Facial Feminisation Surgery

• Posted by Hannah Ceridwen Eluned Cavendish-Grosvenor July 5, 2016 Filed in Society Girl's Personal Blogs 1,228 views
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  This weekend , I am proud to represent the UK Trans Community as Chair of the Medical Conference at the National Transgender Event, 'Sparkle".

   

  As a Professor of Ophthalmic-Facial , Reconstructive and Orbital Surgery, I am often asked at our Trans Group meetings (Manchester, Llandudno, Scarborough and Harrogate) questions regarding Facial Feminisation Surgery. Not infrequently, the potential patient already has a surgeon's name, acquired from a 'besotted' (frequently) previous patient. I was asked to check out a certain surgeon by one Lady who has become a close friend: the surgeon in question had worked in a District General (no problem there), prior to retirement (problem there). He/she listed on their website every Plastic proceedure I could quickly think of; and hardly mentioned, or did not mention at all the Facial Feminisation ang Gender Re-assignment Surgery they regularily undertook. Such a declaration might lead to being labelled a 'jobbing' surgeon, a 'jack of all trades, master/mistress of none'.

   

  FFS is not available on the NHS: thus surgery in the UK is inevitably funded by the patient themselves; and, patients frequently chose to travel outwith the UK in order to be submitted to Surgery.

   

  How can you be sure that the Surgeon is 'safe' and up to date? Here are a few tips, identifying important indicators, potentially assuring a top quality service and an essential high level of Patient Safety.

   

  1) Does the Surgeon (in the UK) a) hold a Specialist Registration with the General Medical Council (GMC)? It is a simple matter to look up the practitioner's name on the GMC web-site, b) hold a higher surgical qualification: i.e. Fellow of a Surgical Royal College, or equivalent.

   

  2) Are they in employment as an NHS Consultant, or an University equivalent with an Honorary NHS appointment?  If not, you are wise to avoid, unless you are seeking and requesting merely a private opinion. A retired Specialist gives a balanced opinion, but cannot or choses not to keep 'up to date'. What stimulates you to achieve continued personal excellence is a) constant questions from, and teaching, your trainees b) the requirements of regular formal peer review - approved by your employer, and required by the GMC. Appraisal in a solely private setting inevitably introduces financial considerations; which may blur over, or turn a 'blind eye' to, inadequacies and/or defects in performance and quality of care.

   

  3) The quality and experience of the Anaesthetist: no problem if they are employed in the NHS or University. Avoid otherwise, unless they have recently retired from such an appropriate post. Remember no surgeon or Anaesthetist cannot obtain Medical Negligence Insurance after a certain age in the UK (it was, until recently, a 70 years of age limit).

   

  4) What Facial Plastic, peer-reviewed, publications and Conference presentations has your Surgeon of choice accumulated? They should state these publications clearly on their web-site.

   

  5) At initial consultation, do they a) explain in detail the potential risks of intervention, as laid down, with annual revision, by the Royal Colleges? b) undertake pre-operative photography, for comparative purposes? What clinical and financial arrangements are in place for resolving and treating the inevitable complications which occasionally arise. Most important is what measures are in place to assure additional treatment in the case of a major health problem, arising post opersstivley.

   

  5a) INDSURANCRE FOR Complications

  Are measures in place for majot untoward events. Intensive care is expensive, and `High Dependancy' is priced in excess of a suite at the Ritz hotel.

   

  6) Are they one of the (currently seven) FFS specialists approved by the Cender Identity Clinic at Charing Cross? The three on 'the tip of the tongues' of the Transgender population are not actually mentioned or included!

   

  7) What accomodation and post-operative care is there in the immediate recovery period for the patient, and also for an accompanying companion or relative (more important the further you travel)?

   

  8) If the proposed surgery is to be undertaken abroad, it would be foolish (in my opinion) to simply attend a hospital in a strange country for assesment and surgery in one visit, purely on recommendation from a previous patient and without previous clinical assessment. Personally, I would only consider surgery with a named group, rather than an individual (solo) practitioner, from abroad; which group undertake regular initial assessments and quotations in the UK. I do not propose to name the European Group I would personally chose here on social media. However, now we are leaving the EU, I am happy to state that I would certainly avoid Brussells/Belgium and its environs without the slightest hesitation.