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FACIAL FEMINIZATION SURGERY FFS AND SRS SURGEON LISTINGS
FACIAL FEMINIZATION SURGERY PROCEDURES

This is an account of my experience with Dr. Douglas Ousterhout and Mira Coluccio at Davies medical center.

The above photo is of me being freaked out while Mira is explaining to Dr. O about my chin Problems and I'm stting there scared to death about the composer of Dr. O's face as Mira told him my chin had been moving around not more then two weeks after surgery.

Updated 5-27-2005

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On April 8, 2004 I had facial feminization surgery with Dr. Douglas Ousterhout M.D., D.D.S. in San Francisco, CA.

As most transsexuals I heard of Douglas K. Ousterhout, M.D., D.D.S. through the internet by browsing the web on TG related issues. Like other transsexuals, I became interested in his facial feminization surgery (FFS) and what he could do with the male face to transform it to a female shape. So I was thinking about having facial feminization surgery for a few years as I was learning about transitioning.

I joined a group dealing with surgeries of that nature, so that I could research some of his work on other people and spent some time there while reading up about his surgeries from other people’s postings. I talked with some other women who had facial feminization surgery with him and was advised by them that he was a great surgeon and their surgeries went well. I also talked with a beautiful woman that had surgery with him and had problems with her nose and chin after having the works in pieces and she had to have it corrected with another surgeon after Dr. Ousterhout tried to fix her problem with a revision. I personally thought it was an isolated case and I would be fine if I had surgery with him. I had my first meeting with Dr. Ousterhout and Mira Coluccio on Dec. 01, 2003 for my consultation with Dr. Ousterhout. Mira and me made some small talk while he was running late with another consult.

I met with Dr. Ousterhout for about 15 minutes. He took a look at my face and measured my chin and told me the vertical height of my chin was too high and I would need a sliding genioplasty to reduce the height and some light jaw tapering to round the jaw just a little and I agreed. I advised him that I wanted to retain the current length of my chin and he agreed that the length was fine. I also said that I would like to have the chin come to a sharper point and he thought he could do that, but he also said that he would like to take some vertical height from the chin. He said that I would need a scalp advancement and would need to have a reconstruction of the forehead since the frontal sinuses are large, which is known as a type 3 forehead. He said I would need a rhinoplasty and I said that I would be grateful if he could give me what I call a ski slope nose with an upturned tip. He also recommended a thyroid cartilage reduction. He said I would not need an upper lip reduction. I asked if there were any problems with me having my surgery done in stages, a few things at a time, and he told me “no there is not a problem doing it that way.” He advised me that many of his girls have facial feminization surgery done in stages. He said that I had great cheekbones and very long eyelashes that women would die for. He said that I had a pretty face and he could improve on it a great deal with the procedures he would like to complete. He added his tagline that he does not promise to make me beautiful, but he can make me feminine. And what he wants me to get from his surgeries is to be able to walk to the door with no make up on to answer the door bell, and say it’s a delivery person, and when they see me with no makeup on my face, they will say “mam” to me even with no makeup on. From people I talked with before surgery this was the same thing that he has told them during their consult or something very similar. Mira gave me an updated statement for the cost of the procedures.

That's pretty much what he said in the letter he sent me regarding the photos I emailed him, except before the upper lip lift was listed and it did not include any personal comments about my face. I told Mira that I would think about it and also asked about how far out are their surgery dates for scheduling and she wrote some dates down on the new estimate she also wrote me which removed the lip lift. She said that I had a pretty face and was looking forward to seeing what I would look like with what Doug would like to do. So the consult went well and I went home.

On February 16, 2004 I decided to go forward with the surgery with three of the procedures to feminize my face, which would included feminizing sliding genioplasty, jaw tapering, feminizing rhinoplasty. I choose to have the nose done before the forehead since I had learned that Dr. Ousterhout had many unsatisfactory rhinoplasty results when the nose was done during the same time as the forehead. I figured that having the nose done in such a fashion would limit the amount he could reduce it at one time despite the fact it would cost me more to have the bridge of the nose done latter on with my forehead reconstruction. I asked if there was any problems with having the surgery done in stages and was advised by Mira that many girls have it done that way and there is no problem doing it that way. I asked her questions about my HRT and if it would cause problems or not and was reassured that HRT was not a problem.

I called Mira to schedule a date. I asked her if there would be any problem with me doing the chin, jaw and nose first and she said no, but I would have to have the bridge of the nose done in the future with the forehead and that it would cost me some more money and said that would be fine and that I did understand that.

So I said lets do the feminizing sliding genioplasty, jaw tapering, feminizing rhinoplasty and she told me that it would cost me $15,880 I had a feeling that was kind of low compared to the cost I was quoted in the statement she gave me after the consult I had with them that would have come to little over $21,000. So I asked her are you sure that sounds kind of low compared to the numbers I have to come up with and she said she was sure from her numbers. So I said O.K. and Mira took my credit card number over the phone for the $2,500 down payment and we talked about what dates she had free for a surgery date and the first one was April 8 and she advised me that was the earliest date they have open so I decided to take it even though it was my birthday. So the date was set and the waiting game was on.

Mira sent me a pre-surgery packet on March 5, with my prescriptions slip and what was a form letter type packet of information on what not to do and avoid and other details.

On April 7, 2004 my hubby and me went to San Francisco for the pre-surgery consult with Dr. Ousterhout. When we arrived in the office we were greeted by Mira and were advised that Dr. Ousterhout was in a consult and would be done soon and we could get some forms singed and out the way before we see him if I wanted to do that first and I said sure. So I took a quick look at the forms and signed until I got to a form that said what I was having done and I asked, “Why does it say that I am only having my chin and nose done?” “It should be chin jaw and nose!” Mira said that she must have miss-understood me when we talked on the phone and said that she would add it and that it would add a cost $5,240 to the total, so me and my hubby talked about that for a sec and agreed that’s very close to the number we had when we talked on the phone about setting the date. So the new total cost came out to $21,120, Mira and my hubby were talking about the surgery and Mira was telling me what to expect.

We were chatting with Mira about my nose and I said that I did not want the usual Dr. O nose that people have problems with since I have heard that people have had to fix it after that was done and Mira snapped at me saying “who said they had a bad result from the Dr. Ousterhout,” and I said Kim Reck (she had major problems with her nose partly collapsing before she had a car accident) and a few others who did not like the anime looking nose. Mira lost it for a sec and started going into a story about Kim Reck, which kind of scared me since I had been told so many times how nice Mira was. I dropped the conversion as fast as I could by saying there must be more to it and she dropped it. I didn’t want to worry more then I had to, so I thought it was best to drop it.

Mira then said that we should run over to the lab and have my blood drawn and Dr. O should be ready when we made it back and Dr. Ousterhout would be ready to talk with me. He went over the things I was going to have done and went into some of the possible complications that I could have and what to expect from surgery. I would only be in the hospital over night and should be going home the next day. Then he asked me if I had any special requests, and I said I would like to have the chin come to a sharper point than I already had and how I wanted the nose to have a more upturned tip to give it a more youthful appearance and to have my nose come down like a ski slope to a upturn tip as I described it to him like before.

I asked him how long after surgery it would be before I could have dental work done and Dr. O said that I could have it done in about eight weeks. And my hubby said “that brings up a good point” and asked “how long would it be before I could have the forehead done in the future or any revisions if we need any from the surgery Trinity is going to have?”

Dr. O said that he could do the forehead four months after the current surgeries and revisions could be completed three to four months after surgery. My hubby thought it would take a lot longer for everything to heal before I could have the forehead done, that’s why he asked. I said we don’t have enough money for the forehead yet and it would probably be about a year or two for that.

At the end of the pre surgery consult Dr. O said that he had not made any measurements yet since it was a long day and he didn’t have time yet, but he would go over the x-rays before he goes to bed and reassured me not to worry. Me and my bubby left thinking it was odd that he did not do the measurements yet and had some concerns about it, but came to the conclusion that it would be O.K. since he must do this all the time and people we talked with online, who have had surgery with him, said that he was the safe choice and considered the best surgeon for facial feminization surgery.

I was nervous all night and in the early morning. I fell asleep about 5 hours before we planned to get up to drive to Davies Medical Center for my surgery.

We made it there early and had to wait about 30 minutes before someone showed, and I filled out my forms. We sat in the sitting room until every one was called for surgery and taken to different floors and surgery preparation. I was advised that someone would be by to prep me and take some medical information from me. I was given a hospital gown to change into and pressure stockings to put on my legs to help prevent blood clots in the legs. I changed and laid down in the gurney. So me and my hubby were talking and I was surprised that I was joking around with my hubby and I was not too nervous, since I was happy that I finally made it to this point and soon I would all be back home starting my recovery.

A nurse came in and asked me some medical history questions from a sheet as he read them out while I was either supposed to say yes or no. Then he colleted my bag of cloths and had me sign my paperwork and I noticed that my jaw tapering was not on the paper work so the form was left there so Dr. O could add it. About five minutes later another nurse came in to put in my IV needle (not too found of needles myself). So the nurse and me were talking about the IV and she explained how it really is not a needle in the arm.

There is a needle used to place the IV into the vein and the item that stays in the arm is a plastic tube that is very small and inside the vein. She left and Dr. O arrived. He said that I looked all ready to go and he said that we are doing the forehead today. When he said that. I was sitting up in one quick move thinking to myself “””“OH MY GOD DID HE FORGET WHAT I WAS HAVING DONE SINCE WE TALKED YESTERDAY EVENING AND MIRA HAD ME SCHEDULED FOR MONTHS AHEAD OF TIME”””” I was holding myself back from saying that to him. And I said, “Are you thinking about another patient since remember I was having the chin, jaw and nose done?” And Doctor O replied, “Oh that’s right and your going to be beautiful.” He said that he was thinking about what he was going to do and has some ideas. At that point I was asking for valium and getting ready to bolt out of the hospital room and Dr. O said don’t worry you will be fine and my hubby asked about the form since it said that she is only having the nose and chin done and he said that’s not a problem and added the jaw to the form. Then he said that he would see me in the OR in about 15 minutes as a nurse came in to give me a Valium.

After Dr. O left my hubby and I were talking about what Dr. O said. I told my hubby that I feel like bolting right now since Dr. Ousterhout does not even know what procedures I am exactly having done and does not know exactly what he is going to do. It scares me to death that he does not know exactly since he is my surgeon. My hubby calmly was trying to put my mind at ease and told me that they already have the money and Dr. Ousterhout knows what he is doing since he is considered the best and has done this many of time before. My transporter arrived to take me down to the surgery level/wing and told me that my hubby could not go down there with us and we should say our goodbyes until he could see me after surgery in my room. So my hubby and me gave each other hugs and said our “I love you’s.” I was taken to the elevator with hubby in tow behind us and we waved to one another. The guy taking me down was very nice and we chatted for a few moments about my surgery until he rolled me into the pre-surgery area and said that my anesthetist would be by to talk with me. The anesthetist came by to introduce him self and had a great cheerful personality, which helped ease some of my nervousness and he said that he would see me in the OR in about five minutes. He left and about three minutes later I was rolled into the OR. There were two people there and I was scooted over to the operating table and the anesthetist was talking to me as I asked about certain things there. It was really cold in the operating room and was wall-to-wall tiles. They put these rubber things on both my legs that went all the way up and look like they had air pockets inside that you could see inside of them since they were clear see though rubber. Then they turned something on that sounded like a pump below the table, it felt like my legs were getting massaged up and down. I said that “feels great, where can I get one?” I joked a little about my surgery with the anesthetist and heard a door close and Dr. O walked in and said hi to me and then everything went black.

I woke up dazing in and out in the recovery area as Dr. O was saying something about “yes I did,” it felt like I was in some kind of dream. Was not sure what he said I just kept saying, “yes I remember” then dazed off.

I woke up as they were rolling me somewhere and I saw my hubby walking by with flowers and I waived to him as they put me into another elevator. Everything was feeing like a dream still and my head hurt, then I dazed out again.

I woke up again and saw a nurse writing her name on a board and talking with my hubby. I said “hi sweetie” to my hubby and he said hi back. The nurse showed me the suction tube that was coming out of the wall and she explained that there will be some blood mixed in with saliva in my mouth that will not feel that great in my mouth or taste very nice and I will want to suck it out with a plastic tube. Then she put the PCA button in my hand and explained what it was and I pressed it right away. She asked what my pain level was, I said 7 and she started to ask something as I dozed out.

Woke up again feeling my hubby holding my hand and said “hi sweetie.” He said, “hi honey how are you doing,” and I replied, “I feel like I was hit by a Mac truck, my face hurts and my throat is killing me.” Sorry hon. He showed me some ice in a cup and told me that the nurse wanted him to tell me that it would help and would be better if I sucked on the ice cubes. I asked if he could hold the cup up to get a drink. So my hubby gave me a drink and told me to say when and I waved my hand to stop. My hubby told me that I have to pee in a portable plastic urinal thingy since Dr. Ousterhout could not get the catheter in so I have to pee. So I peed and a nurse walked in a few minutes later asking if I peed yet and I said yes. “Good girl” and she asked me if I needed anything and I said no thank you then she left.

My hubby told me that he talked with Dr. O after my surgery and Dr. O said that it went really well, besides for not being able to get the catheter in and said that I would be very pleased with my results. He repeated this theme three times. He seemed very upbeat and pleased with himself that he did what he planned and got done with the operation under 8 minutes from the allotted five hour operating time. In other words, he said I would be very happy over the results. I asked my hubby if I looked like a raccoon since I am sure that I have black eyes and he gigged and told me yes but I still love you. I used the tube to get some of the nasty stuff from the sides of my mouth then pressed the PCA button and dazed off slowly since I felt really sick to my stomach for a while after pressing the button this time.

I woke up again, chatted with my hubby; he was trying to convince me to press the button so I would get some rest from the pain. He said that he was going to go get something to eat and would be back in about thirty minute. I sucked some stuff out my mouth and then had some ice. Then I pressed the PCA button but did not feel that great after pressing the button and felt like I was going to hurl but didn’t. I dosed off slowly after that.

I woke up that night to a nurse doing something. She asked me if I needed anything and I said a soda would be great, and she said she would try to get me one and left. I was channel surfing and the nurse came back with a 7up and opened it for me as I was saying thank you. The soda didn’t taste that great since my taste buds were shot, but it really helped my tummy get settled and the little burps it gave me made my throat feel better. Couldn’t find anything good on TV so I left it on the cartoon channel. I felt like the cartoons, which were getting hit in the head I thought. Giggles. My hubby, who had been asleep in the chair next to me, smiled as he said, “you must be doing a lot better now since you are watching TV and drinking a soda.” I said “not really just don’t feel like sleeping,” I am however aware of everything now and my mind seems cleared up. He told me that he would have to go back to the hotel before the chair causes him to have problems with his back and I said Ok sweetie see you tomorrow. //

The next morning, after dozing off and on all night with just the TV to keep me company, I awoke knowing I was going to go home. I had the drains taken out in the morning, not the best feeling to have those tubes sliding out, but I was very happy to have them out. And Dr. O came in and removed my head dressing and left me some medical tape and a few packs of gauze padding so I could change out with the one that was under my nose. I told him that I felt like my chin and jaw seemed down farther on the right side compared to the other from feeling them through the bandages. He told me that it’s just swelling and it would go away. Then he left.

My hubby came in and told me that I don’t have black eyes anymore, just a black line under the right eye. I went in the bathroom to get dressed and to take a look in the mirror and after I got dressed and looked at my face I noticed my right chin and jaw area seemed to be lower then the left. Anyway we left and went home.

I slept mostly for the first three days after surgery and I wanted the packing out of my nose and I wanted my taste buds back. Did I say that I want the packing out!!!

April 13, 2004, Goody the day I get my packing out and did I say that I want my packing out giggles. When we were there Mira and Tatiana were talking about emails and some problems with one of the messages containing a computer virus. So we chatted with them about computer viruses. I talked with her for a second and said that I was worried about the chin being two different sizes on each side and the jaw on the right side being down. You will see your chin in a second. After a second she sat me down and she talked with my hubby for a second. Then she removed my nose packing “thank you I could breath again” she took off the chin bandage and gave me this stunned look like there was something wrong and she took a second to get her composure back and told me that she was just surprised that I was healing so well, but I could tell that she saw that something was wrong with my chin. After she reacted to that, it took her a few moments to recover her composure and I was getting really concerned at that moment. Mira handed me a mirror to take a look at my face and as soon as I looked in the mirror I said my chin and jaw on the right side are down farther than the other side and she said there is still too much swelling to tell. So we went back home and I was not exactly too happy since I knew that the chin and jaw on the right side would not go down since it’s the bones that are down lower and not the swelling even despite the fact that the bone felt lower on one side then the other from touching the two sides.

I talked with Mira on the phone a day before my meeting with Mira to take the nose cast off. I called her about the sutures in my mouth since they had started cutting into my gum line and she said that she would cut a few since they don’t seem to be dissolving very well.

April 16, 2004, my hubby and me headed back to San Francisco to have the cast taken off my nose and I would be seeing my new nose for the first time. Goody, I want to see it!! Still was not happy with the difference in heights of the right side of my chin and jaw. Plus it feels like my chin had moved a little. Mira greeted us and she sat me down so that she could put some stuff on, to dissolve the glue that Dr. Ousterhout used to hold on the nose cast, onto the skin of the nose and Mira told me that it takes a while to loosen it up.

In the mean time she cut and removed a suture which was holding in two plastic things, one inside of each of my nostrils, she pulled out each one, they felt weird coming out and they are folded over to support the nose while it is healing and they flipped open making them the size of a silver dollar. I was surprised too see how big they were. After that she started to slowly take off the nose cast on the right side and she was able to get it off the skin with out any problems on that side of the nose, then she started working on the left and started pulling it off and it was not coming off very well. She started pulling harder and I yelled out “ouch” in pain since it felt like my whole nose pulled to the left and snapped back in place after the cast was pulled off. I had tears in my eyes because it hurt so badly. Took me about five minutes to get my composure back after that.

Mira handed me a mirror and I took a look at my new nose and I told her that it looks good just hurts right now. She cut a few sutures from the right side of the gum line since that is where they were cutting into the gums. She started looking around in my nose to get some big scab build up out since they don’t want really big scabs to build up in the nose over the sutures. While Mira was digging around in my nose I was telling here how it felt like my chin had moved a little forward and at the end of the cut on the right side moved a little in and it really hurt a great deal. She told me that she had never heard of something like that happening and stopped playing around in my nose and told me that she is going to see if Dr. O is on one of his breaks he takes, during some of the longer surgeries. She called Dr. Ousterhout on the intercom and asked him if he was busy or if he was on break and he said that he would be taking a break soon and she told him that he should try to stop by and take a look at my chin and he said to give him about 15 minutes.

So we chit chatted with Mira until he got there. Mira explained what I was feeling and I was freaked out by his composer since it looked like he was not sure how to react, He looked at my chin and said “don’t worry” the chin is fine. Then Mira asked him to get a scab out of my nose that had started healing on the suture and he removed it. It didn’t hurt but it bled a bit. He shoved some kind of long paper thing in my nose that was soaked in what he said was a solution that contains a little bit of cocaine to numb and will help stop the bleeding. Then he took off. Mira gave me a paper towel so I would not have blood running down my face.

My hubby was wondering what it would cost for a face lift with them so Mira said that she could give him an estimate while we were there so we went into her office and wrote out a statement for him that was $17,715 for a face lift and upper and lower eyes. “Yikes” is what I said. She gave me an estimate for my forehead also. I asked her about my chin and jaw being two different sizes on each side and she told me that Dr. Ousterhout can’t chase symmetry and I said, “but the chin and jaw were the same size before I had surgery” and she didn’t go into it more and the meeting ended and we left at that point. I was less then happy with what she said and my hubby and I talked about it during the trip home and he thought it was kind of odd for her to say that.

April 25, 2004, I felt my chin move again, and this time it felt like the whole chin moved to the left. Now I had a sharp piece of bone sticking out on the left side that was irritating the skin above it. It felt like something sharp was rubbing inside of the skin every time I eat or when I would smile. The right side of the chin started feeling like there was a gap forming too. The swelling was getting down enough by now, I could see this big bump was showing up on the right side of the chin and when I touch it I notice it was part of my old chin, which was not ground down to taper down with the chin. At this point I was freaked out about all this. I gave Mira a call and told her what I was feeling. She told me to switch back to soft foods and she will tell Dr. O and I may need to get x-rays for Dr. O and I said fine. She told me that Dr. Ousterhout would give me a call later and he will tell me what he thinks we need to do. He called me later that evening and listened to what I said and said that I should come in so he could check on it and I asked if he would like me to get some X-rays, he said he did not need them. So he told me to come in on May 1st and I asked if that was the soonest he could see me and he said yes.

I was not too happy about having to wait five days until he sees me for a problem. And was really panicked about all this and cried my eyes out over the whole thing. My hubby tried his best to comfort me and was not too happy about having to wait five days to check on a problem.

May 1, 2004 My hubby and I made the trip to San Francisco to see Dr. O again. We walked in and the office seemed deserted. We headed for the counter and there was no one there. So we walked over to Mira’s office she was not there. Dr. O noticed us and came out of his office and said that Mira was not around. So he had me sit down as we said our little greetings and him and my hubby chitchatted. He then asked me to open my mouth and he put three fingers from each of his hands on top of my lower teeth and he pushed down on my teeth as I let out some moans and few shrieks as the pain flowed through my whole head, and after a while he stopped pushing down.

My hubby looked stunned and me with tears in my eyes from what Dr. Ousterhout just did.

Dr. O said my jaw is not broken and my chin is fine. And I asked him if it would be safer to have some x-rays made and he said he did not need them. I asked him what the bump on the right side of my chin was, since it is very noticeable, and he felt it and told me that it would go down and was not sure what it was. I asked him about the jaw and chin being a lot farther down on the right side and he told me that it was just what he called a marble that would go down in time. I tried to get an explanation from him about the details on it and he shushed me. The visit was left there.

About two to three weeks later I gave Mira a call to let her know that I was concerned about all the people who had been talking about their problems from surgeries with Dr. O on the web, since I am having some of the same problems and the chin looks worse. She told me that an ex-employee is behind all of it and that she has paperwork from a small claims law suite that was filed against her personally that shows she had problems with that person. Mira said that person is the cause of it all. We chit chatted about our personal lives and I said that I was very concerned with my chin. She told me that I should look into fat grafting to fill in the two front areas of my chin where the bumps are. She said that they do not perform that soft tissue work since it would cost the patient too much from them and she could refer me to a surgeon in New York that has a high percent of the fat graft taking. I asked her why she would say that because those are pieces of my bone sticking out and you are suggesting that I have them filled in when they need to be ground down and she said I would have to talk with Dr. Ousterhout about that at the three-month consult.

My personal thoughts about what she told me sounded very fishy, since there were way too many people talking about their problems with Dr. O for them to be the work of one ex-employee causing it all. I was starting to get the feeling that they were going to try to avoid fixing the problems with my chin and jaw after what she told me about getting fat grafts. So at this point I was a getting worried.

Then about a week after having that disturbing talk with Mira I decided that I needed to get a copy of my medical records and X-rays so I could get an idea of what Dr. Ousterhout did to my chin and jaw, and to also try to figure out what had to be done to fix it.

So I gave Mira a call and asked her if I could please have a copy of my medical records and X-rays and that was the only thing I said. Mira lost it with me on the phone. She told me in a frantic tone, who are you going to go besides us, you have no idea of how many of Dr. S patients that we have to correct their work then there is Dr. Z he has a great reputation, but he can’t cut bones and can’t take off as much as us and he just uses fat grafting. So whom do you have besides us? You know by asking us for your records, you are saying that you don’t trust us and we might have a problem working with you. I was totally freaked out and really didn’t know what to say. After about a minute or two being speechless I said I would call back later. When I got off the phone with them I sat there stunned not really knowing what I should do. I was thinking to myself what have I gotten myself into with these people and what am I going to do? She didn’t even ask me why I wanted the medical records and X-rays. I called some family friends that are in the medical field to get some advice from them and left messages on their answering machines.

A few days after that extremely disturbing phone call with Mira I had gotten all the input from the friends of the family in the medical field that advised me that under the law the doctor is required to give me copy of my medical records and X-rays when I ask for them, but they will want it in writing. I was also advised that it is quite common to ask for records and X-rays for dentistry after having the cosmetic procedures done that I have had with Dr. Ousterhout. So I gave Mira a call again and asked her if I could please have a copy of my X-rays and this time she said to send her a fax stating what I want and sign it. So I sent her a fax on June 1, 2004 asking for my medical records and X-rays and I signed it. I am lucky that the UPS store prints the send date and time on the back of the papers you fax with them or I would have not remembered the exact date I sent it right off hand.

July 10, 2004, my hubby and me went to see Dr. O for my three-month meeting. Truthfully I was very scared of Mira at this point from the past experience I had with her. We waited in the waiting room for about 30 minutes. I went out to the truck to grab my soda and finished it on the way back down and saw my hubby peeking out the door looking for me so hurried back. I walked over to the front counter and my hubby was sitting in Tatiana’s chair looking at the computer with Mira looking at the computer also and Dr. O on the side too. Right when I was standing at the counter Mira said, “look at me straight” and I did and my hubby said, pointing at the before photos of me that they were looking at on the computer, “see the difference, now the right side is lower than the left!” Mira didn’t say anything and stomped off. Dr. Ousterhout motioned us to one of the examination rooms and closed the door.

Dr. O asked me if I had any pain and I said in the right side of the chin where the gap is and underneath like inside of the bone when I touch it there is pain. Dr. Ousterhout asked me what the problems were and I said, “My chin and jaw are too far down on the right side. There is a gap between the chin and jaw where the sliding genioplasty cut was made and there might be too much bone taken out on the right side of the upper jaw. There is a dent in the right side of the chin. There is also a scoop of bone missing from the mid section of my jaw on the left side.” Dr. O laughed and told me that he could not do anything about the jaw and chin being further down on the right side than the left side, since he does not have any instruments that will remove the bone in the mid section of the jaw, and I said “but you did it on the left side during my surgery and that’s what made my chin and jaw uneven on the right side and further down than the left” and he just said it was from the sliding genioplasty. I asked “why was it not done on the right side also then?” He didn’t go into it. I asked about the gap in my chin and he walked over to me and felt my chin on the right side and said it’s an irregularity, but it’s fine. Then he started talking about my forehead and how I should be glad to have a nice hairline and compared me it to some other girls that just had surgery within the past few days. I felt like he was hinting that I should get the forehead done with him in order to get my corrections done.

I commented that everyone who knew me before surgery, with him, have told me that I look worse after surgery in the chin and jaw areas. He didn’t say anything about that. I said I could even show him hundreds of before and after photos of my chin and jaw and they were close to being even and there was not a step down problem before the operation, and he responded by saying “what did you do, reverse them?” I said, “what about the before photos of me before surgery you have copies of on your own computers showing that my face looked better before surgery and there wasn’t a step down problem on the right side. I sent those to you before I had surgery with you?” He didn’t say anything about my before photos that he had before surgery.

My hubby said that aside lets just fix the problems with the chin and the jaw. Dr. Ousterhout told us that he might consider correcting things but not until six months past the operation date and I should feel lucky since it could take up to a year depending how he feels then he laughed about it. Both my hubby and me were kind of shocked since Dr. O said it would take three to four months after surgery to fix things if there was anything wrong. He then told me to go tell everyone on the Internet that he didn’t want to treat me or he provided substandard care. He acted like no one would believe me no matter what he did and out the door he went. I ran out the office crying my eyes out scared to death thinking what in the world have I gotten myself into with this doctor and what has he done to my face and what am I going to do. I totally lost it and I cried my eyes out the entire hour and a half trip back home. My hubby was trying to comfort me, but it didn’t help.

All I could do on the way home was cry my eyes out since Dr. O was acting like he was trying to avoid even the fact that I would need corrections. I was so depressed about how he treated me after I paid him $21,000 and was so sure that he would say sure lets take care of the problems, but instead he just avoided even giving me a reassurance that he would fix them and acted like he was going to avoid even doing them and he could get away with it. All I could think about was that I did not want to live with a fucked up face for the rest of my life and not wanting to live at all at that point. I just wanted everything to end and be over with. When my hubby and me made it home I got on my computer while I was crying my eyes out. I had totally lost it and all I wanted to do is die at that point and say some good byes to my friends. I said my good byes to everyone and grabbed my few bottles of pills and gave my hubby a kiss and told him that I loved him with all my heart. I took off out the door with every intention to take all my pills kill myself. I went to a friends house that was out of town and sat there for three days without much sleep crying my eyes with the pills and looking at the gun cabinet thinking that I should take all the pills and then when my liver starts shutting down I should blow my brains out since I did not want to suffer as my organs failed or have anyone finding me in a vegetable state and being put on a machine to keep me alive. Luckily I fell asleep with the pills and gun in my lap and awoke the next day in a better mood. I am lucky to be still around.

I had a few chats with Mira and Dr. Ousterhout when I was at Davies visiting a M2F girl I met on the web before and after her surgery about a week after my three-month consult with Dr. Ousterhout. Dr. O yelled at me for talking about my problems on the web when he saw me that morning and the girl I was visiting asked him to leave me alone and I didn’t say anything to him. I talked to Mira who said they were not happy that I talked about my problems on the web. I saw Mira later that afternoon and advised Mira my bite radius was off and that I could not bite down correctly, She told me that it is just a feeling people have after surgery, but everything is fine.

On July 23, I gave Dr. Ousterhout’s office a call to see if I would be able to get a copy of my medical records from them. I talked with the receptionist on the phone and asked her about getting a copy of my medical records. She told me that she would have to ask Dr. O about it and I said OK. I went out for a bit and returned and had a message from Dr. O on the answering machine telling me if I wanted to get a copy of my medical records I would have to send him a signed letter requesting them and that it cannot be a email. I gave the office a call again and the receptionist answered so I explained that I had gotten Dr. Ousterhout’s message about what I have to do. Then I advised her that I had sent Mira a signed fax on June 1st requesting a copy of my X-rays and medical records she told me that Mira was out for a few days and Dr. O. was handling everything himself. She said to give her a second to run to the records room and see if she could find it in my file. About five minutes later she made it back to the phone and she explained she had trouble finding it since Dr. O had it on his desk in his office. So she went through the file and told me O.K. I found it and I will let Dr. Ousterhout know that it was there already. I did not get a phone call back after that.

On July 26, I checked the mail and found that I had an envelope from Dr. Ousterhout’s and it was my medical records. I found out during my facial feminization surgery that Dr. Ousterhout reduced one side of my face more then the other so I was not surprised that it is so totally uneven and I have problems. He never told me that he was going to be doing any such thing; he just did it on his own. I started crying as I read my file.

Throughout this whole time the pain from the right side of my chin and jaw has been getting worse and worse. Throughout my facial feminization surgery there was only one week when my chin and jaw on the right side that it didn’t hurt.

I did not have any contact with them until August, when I logged into my email and I took a look at my email and found that someone had sent me web formatted financial documents of Dr. Ousterhout’s. I looked through the emails and thought wholly shit. Someone was trying to egg me on to publish the documents. So I thought I would be nice and let Dr. O know that someone is sending this info to people on the web. So I gave his office a call and left a message for him to call me when he had the time. Dr. O called me in the evening and I told him what was sent to me and he asked a few questions about the documents and I read the information to him as he asked. Dr. Ousterhout was wondering how people had been able to get a hold of the documents and I told him that I was not sure. He told me that I should send him hard copies of the documents and I said sure I can print some up and send them to you and then I will delete them. Then Dr. Ousterhout thanked me for informing him regarding what was sent to me and he was going to call some people about it.

About five minutes later as I was about to head out the door my hubby handed me the phone and told me that it was Mira. I answered the phone and Mira said hi Trinity and started threatening me regarding the documents and told me that she was threatening me for my own good. I was horrified and was thinking to myself Mira has lost her fucking mind threatening a patient. I was very nice to let Dr. Ousterhout know what was being sent on the Internet and now Mira was treating me like this. Mira was extremely rude then told me that I better forward her the emails and I said O.K.

I made myself a drink after Mira’s phone call thinking I should write an email to the author of the www.allaboutmira.com web site so I could find out what I had gotten into having surgery with Dr. Ousterhout and having to deal with Mira. I was thinking that I didn't want to deal with Mira since she is totally out of her mind and had to figure out a way to try to avoid having much contact with her if I could get Dr. Ousterhout to do my corrections to my face after his facial feminization surgery (FFS) on me.

Before I could even finish my drink the phone was ringing again and I let my hubby answer it. He called out to me and said it was Mira again. I was thinking “not again.” So I picked up the phone and now it was like she went from night to day and she was speaking to me nicely this time. She asked me why someone would have sent me the documents and I said that I could not be sure, but most likely it his because people know that I am not happy about the treatment I have received from you and Dr. Ousterhout regarding my after care and problems that are affecting my life from my FFS with Dr. O. I also said that you know that this all started when I defended a girl on the internet that was being bashed to death my one of your supporters and also being advised to commit suicide by that person since they would not provide photos of her problems from Dr. Ousterhout's FFS. So I posted photos of my problems that day and here we are today.

Most likely I told Mira that the person that sent me the documents could be someone who had FFS with Dr. O and was not happy because he caused them some problems and they think I will post this information on the Internet since I talk about my problems with you and Dr. Ousterhout. I was surprised that she listened and did not jump out with some thing. Then she did and said that there are still better people that they could have sent them to and I asked who would that be and she went silent. I told her that this is really Dr. Ousterhout’s problem and I was nice to let him know about the documents and it's not my problem. Then Mira asked me if I was recording the conversion. I thought she was starting to sound strange so I told her that I had to go. I forwarded Mira an email and was done dealing with that.

After the phone calls from Mira I did not feel that great about calling Dr. Ousterhout's office since I really did not want to deal with Mira. But I was feeling so much pain now from my gap on the right side of the chin that I was to the point that I could no longer get more then 3 to 4 hours of sleep a night if I was lucky. At this point the pain was so bad that I felt like I would collapse any time that my hubby's chin just slightly touched my when we would kiss. And I was breaking out in tears constantly now from the pain. Eating anything too solid became impossible with feeling bone grinding in my chin on the right side and the pain I was feeling.

So I called Dr. Ousterhout's office and left some messages and never did get an answer back from them. Two weeks went by and no word from them even though I was told by the answering service that the on call nurse was Mira. So I wrote a letter to Dr. Ousterhout about what he would fix and again weeks went by without answer. At this point I was contacting other doctors trying to figure out what to do and figure out what was causing the pain. I was advised to get a panoramic x-ray by Dr. Mark Zukowski. So me and my hubby made a trip to San Francisco and had one made at SF dental imaging which is the same place Dr. Ousterhout has everyone go for x-rays and that way the x-ray would be done by the same place and could be compared with the before x-rays I have.

Since then I have had two meetings with Dr. O and Mira both there together in the same meeting room. Dr. O claimed he was going correct everything and he could have me in surgery in a week since it had been six months already and Mira who was in the room during both the meetings said you should go home to talk about it then to give her a call if I needed more information if I needed it or just schedule surgery out right. We gave her a call the same day after the meeting not more than three hours later and we asked her if I could please have a pre operative plan and I wanted to schedule surgery. Mira, said there was nothing wrong and that I didn’t need a pre operative plan.

I don’t think I was given all my records either since when I was at the meeting Dr. O pulled out my file to look at some things and I was able to see documents he never sent me when they sent me my medical files. I didn’t say anything about it since I did not want to start anything and get my correction done.

It had come to my attention from emails from people having consults with Dr. Ousterhout’s office that Mira the office manager for Dr. O has been providing personal details about me from my medical records to patients having consults or surgery with Dr. O. I have written Dr. Ousterhout a certified letter advising him to have Mira reframe from disusing my personal details with anyone. You can see the details and the certified receipt for the certified letter in the following links THE LETTER I SENT TO DR. O and the other link CERTIFIED RECEIPT FOR THE LETTER To see the letter and other item in a larger size run your cursor over them and click on the box which apprears at the bottom right.

Since the meetings with Dr. O and Mira I have talked with a great many doctors some of which just said go back to the doctor who did it and some that said that they don’t feel comfortable doing a fix on the problems since it requires removing the screws and dead bone then referring me to other surgeons. I have had a massive amount of x-rays made for doctors. You can take a look at the following link to see just how many x-rays are left after sending half of them to Dr. Mark Zukowski. PHOTO OF X-RAY It was really interesting though since most of the surgeons wanted to know who the surgeon was that completed the work since they wanted to look him up. I am not sure what that was about and they did not tell me.

So to ad insult to injury not only do I have a very nasty out come from Dr. O’s surgery when it comes to the appearance of what my face looks like I am also stuck with going into debt to borrow money to have results corrected due to the appearance and I have to get it corrected because it is directly affecting my health. I have been diagnosed with having a non-union in my chin, which means that part of my chin had not been attached to the rest of the chin and is free floating. The problem was ignored so long by Dr. O that I need to have dead bone removed from my chin and the plates and screws have to come out so that my chin can be reconstructed, and lag screws have to be placed into the bone to hold my chin together after surgery and I have to pray that the pain might go away since I have damage to the major nerve in my chin from my FFS with Dr. O.

Dr. Zukowski told me in his letter he would need to remove the plates and screws Dr. O put in to, so he can fix the non-union. See link to letter below for more information about all the problems.

Here is a copy of the letter Dr. Mark Zukowski sent me regarding my problems and what will have to be done to fix them. It goes into greater detail about everything. THE LETTER IS MUST READ TO GET A UNDERSTANDING OF WHAT WAS WRONG AND WHAT HAD BE FIXED.

Click here to read Dr. Zukowski's letter.


I have tried my best to condense my writing as much as I could to make this easy to read, but there are a few things I will be adding in the future.

I have had my chin and jaw reconstructed with Dr. Mark Zukowski on January 29, 2005 and I will be adding further information on what was done to correct everything from my facial feminization surgery with Dr. Douglas Ousterhout and about the interesting developments from the surgery with Dr. Zukowski.

Here are the updates from my surgery with Dr. Mark Zukowski. During the surgery Dr. Zukowski found two items inside the soft tissue of my jaw on the right side, which did not belong in there (in medical terms they describe items like that as foreign body). The items were not there in the X-rays Dr. Ousterhout had taken before his surgery. The items are visible in my x-rays after my surgery with Dr. Ousterhout. I have had a postoperative x-ray done after Dr. Zukowski removed the items and thank god there are no more items in there. The items removed from the jaw are jagged, so that would explain the poking pains I used to have in that area of the jaw on the right side. I am including two photos showing the two items Dr. Z removed from the soft tissue in the upper jaw area and these two photos also show the plates and screws Dr. Zukowski had to remove. It was also noted that the screw diameter on the right side was inadequate.

Click here to see the three page Operative Report that describes everything that was done and problems found


The plates and screws are in the order of orientation they were removed from my chin. You will notice that the screws very in length, diameter and size. The two large screws match in diameter. Three of the medium size screws match in diameter and one medium size screw that does not match in diameter to the other three medium size screws. I have been advised the two smallest screws in the photos were too small to hold my chin together after surgery. Also the screws were so loose and moving around in the bone segments in my chin that the screws were wearing grooves into the bone and you can see this in operative photos. Most of the work done was through an incision below my chin. Here is the link to the photos of the two objects, which were removed from the soft tissue in my jaw and the plates and screws. Photos of the screws and plates, plus the other two objects

A warning to people who may have a weak stomach, the photos of my surgery do show my chin in stages of surgery. Here is a link to the photo of the non-union in my chin and if you look at the photo you can see the round groove lines the screw on the right lower section made from being loose and the bone segments moving around. Photo of non-union in my chin

Here is a link to some photos that show the non-union and some angle deformity. Photos of non-union in my chin some angle deformity

Here is a link to a photo of the lag screws in my chin Dr. Zukowski placed in the bottom of chin to hold the bone segments together. Photo of the bottom of my chin and lag screws in it

Here is a photo of the medpor jaw implant Dr. Z placed in the right side of my jaw. Here is a photo of jaw implant before placement

Here is a photo of the gap in the bottom of my chin after the scar tissue was removed and before it was filled in. The gap in the chin