VFSRAC Q&A
VFSRAC Q&A
Q&A about VFSRAC
- Q.1. Can I feminize my voice through the voice therapy? +-
- Voice therapies may help you mimic the feminine voice but the end result may induce laryngeal diseases like functional voice disorder, vocal tremors, vocal nodules, and so forth due to the repetitive abnormal phonatory pattern which you strain the larynx to produce the higher-pitched voice. Your voice can get easily tired and sore. Another disadvantage is if you do not concentrate on your voice then your pitch may drop back to your male range.
- Q.2. Why is having a voice therapy required then after the VFSRAC surgery and for how long?+-
- There are various types of post-operative voice therapies available and the voice therapy you are required to do is called ‘vocal function exercise’ which mainly focuses on the adaptation of your new vocal folds to train the female resonance without straining vocal folds. Doing the voice exercise plays a vital role to retrain your brain in order to modify your phonatory pattern you need to fully use the newly recreated vocal folds. Voice exercise is required at least for up to 8~12 months usually until your pitch gets stabilized in the female fundamental frequency because the memorization process of the new voice pattern takes 6-8 months in general. If you don’t see any progress then we recommend you should see a laryngologist or a speech language pathologist to practice the exercise in the proper way.
- Q.3. Why does it take so long to have an end result following VFSRAC surgery whereas other types of voice feminization surgeries may bring the instant outcome? +-
- VFSRAC surgery technique is highly differentiated from other existing voice feminization surgeries where it can bring the most natural and permanent outcome through the perfect modification of vocal folds shape itself. It’s not only approximating the vocal folds to make them look shortened on the surface solely but an accurate design of vocal folds is added to make them completely shorter, tighter and thinner considering the vibrating portion and the balance of newly recreated vocal folds. In General, post-op vocal fold muscle remodeling process takes about 5~6 months and as a result you can have perfectly female-shaped vocal folds. It requires certain period of voice training to boost the adaptation process for up to 1 year.
- Q.4. How long is the recovery and adaptation process?+-
- Following VFSRAC surgery you are required to keep in silence for 1 month. Depending on the patient’s ability to retrain their brain to modify the old phonatory pattern it takes 6~12 months in average until one can finally work out on the full use of the newly recreated vocal folds.
- Q.5. What’s the successful rate of VFSRAC? +-
- The successful rate is at 92% and the average pitch increase following VFSRAC surgery is 74hz. However, it does not mean anything to you if you are going to be the 8% of the unsuccessful case. Most important steps consist of post-operative voice rest, voice care and following all given instructions. Depending on your post-op ability to adapt to using your newly recreated vocal folds, brain flexibility, pre-op vocal folds characteristics such as your pitch, severity of vocal tremors, phonatory pattern and so forth will determine the surgery outcome. Despite of the successful surgery procedure, if you cannot make a full use of your new vocal folds you can experience only a slight pitch increase. In that, you will be required to make continuous effort doing the vocal function exercise until you could finally work out on your new vocal folds. We are pretty sure that we have the most reviews from patients and this proves the effectiveness and high satisfaction rate of VFSRAC surgery so it’s worth having this procedure if you should feminize your voice.
- Q.6. Why is Botulinum Toxin treatment required? +-
- A number of patients are diagnosed with a functional voice disorder like vocal tremor. It could be either of genetic problem or from smoking, using an abnormal phonatory pattern, and so forth. In case of patients diagnosed with vocal tremor or focal laryngeal dystonia, they must undergo the Botulinum Toxin treatment to have the vocal tremors under control since vocal tremors could be more exacerbated after the vibrating portion of vocal folds get shortened. With vocal tremor, the use of lower pitch is easier to sound steady that patients unconsciously strain their larynx to sound better which in turn can disturb the pitch-increasing process.
- Q.7. How long should I take the Botulinum Toxin treatment? +-
- When vocal tremor is not severe, taking a single time Botulinum Toxin injection that lasts for 3~4 months and taking 4 month medications (Clonazepam or alternatively Baclofen) when the Botulinum Toxin effect wears off helps the adaptation process but in the severe case you may need further Botulinum Toxin treatment depending on your voice progression. 3 month post-op voice file is required to check the necessity of further Botulinum Toxin treatment.
- Q.8. Why do some people sound hoarse after VFSRAC surgery? +-
- VFSRAC surgery doesn’t leave any scarring on vocal folds that it doesn’t affect the voice quality but when the Botulinum Toxin effect is both on-going and wearing off you can sound hoarse. This is part of the healing process and hoarseness may improve within couple of months or you may need further Botulinum Toxin treatment (usually with medications) to control vocal tremors.
- Q.9. Isn’t the use of laser better than the microscopic works?+-
- Laser creates a web in vocal folds through the vaporization of mucous membrane and this is being done to make it possible to attach bilateral vocal folds and it may leave huge scarring on vocal folds, which could be led to the problems of glottoplasty that are hoarseness and the loosening of the surgical site which decreases the pitch again by time. In that, dissecting the vocal folds membrane using the microscopic tools can draw more effective outcome by precisely preserving normal mucosa and calculating the right membrane to dissect and suture out. This technique requires extensive experience and precise skills of Dr. Kim. The paper about Dr. Kim’s VFSRAC surgery technique is published in the world’s best ENT journal, ‘Laryngoscope’ and this indicates VFSRAC is the most successful way of feminizing one’s voice and all the results we have drawn are not counterfeit but proven in the objective manner.
- Q.10. Is it possible to have VFSRAC surgery after the Cricothyroid approximation or Glottoplasty?+-
- If you have had another type of Voice Feminization Surgery by other surgeons then firstly you should send your video laryngoscopy to check your surgical eligibility. We’ve had many cases of patient who sounded slightly higher-pitched but badly hoarse and rough that the end voice could be barely heard in a quiet room. In this case, we have to undo the surgery and newly perform VFSRAC surgery. At this stage, our first priority is to restore the patient’s voice quality than to feminize the pitch. Pitch could improve through the revision surgery though there could be some limitations on the pitch-increasing process due to the damage already made on vocal folds and related muscles.
- Q.11. Why does it take so long to have feminine pitch after VFSRAC whereas CTA gives the instant outcome? +-
- Firstly Cricothyroid approximation (CTA) requires skin incision in the neck then it binds the cricoids cartilage and thyroid cartilage together to narrow the way to increase the voice pitch. This generates 24-158hz of pitch increase in general but by time pitch may drop resulting in the 58% satisfied and the 33% unsatisfied. Among them the 42% has reported the damaged voice quality and unnatural falsetto voice, especially sounding too hoarse. Especially people who have CTA before the age of 30, there are more chances of inducing voice disorder due to the calcification of cartilage and laryngeal framework change in shape, and the satisfaction level decreases significantly following this issue.
To conclude, CTA approach makes the pitch higher immediately by disrupting the biological function of normal vocal folds while VFSRAC feminize one’s pitch most naturally by preserving all functions of vocal folds and larynx. The cons of VFSRAC surgery is that it takes longer period until you can make the newly recreated vocal folds work through the modification of phonation and it takes around 6~8 months for the full adaptation process. It takes up to 1 year until you could unconsciously sound most naturally feminine through the voice rehabilitation training. However this is a permanent effect and worth it.
General Q&A
- Q.1. What’s the minimum length of stay to have VFSRAC?+-
- We recommend you should stay in Seoul for 9~10 days but in case you need to have an early follow-up then please let us know.
- Q.2. How long is the recovery?+-
- You may have sore throat for couple of days following VFSRAC surgery. Until the surgical site is healed, you are required to keep in silence for 4 weeks completely. Full recovery takes 2 months where you can use your voice without any restrictions in particular.
- Q.3. What should I do to make an appointment?+-
- Before scheduling, please email us via English@yesonvc.com and check your surgical eligibility by submitting the pre-op checklist form and voice file according to given instructions.
- Q.4. How soon can I schedule my appointment?+-
- You can book 1~4 months in advance. 6 week pre-notice must be given to reschedule or cancel your appointment otherwise rescheduling process will be restricted.
- Q.5. Payment +-
- The best way of paying for the surgery fee is to wire-transfer the full amount at least 2~3 weeks ahead. It’s the safest payment method to avoid any conflict with your bank using the credit card.
- Q.6. Hotel recommendation+-
- We recommend you should stay at Princess hotel located within walking distance from our center or you can choose to stay in any hotels in Sinsadong most preferably to avoid heavy traffic during the rush hour.
- Q.7. Korea safety +-
- Korea is very safe and well known for its lowest crime rates. South Koreans are generally very friendly and this friendliness comes from their pride in their heritage.
- Q.8. Food+-
- Not only spicy food is the signature dish in Korea but also western style fusion food are also famous everywhere. It’s easy to get information on the best restaurants in Seoul and most of them are located in the place called ‘Itaewon’ where you can experience all different kind of world food.
- Q.9. Transportation +-
- The main transportations Koreans use include Metro and taxi. Taxi fare is pretty reasonable starting from $3.00 but you must have the address in Korean only. Korea also has well organized Metro system with clear signs in English. You should get ‘T money card’ either for the single use or to top up the money during your stays.
- Q.10. Wi-Fi +-
- Korea’s wi-fi heaven that you can use Wi-fi in nearly all places where you shop, drink and eat. Wi-fi is available at the airport and in metro as well but to make the full use of wi-fi we recommend you should rent a WiFi egg from the mobile companies at the airport. KT, SK and LG U+ are the top 3 mobile companies in Korea.
*For more information, please ask for the guidebook via email Thank you!