Jordan Deschamps-Braly - Facial Feminization Surgery: The Journey to Gender Affirmation

AN ADDICUS NONFICTION BOOK

Copyright 2021 by Jordan Deschamps-Braly, M.D., and Douglas K. Ousterhout, M.D., D.D.S.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopied, recorded, or otherwise, without the prior written permission of the publisher.

For information, write Addicus Books, Inc., P.O. Box 45327, Omaha, Nebraska 68145.

ISBN 978-1-950091-39-3

Cover design and typography by Peri Gabriel Design

This book is not intended to serve as a substitute for a physician. Nor is it the authors intent to give medical advice contrary to that of an attending physician.

LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA

Names: Deschamps-Braly, Jordan, 1979, author. | Ousterhout, Douglas K., author.

Title: Facial feminization surgery : the journey to gender affirmation / Jordan Deschamps-Braly, M.D., F.A.C.S., Douglas K. Ousterhout, M.D., D.D.S.

Description: Second [edition]. | Omaha, Nebraska : Addicus Books Inc. [2021] | Revision of: Facial feminization surgery /Douglas K. Ousterhout.

Identifiers: LCCN 2020031902 (print) | LCCN 2020031903 (ebook) | ISBN 9781950091393 (trade paperback) | ISBN 9781950091478 (pdf) | ISBN 9781950091485 (epub) | ISBN 9781950091492 (kindle edition)

Subjects: LCSH: FaceSurgery. | Surgery, Plastic. | Transfeminine individuals.

Classification: LCC RD119.5.F33 O96 2021 (print) | LCC RD119.5.F33 (ebook) | DDC 617.5/20592dc23

LC record available at https://lccn.loc.gov/2020031902

LC ebook record available at https://lccn.loc.gov/2020031903

2009035951

Addicus Books, Inc.

P.O. Box 45327

Omaha, Nebraska 68145

AddicusBooks.com

Printed in the United States of America

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To my mentorsgreat surgeons all:

Douglas Ousterhout, Daniel Marchac, Joachim Obwegeser,

Arlen Denny, and Christian El Amm

To my parents George Braly and Dania Deschamps-Braly

JORDAN DESCHAMPS-BRALY M.D.

To Naomi and Ken

Nancy

Dean and Don

Don, Susan, Oliver, Thomas, Lauren

Marlene

Jessica, Michaela, and Sarah

DOUGLAS K. OUSTERHOUT, M.D., D.D.S.

The Deschamps-Braly Clinic of Plastic and Craniofacial Surgery offices in San Francisco, CA.

Dr. Deschamps-Braly and Dr. Ousterhout performing facial feminization surgery.

MY STORY BEGINS WITH DOUGLAS Dr. Ousterhout. His pioneering work in aesthetic surgery of the craniofacial skeleton evolved into procedures that changed the lives of many transgender people. For these patients, gender incongruence was a terrible fact of daily life. Dr. O felt strongly that his work and expertise should be passed on and continuedhopefully, in hands as skillful as his own. When I first performed surgery with Dr. O, I was impressed with his deftness, focus, and stamina. While he was more than twice my age, he could ably perform procedures that typically took ten to twelve hours.

At the end of the summer of 2014, Dr. Ousterhout retired from active surgery. Some surgeons wait too long to make that decision. Dr. Ousterhout retired while his skills were still razor sharp at the age of seventy-nine. I was then extremely fortunate to have Dr. Ousterhout in the operating room as my assistant on a regular basis. After several years, he settled into full retirement. While semiretired, he taught me the techniques, visual understanding, and judgment required to perform these complex, magnificent surgeries.

As we collaborated on many surgeries, I learned the skill and knowledge needed for facial feminization from a great teacher, mentor, and friend.

Douglas never showed or taught anyone else how to do this work. He rejected several surgeons who approached him as being inadequately trained and skilled. He felt strongly that one had to be not only a plastic surgeon, but also an accomplished craniofacial and maxillofacial surgeon to do this work. To train me as his successor, he required that I spend several years working with him. He would not allow casual visitors in the operating room who he worried would learn just enough to be dangerous.

Other great surgeons have helped me lay the foundation for doing this work. Dr. Arlen Denny at Childrens Hospital, Wisconsin (who, like Dr. Ousterhout, trained with Dr. Paul Tessier in Paris) taught me to perform complex pediatric craniofacial surgeries during a yearlong fellowship. After my training in Europe and my move to San Francisco, Arlen introduced me to Dr. Ousterhout. For that, I will always be grateful.

The late Dr. Daniel Marchac and Dr. Eric Arnaud, both in Paris, provided me with an enormous opportunity to further my skills in craniofacial surgery. With their guidance I was able to acquire a wealth of experience in aesthetic facial surgery. That year of surgery in Paris was an opportunity and experience unlike any other available to American surgeons, even at the most prestigious institutions in North America. Dr. Marchac passed away shortly after my time in Paris. I was truly blessed to be the last young surgeon to have had this great experience with Dr. Marchac.

Dr. Obwegeser of Zurich, Switzerland, also trained me in one of the many essential skills for facial feminization surgeryorthognathic (jaw) surgery.

Finally, I want to express my appreciation to Doug Ousterhout for selecting me to continue performing his pioneering surgeries, and for showing me the ropes.

To each of these mentors, I express my enormous gratitude.

JORDAN DESCHAMPS-BRALY, M.D.

IN 1995, DR. DOUGLAS OUSTERHOUT mailed me his brochure about facial feminization. It contained a life-changing epiphany. It began: Looking feminine is, of course, extremely important to you. First impressions are often based just upon your face. That which is first seen in an initial contact is frequently what defines you.

Dr. O then described exactly why my forehead seemed to be my main hindrance to having a feminine face. I had previously undergone an expensive yet useless hair transplant that did nothing to address the underlying structural issues. Dr. O gave me the language to describe what I knew I needed. His brochure mentioned his ground-breaking book