tend to see beauty more in terms of how you carry yourself, who you are, and how you nurture your personal growth over time, but apparently whatever pretty privilege is, I have it now. *Gulp*.

Life after lockdown is going to be exciting. :)

-Age: 25
-Gender: Male (FTM)
-Procedures involved: Adam's apple augmentation, genioplasty, jaw implants, rhinoplasty
-Years transitioning on HRT prior to this procedure: 3

The man has many glowing FFS reviews but his superior abilities as a facial masculinization surgeon are not to be underestimated.
Dr. D completed the world's first ever female-to-male (FTM) facial masculinization surgery, including his new Adam's apple procedure which he performed on me. The drastic results after just four weeks are pictured below.

My name is Allen and I identify as male, even though for 22 of my 25 years walking this earth I was called 'Allie' and friends knew me as a girl.

The experience that I had at the DB clinic has been unlike any of 7 previous gender affirming surgeries I have had. Throughout every step of the journey, Dr. D and his team have treated me exceptionally--with great love, care, and attentiveness, and as a member of their family. They have changed my life forever, and they will always be a part of me. When I look at myself in the mirror, their artistry and the love that they put into every single aspect of it smiles back at me in the form of a face that finally feels like my own.

Since this procedure, the swelling continues to decrease and I've become more confident in my body. Most notably, for the first time I see myself as a man. I am still without words for the feeling and sense of aliveness that that brings me.

I can wear many clothing options now, and I don't worry about misgendering myself, which I wasn't even aware I was doing until I realize now that I'm not doing it anymore.
I didn't realize the profound effect this surgery would have on me.

Each member of the DB Team played a unique, integral part in transforming an otherwise potentially scary surgical experience into one of the most special, meaningful opportunities of my life.

I had about everything done for FFS, and I can say with certainty that it was worth it. I knew this even when I was swollen and mummified in bandages. It has been a few months since then, and I have never been happier. The face in the mirror isn't something I hate anymore, but something to smile at. That change in attitude has had a huge effect on my life, and it shows in my eyes and how I interact with the world. I'm not afraid anymore.

Additionally, Dr. D's team is excellent. Everyone in his office treated me with a personalized kindness. And speaking of his office... It's probably the coolest you'll ever see. The post-surgery care is the best there is: the private nurse assigned to me was an angel that I will never forget. Lastly, I was able to email Dr. D's team whenever something came up and receive a prompt reply. There is a lot to remember in post-op care and having such resources available was (and still is) awesome.

I should also mention that I am mixed race, being both Chinese and Caucasian. Despite this, Dr. D was able to maintain that subtle balance. The result looks perfectly natural. I would post pictures but I'm shy!

I had the works done for my FFS with Dr DB. I am extremely satisfied with the whole process, and the incredible hospitality along the entire process. I felt like I was in good hands as soon as my consult began.

I had seen before and afters on the internet, that really impressed me over the years. But it was really the consultation, how thorough it was, and how detailed the plan Dr. DB laid out for me ended up being that sealed the deal. I had a very pronounced brow, and just a lot of other masculine features and facial asymmetry, and that's almost all gone now. And the whole result look so stunning, all in all.

I'm eternally grateful to Dr. DB and his whole team for giving me a new lease on life.

I called Deschamps-Braly for a consultation for a non-surgical RF procedure and I was told they needed to see pictures of my face before they would schedule me. Melissa said they have weekly meetings every Friday morning where they discuss prospective cases and my pictures would be reviewed at the meeting. She then sent me a detailed e-mail of all the different angles of my face that I needed to send photographs of.

I wasn't comfortable doing this, so I replied to her e-mail explaining that I was not comfortable sending pictures ahead of time and that I would prefer to be evaluated in person. (I didn't want them evaluating me based on my amateur home photos without even seeing me! What?)

I asked if it was a requirement for me to send photos ahead of time in order to book a consultation and she replied that it was! I was shocked. I replied that I would pass, then. Here's the kicker, I was trying to book with their NURSE for this non-surgical procedure and not even the doctor! Who requires photos ahead of time to consult with the nurse??

I've been to several doctors / nurses in the past for occasional cosmetic treatments and never have I have been required to send in half a dozen photos of my face prior to seeing me. Ridiculous. Are they only looking for the easy patients??

I wanted to provide an update, as I had gotten some email notifications regarding my previous post!

What I Had Done
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Surgeon: Dr. Jordan Deschamps-Braly (San Francisco, CA, USA)
Date of Operation: April 14th, 2017
Cost: ~$50,0000 USD
Procedures Performed:
- Scalp advancement
- Forehead contouring and reconstruction (Type III)
- Rhinoplasty
- Chin reduction
- Sliding genioplasty
- Mandible contouring
- Masseter muscle reduction
- Trachea shave

NOTE: I also had a hair transplant done 8 months later with a different surgeon, as Dr. Deschamps-Braly suggested I would have better success with the transplanted hair surviving if I waited until my scalp had fully healed from FFS.

About the Photos
----------------------------
The "before" photos are all taken within a couple of months of one another in the winter of 2017 with an iPhone 7 Plus. I am not wearing any makeup. There are applied filters that I am unable to remove. I had been on HRT for roughly 11 months and had done ~6 sessions of laser hair removal on my face. I was still presenting male in public.

The "after" photos were taken this past week (August 2020) with an iPhone 11 Plus. I am wearing some color corrector under my eyes, mascara, and a lip tint. There aren't any filters and no post-processing has been applied. I have been on HRT for almost 4 years now (4 mg Estradiol x 2/day, 100 mg Progesterone 100 mg x 1/day - I'm not taking spironolactone anymore). I have done roughly 12 - 15 laser hair removal treatments on my face, and I imagine I'll have to continue to do so periodically. I had FFS and I had feminizing hair transplants done 8 months after. I get botox treatments every 4 - 6 months and hyaluronic acid fillers once a year.

My Thoughts
---------------------
With regard to choosing a surgeon, to be frank, facial surgery is no fucking joke - both from a technical standpoint on the surgeon's end and an emotional one on ours. I met with a number of surgeons before I decided on DB, and I didn't feel confident with them for the following reasons: 1) their aesthetics didn't seem refined, which was likely the result of 2) not having performed enough surgeries to really hone their technique and style, and 3) I didn't feel like they were personally invested in me. Additionally, 4) they didn't have the necessary craniofacial training to be as aggressive as I was hoping with the bone structure in my face, and 5) they weren't up for the demanding task of doing it all in one shot - for context, my surgery ended up being 12 hours long.

Lastly, everyone has their own experience, but I can't say enough good things about DB as a doctor. When I walked into his office, back in 2017, I was still presenting male, doing my best guy voice, and despite all of that, he took my request to have FFS as part of my transition with seriousness and respect. I can't think of another time in my life that I felt so hopeful - like I had met someone who actually understood what I was trying to do and could help me get there. Most importantly, though, beyond his aesthetic sense and technical qualifications, I could tell he really cared; nothing demonstrated this more so than when I came to after the anesthesia had worn off, and he was the first person I saw. I have had surgeries before in my life - unrelated to my transition - and this was the only time my surgeon was there to wake me up. That, to me, speaks volumes - that someone would stick around and wait after having been on their feet for 12 hours straight instead of delegating a task to someone else.

FFS was, and is, the most impactful, transformative, and essential step I have taken in my transition. I was 29 when I started my transition, and it was tough to come to terms with the arduous path that lay before me as a result of avoiding the truth about my gender identity for so many years. Now, at 33, I can say that I still wake up every morning, look in the mirror, and am truly baffled that this is my life and not a dream. I am so grateful that I took the plunge, did the research, scraped together the money, and made this all happen - despite the hardships and challenges, both personal and financial, that resulted from those choices.

Dr. Deschamps-Braly performed a cheek, neck and lip lift with fat injections on me and I am a changed woman. My new appearance has taken 15 years off my face -- when you're 71 that's significant! It's not just the physical but the emotional and psychological impact has been profound.

I can't speak enough about Dr. D's warm, attentive, informative manner. He spent as much time with me as was needed and then some. Also, a big thank you to Zhanna, Amy and Jennifer, a wonderful team of professionals who were always there for me as well.

I had FFS back in May 2018 with another well-known surgeon. The results were 'ok' but not dramatic enough for what I wanted, so I had a consultation with Dr Deschamps-Braly in June 2019 for revision FFS. Their new office is amazing. I've never seen anything quite like it...

My surgery with Dr D. was in October 2019. Here's a rundown of the procedures I had done:

- Forehead contour revision
- Fat grafting (lips, cheeks and temples)
- Hardware removal from previous FFS
- Jaw contouring/augmentation
- Sliding genioplasty
- LeFort 1
- Upper lip lift

My starting point before any of my surgeries wasn't great, so I didn't have a lot of expectations for the surgery, especially after the results of my first FFS being not that dramatic. After I woke up from surgery and was wheeled to my hospital room I immediately took out my phone and took a selfie to see what I looked like. When I saw the shape of my new forehead I almost started crying. I couldn't believe that I now had a rounded forehead that didn't shadow my eyes. Even today, I still can't stop feeling my smooth forehead. The rest of my face was really swollen at the time so it was hard to judge the results of my jaw and lip lift. I spoke to Dr. D shortly after and he told me that, in addition to the 5 mm of bone that was taken off my facial height from my first FFS surgery, he took off an additional 12 mm of facial height using jaw reduction techniques, genioplasty and the LeFort 1. I was shocked. I didn't think that was possible. The most reduction that I had heard about in the past was 10-12 mm, for me it was a total of 17 mm! While most of the skin has settled to fit my new jawline, I'm planning on getting a neck/face lift to define my jaw a bit more. I somewhat expected that after having so much bone removed. Note about the LeFort 1 - It's a very expensive and invasive procedure, which requires 3+ months of surgical braces before and after surgery. Be sure this is something you want and that you don't have any other surgery that may be more important to you if you are using up all your savings on FFS.

I've had quite a few objective experiences that have verified I've had good results with the surgery.

My first flight that I took after I healed from my surgery resulted in additional questioning from the TSA because of how I looked in my photo compared to what I look like now. The agent said, "Do you have any additional form of identification?" ... "The photo on your passport is drastically different." This happened with no makeup and I rushed to get ready so I could make my flight on time. Thankfully I had my driver's license with me as well as my passport.

My orthodontist mentioned that Dr D. did an amazing job with the LeFort to line up my upper and lower jaw. (I had an under bite before surgery and a slightly rotated upper jaw) He didn't have to adjust the bands on my surgical braces at all to counteract any misalignment with my jaw and my braces were removed earlier than expected.

Also, my local plastic surgeon, that I go to for Botox and fillers, mentioned that whoever I went to for my lip lift did an outstanding job, especially since he had seen some really bad lip lift surgeries in the past.

If you have the funds or insurance to cover the costs of FFS, I would 100% recommend Dr. Deschamps-Braly, especially for any forehead or jaw work.

I do have to give a proper shout out to his staff as well. Melissa, Zhanna and Robin were soooo helpful and kind throughout the entire process. They were extremely responsive to emails and answered all my questions during pre-op and post-op appointments. It was such an exceptional process from start to finish.