Hey folks, me again back to detail my experiences at Yeson.
For a summary of my decision to get VFS, I had always been curious about VFS and some of the promises it made, but it was never a priority for me as my voice has always been assumed as cis. Frankly I've received a lot of compliments about my voice and in the past had people accuse me of lying about being trans on the basis of my voice. None the less, I was still curious. My voice was always decidedly in the lower register of the female ranges, and I wanted it to be more average.
In recent years I noticed the pitch of my voice come down a bit and it became increasingly difficult for me to even reach the prior speaking pitches/it required a lot more concentrated effort. At a certain point the absolute higher range became inaccessible. As I approached the higher range I noticed an air leaking sound in my voice, picture opening a bottle of seltzer water very slightly. Additionally I had developed a vocal tremor. My voice also tended toward vocal fry a lot so I started needing to control my speaking differently to avoid every word turning into a fry sound. I needed to speak very punchy with a lot of air pressure to compensate for these things. These were all things I had observed that led me to deciding I would seek VFS and see what was up and if any of this could be corrected.
It could be a complication of numerous intubations, or even a tracheal shave procedure, but I never collected enough data to say conclusively if A led to B. It could also be that because my vocal training was self directed I was doing it "wrong" and slightly straining every time I spoke for almost 15 years, and it just has this kind of end result. Regardless of the why, I know the what.
Now, into the actual details.
Travel to Korea
The flying was uneventful. I have airline status and bought nice seats, spent some time in the airline lounges yada yada. I arrived, there were taxis waiting, I got one, and it took me to my hotel. I stayed at the Entra Hotel which is maybe half a block away from the clinic. It does require one street crossing, the walk was less than 5 minutes door to door. I stayed in one of the "superior king" rooms with the nice views and a fancy bathtub that looks out the window.
The hotel is nice, the hot breakfast is not vegan friendly unfortunately, but the buffet had options and was nice and easy. The staff are nice and have likely dealt with a few Yeson clients and were quick to assist me reading messages off my phone. There's a supermarket maybe 3 blocks away, called SSG. Definitely stop there, buy some extra water and some snacks for yourself all that good stuff. They give you 2 bottles of water per day at the hotel, and will provide more on request.
For the consult they had the clinic staff responsible for arranging transportation for the clients pick me up, take me to a nearby hospital, he arranged everything I just had to follow him, get a chest X-ray, then he drove me to the clinic. This too maybe half an hour total, way more efficient than US hospitals or urgent care centers.
At the clinic I had to fill out some paperwork that detailed my feelings about my voice. There is a general form about vocal disability and then a trans specific form to fill out. Some forms and charts may have your sex listed as "T." This is better than misgendering, though I'd prefer if it said "F" I'm not about to wage a war against medical practice in Korea to get them to change this. It might even be legally required for all I know. Regardless I still wrote F everywhere it asked, and they didn't care.
At the clinic you'll meet with the international patient care coordinator who will help you out a bunch throughout this process. She'll bring you to a room where they have you do a standard vocal exam. You have to read some stuff in a lower voice and a higher voice. I'll admit I was anxious during all this so I think I limited both ends of my range as my voice gets tight when I'm anxious. I wasn't anxious from worry, I think just from being recorded and wanting to do the best I could or something. Not really sure.
Anyway you do some tests, they stick a camera down your throat and observe your vocal folds. Then they take you downstairs, draw some blood, do an EKG. All standard stuff, and the coordinator is with you the whole time to assist you so you don't need to be worried about not speaking Korean.
Then you meet with Dr. Kim, he'll have you do some more exercises, he'll stick a camera up your nose this time, and then will answer any questions you have while discussing what he sees. This is where things got interesting for me because there was a physical reality behind each of my observed symptoms. My vocal folds are asymmetric, I sort of twist my whole vocal instrument when I speak to accommodate for this, my vocal folds do not actually touch when I speak leading to some of those other issues, I speak with 3-5 times the air pressure of a normal person, and consume about 8x as much oxygen speaking as well as a result.
Dr. Kim theorized this all might be the result of just how I've used my voice over the years, but had a few other potential theories including potential injury at some point and so on. Regardless he assured me that his approach would actually address my concerns if I was diligent about following the care rules. And I will be, I always am.
This process took maybe 2 hours in total, but we did a lot so there's not a lot of doing nothing. It goes by quickly.
Surgery day is easy. Walk 5 minutes, get myself prepared for surgery, lay on the bed. I chatted with the care coordinator for a bit, the nurses put your hair up and put a hair bonnet on, you meet with the doctor, the anesthesiologist, and sign some papers then you walk to the OR and get put under and that's that. It's all super standard stuff like every other surgery I've had. Easy peasy.
You wake up and will probably have a sore throat (3-4 discomfort for me) and some discomfort swallowing (3-6 depending on if it was a good or bad one). Especially if you typically swallow "hard." I found it more comfortable if I had my chin at 80-110 degrees angle with my neck. Might vary person to person. You are advised to practice circular breathing in through nose out through mouth, so do that. You might get a little phlegm, I didn't at this stage, but make sure not to cough or speak. You'll get nurse visits at noon, two, and four. At four you'll meet with the doctor before you get discharged, and he'll do the camera nose thing again and repeat the care instructions.
They usually bring people ice cream I guess, but I'm vegan and so they brought me some insanely good pumpkin soup that I need to try to recreate. This will come around noon with that nurse checkup. Just try to sleep as much as you can honestly, but you can get up and play on your phone or something if you prefer.
The follow up was two days later in the late afternoon. They do the camera nose thing again, take some pictures, go over the care instructions again, answer any questions you have in written form, do not speak. You get a copy of the pictures, and a copy of all the exam and test results, you get some pills you might have to take depending on the 3 month follow up audio results, you get a USB device with some of the recordings they took and some follow up videos and all that. I really think these videos are super neat, and I get to see the patterns I habituated, where I really narrow the area I'm speaking from and all that. Cool stuff.
In my case there was some raw and slightly bloody looking area near the former anterior commisure, but not on the folds themselves., this may have been due to coughing in my sleep. I had worried I coughed and spoke in my sleep the night before as I dreamed vividly about it and woke up immediately after, but I wasn't sure. I raised this with the doctor, he says botox will help prevent this from happening. I think it may have also been due to just how bad it hurt to swallow a few times, but regardless he said it was nothing to be worried about and that overalll it looks fine and should heal if I stick to the care plan. There will be some sloughing looking skin above the stitching, it'll look weird, but it's fine and part of wound healing so don't be worried there. If you've had other surgeries, you know what this is so you'll not be scared.
You'll meet with a speech pathologist who covers the follow up training you have to do starting at 2 months to connect your brain with the new action of your modified vocal folds. I'm told this training is essential to get the full benefit of the surgery, so make sure you do it. The exercises are very simple and will take you maybe 15 minutes, 3-5 times a day as advised. Do one in the morning, one before bed, and fit in the others anywhere else.
Then I met with the doctor again, he injected botox into the muscles around my vocal folds to help correct the tremor and also to help prevent potential damage to the surgical site thru coughing or all that. They come in through the front of the neck so be prepared. For some reason the second one scared me a little, so be prepared for more than one jab. I did notice less static discomfort overall after this, but you know botox does block up the nerves so it might just be that I can't feel the pain.
They use much less botox than say you'd get in your forehead, so it should wear off somewhat quicker and not lead to any long term muscle atrophy, though there may be in the short term after 2 months of not using so be prepared for a tired voice when you start training again.
You'll be advised not to tip your head back with a mouth full of liquid to avoid aspirating any water while the botox is in effect, so just do that. Essentially your vocal folds will be paralyzed wide open, so it would be easy to aspirate water and you don't want the resulting coughing fit.
Largely uneventful. I made sure to let the flight attendants know I couldn't respond verbally and just kept my requests simple. Like writing "water please" before they got the beverage cart to me so I could just hold it up. They were all sympathetic, likely because I'm not old and look overall healthy so they felt bad for me and wanted to help.
I'm home now, drinking my usual 4-5L of water per day, crying that I can't have coffee, chocolate, or spicy food for 2 months. Making sure not to speak or talk and just waiting to see if this was worth the 9k lol (I'm sure it will be)
Anyway, not too much to note, it was very uneventful, the area being operated on is like 1.5cm big so there's nothing major to discuss with you all like some of my prior surgeries. But yeah here it is! Feel free to ask any questions. I'll follow up later once I can speak to let you know what's going on.
Currently I feel no pain, occasionally very slight discomfort when swallowing, haven't had to cough, had to stop myself when I was about to speak a couple times. I noticed how much I occasionally mouth words to myself when I think them, so trying to make sure not to do this as well.
My throat feels maybe slightly heavy? I think I was subconsciously keeping my larynx elevated for the last 15 years, and so with botox weakening the muscles they get extremely fatigued when I try to do this without thinking lol.
If I get a lot of phlegm build up and feel like I have to cough, I bend over and let it kinda grossly slide up more toward my mouth, and then it's easier to clear via swallowing.
Prior Yeson related post: https://www.reddit.com/Transgender_Surgeries/comments/10vj6kyeson_first_contact_thru_booking_current_price/
I have what might seem like an unusual/ not typical hair transplant question.
For someone who has extensive balding and/or a limiter donor area and wants to get a transplant with a lower, juvenile hairline (like Norwood 1) but is unable to do so due to A) the limited donor and B) the need to reserve additional donor hair for potential future hairloss, can they get a transplant that utilizes less grafts to create a highe more conservative hairline and then at a later time (after the grafts have grown in) get a scalp advancement/forehead lowering surgery to bring their hairline down to the position where they want it? Since the initial, higher hairline was created with donor hair, they wouldn't have to worry about it receding after the advancement procedure and revealing a surgery scar.
In doing this approach, it seems like a good solution and kills two birds with one stone: it ultimately results in you having the lower hairline that you are seeking while simultaneously using less grafts and reserving them for future hairloss in other areas of the scalp.
Any thoughts? Is this a possibility and has anyone done it or know someone who has done it?