Dedicated to the acceptance, medical treatment, & legal protection of individuals in the process of correcting the misalignment of their anatomical sex, & supporting their transition into society.
Choosing A Surgeon. Planning for a sex change involves an assessment of surgical options for Sex Reassignment Surgery (SRS — aka GRS) and quite possibly a variety of other related surgical procedures.
The doctors and surgeons you consider should fit at least these basic criteria:
2. The doctor is an active member of medical societies that relate to her or his specialty, and those with missions for public safety, ethics and excellence in practice. See the American Society of Plastic Surgeons (ASPS).
3. The doctor practices exclusively in the specialty in which he or she holds board certification. For example, there is no requirement that a doctor have any training or experience to purchase breast implants and surgically place them into your body. Certification is important.
4. The doctor listens to your concerns and answers your questions directly. The focus is on you.
5. The doctor has performed the procedure you are interested in (e.g., SRS) many times and can provide recent before-and-after photographs of actual patients. The doctor should explain the outcomes and how they were achieved.
6. The doctor performs all procedures that require more than a local (topical) anesthetic in accredited or licensed office-based, ambulatory or hospital surgical facilities. The doctor should clearly define the anesthesia you will have and the credentials of the person charged with its administration.
7. The doctor has privileges at a local accredited hospital facility to perform the specific surgical procedure you are considering. If a local hospital has barred the doctor to perform surgery on hospital property, do not consider letting this doctor perform surgery on you.
8. The office is clean and orderly. The staff is respectful of your time and presence. The attention you get should be consistent. Your privacy is respected. You should feel safe and welcomed.
9. You have checked with the applicable state medical board and the doctor is licensed to practice in the state. There should be no prior or pending actions against her or him. Lawsuits are frequent but only actual negligence can jeopardize the status of a doctor’s medical license.
10. You are comfortable with the doctor and willing to place your life in her or his hands.
New Haven and Greenwich, CT, USA. Human beings naturally wonder how others might perceive our appearance — and to what extent that might imply estimates by others of the the state of our feelings. Do the indicators suggest we are withdrawn or hostile (e.g., do we look tired or angry)? Our comfort in social situations might well depend on the answer to that question. Recent research suggests that looking tired or angry may have more to do with facial aesthetics than how we actually feel.
The Influence of Forehead, Brow, and Periorbital Aesthetics on Perceived Expression in the Youthful Face. Bianca I. Knoll, Keith J. Attkiss, John A. Persing. Plastic & Reconstructive Surgery. 121(5):1793-1802, May 2008. [ Download PDF ]
Researchers found that variations in eyebrow shape, eyelid position, and wrinkles significantly impact how your facial expressions, and subsequent mood, are perceived by others.
"A key complaint of those seeking facial plastic surgery is that people always tell them they look tired, even though they do not feel tired," said John Persing, MD, ASPS member and study co-author.
"We found that variations in eyebrow contour, drooping of the upper eyelid, and wrinkles may be conveying facial expressions that don't necessarily match how patients are feeling."
In the study, a standardized photo of a youthful face was digitally altered to change a number of variables, including
eyebrow shape and position;
upper and lower eyelid position;
upper eyelid drooping and removal of excess skin;
and facial wrinkles.
Twenty health care workers were given 16 photos and asked to rate, on a scale of 0 to 5, the presence of seven expressions or emotions: tiredness, happiness, surprise, anger, sadness, disgust, and fear
The results for each altered photo were compared with scores from the original unaltered photo. Overall, eyebrow shape had a greater influence than absolute position on perceived mood.
Tiredness
Drooping of the upper eyelid was the biggest indicator of tiredness, according to the study. Simulating skin removal of the upper eyelid, as performed in some eyelid procedures, but not correcting accompanying eyelid ptosis (drooping), resulted in an increase in the perception of tiredness (and sadness). Photos that included an overall elevation of the eyebrows or an increase in the distance between the eyebrow and upper eyelid also increased the perception of tiredness.
Anger & Disgust
Lowering or slanting the inner corner of the eyebrows towards the nose, as well as adding forehead winkles significantly increased the perceived facial expressions of anger and disgust.
Fear & Surprise
Raising the upper eyelids produced an increase in the perception of surprise and fear. Also, raising the outer corner of the eyebrows produced an increase in the perception of surprise.
Sadness
Raising the inner corner of the eyebrows away from the nose was perceived as a sad facial expression.
Happiness
Happiness was perceived by raising the lower eyelid and the presence of crow's feet, which, according to the study, seem to simulate the cheek elevation that occurs with smiling.
"The eyes and their related structures nonverbally communicate a wide range of expressions that are universal to all people," said Dr. Persing. "Therefore facial expression should be a factor in how patients and their plastic surgeons select various rejuvenation procedures. As our findings show, even the slightest modification can elicit profound changes in how others perceive us." [2]
The ASPS website handles referrals to Member Surgeons and provides information on cosmetic and reconstructive plastic surgery.
[2] According to ASPS statistics, more than 241,000 eyelid surgeries, 43,000 forehead lifts and 118,400 facelifts were performed in 2007 (USA).
The Influence of Forehead, Brow, and Periorbital Aesthetics on Perceived Expression in the Youthful Face. Bianca I. Knoll, Keith J. Attkiss, John A. Persing. Plastic & Reconstructive Surgery. 121(5):1793-1802, May 2008. [ Download PDF ]
Abstract
Background. The purpose of this study was to characterize the relative influence of eyebrow position and shape, lid position, and facial rhytides on perceived facial expression as related to blepharoplasty, with a specific focus on the perception of tiredness.
Methods. A standardized photograph of a youthful upper face was modified using digital imaging software to independently alter a number of variables: brow position/shape, upper/lower lid position, pretarsal show, and rhytides. Subjects (n = 20) were presented with 16 images and asked to quantify, on a scale from 0 to 5, the presence of each of seven expressions/emotions as follows: "surprise," "anger," "sadness," "disgust," "fear," "happiness," and "tiredness."
Results. Statistically significant values for tiredness were achieved by changes of increasing and decreasing the pretarsal skin crease, lowering the upper eyelid, and depressing the lateral brow. Happiness was perceived by elevation of the lower lid or the presence of crow's feet. Brow shape had a greater influence than absolute position on perceived expression. Elevation of the lateral brow was perceived as surprise, whereas depression of the medial brow and rhytides at the glabella were perceived as anger and disgust. Elevation of the medial brow elicited a minimal increase for sadness.
Conclusions. This study showed that the perception of tiredness is most affected by the length of pretarsal lid height (e.g., ptosis). Surprisingly, simulating the skin resection of an upper blepharoplasty results in a paradoxical increase in the perception of tiredness as well. Modifications of brow contour elicit profound changes in perceived facial mood to a greater degree than absolute brow position.
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I am not transgender. Transgender is full time transvestism. Research the definer's actual words on the subject and not the identity politics that insist I am something I am not so they can colonize my life to further their politics.
"A key complaint of those seeking facial plastic surgery is that people always tell them they look tired, even though they do not feel tired," said John Persing, MD, ASPS member and study co-author. 
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