Author: keojampamd

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Hair transplantation and Hairline Lowering in San Francisco and Los Angeles

Unlocking Confidence: A Comprehensive Guide to Hair Transplants and Hairline Lowering

In a world where confidence often goes hand in hand with appearance, hair loss can be a significant blow to one’s self-esteem. Whether it’s due to genetics, hormonal changes, or other factors, the emotional impact of thinning hair or a receding hairline can be profound. There are also significant differences in hairline shape for men and women.  Fortunately,  hair transplants and hairline lowering are options available.  We specialize in hair transplantation for men, women, and transgender patients.

Understanding Hair Transplants:
Hair transplantation is a surgical procedure designed to address hair loss by transferring hair follicles from one part of the body, typically the back or sides of the scalp, to the balding or thinning areas. This process involves two primary techniques: follicular unit transplantation (FUT) and follicular unit extraction (FUE).

FUT involves removing a strip of scalp from the donor area and dissecting it into individual follicular units for transplantation. This method may leave a linear scar but allows for the transplantation of a large number of grafts in a single session.

On the other hand, FUE involves harvesting individual follicular units directly from the donor area using a small punch tool, resulting in tiny, dot-like scars that are less noticeable than those from FUT. FUE is preferred by many patients due to its minimally invasive nature and quicker recovery time.

Both techniques offer natural-looking results when performed by skilled surgeons and can effectively restore hair density and coverage in areas affected by baldness or thinning.

Exploring Hairline Lowering:
Hairline lowering, also known as forehead reduction or scalp advancement, is a cosmetic procedure aimed at lowering the hairline to create a more proportionate and aesthetically pleasing facial appearance. This procedure is particularly beneficial for individuals with a high forehead or a disproportionately large forehead-to-face ratio.

During a hairline lowering procedure, excess forehead skin is removed, and the scalp is advanced forward to lower the hairline. This results in a shorter forehead and a more harmonious balance between the facial features. The incisions are carefully placed along the hairline to minimize scarring, and the procedure can be customized to suit each patient’s unique anatomy and desired outcome.

Benefits and Considerations:
Both hair transplants and hairline lowering offer numerous benefits beyond aesthetic improvement. Restoring a fuller head of hair or achieving a lower, more proportionate hairline can significantly enhance self-confidence and quality of life. Many individuals report feeling more youthful, attractive, and self-assured following these procedures.

However, it’s essential to approach these treatments with realistic expectations and an understanding of the potential risks and considerations involved. While hair transplants are generally safe and well-tolerated, they may require multiple sessions to achieve optimal results, and there is a risk of complications such as infection, bleeding, or scarring.

Similarly, hairline lowering surgery carries risks such as temporary numbness or discomfort, as well as the possibility of visible scarring along the hairline. Patients should carefully weigh these factors and discuss their concerns with a qualified cosmetic surgeon before undergoing treatment.

Hair transplants and hairline lowering procedures  offer effective solutions for individuals experiencing hair loss or dissatisfaction with their natural hairline. Whether you’re seeking to restore thinning hair or achieve a more balanced facial profile, desiring a more feminine hairline, and shape, these treatments can help you unlock newfound confidence and embrace life with renewed vigor.

With the right approach, and an experienced hair restoration team can be a transformative journey toward enhanced self-image and well-being.

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Zygoma cheek bone reduction

Zygoma reduction, also known as zygomatic reduction or zygoma reduction surgery, is a procedure that is used to reduce the size of the cheekbones. This procedure is typically performed for cosmetic reasons, as large or prominent cheekbones can make the face appear unbalanced or disproportionately wide.

The zygomatic bone, or cheekbone, is located at the top of the cheek and is a key feature of the face. It is made up of three parts: the frontal process, the temporal process, and the zygomatic arch. In zygoma reduction surgery, Dr Keojampa will perform osteotomies to in-fracture lateral cheek bone in order to reduce the facial width.

The procedure is typically performed under general anesthesia and takes about two to three hours to complete. Dr. Keojampa will make a small side burn incision and an incision inside the mouth, and then use specialized tools to remove to cut the bone. The incisions will then be closed with sutures and the patient will be placed in a compression dressing to protect the area during the healing process.

Recovery time for zygoma reduction surgery varies depending on the individual, but patients can expect to experience some swelling, bruising, and discomfort for the first few days after the procedure. They will also need to avoid strenuous activity and follow post-operative instructions provided by the surgeon.

Overall, zygoma reduction surgery can provide a more balanced and proportionate appearance to the face. It is important to have realistic expectations and understand the risks and benefits of the procedure before deciding to undergo surgery. It’s also important to find an experienced and reputable surgeon who is trained in craniomaxillofacial surgery to perform the procedure.

It’s important to have a detailed consultation with the surgeon to know the outcome of the surgery and post surgery care. The surgeon would also provide the patient with pre-surgery instructions and post-surgery instructions which must be followed carefully to ensure safe and successful recovery.

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Asian V line Surgery | Jaw Reduction Surgery | Cheekbone Reduction

Asian V line Surgery | Los Angeles | Beverly Hills | San Francisco Bay Area

Dr. Keojampa is one of the few experts in the United States that specializes in Asian V line Surgery which includes extensive jaw reduction surgery and Cheekbone reduction surgery.  Unlike many plastic surgeons, Dr. Keojampa performs jaw reduction surgery on a weekly basis and one of the most experienced in the world.

Why consider Asian V line surgery?

Patients who have a boxy, angular, or a wide chin may benefit from jaw narrowing.   Square faces and jaws can be converted into a more oval and feminine shaped.  Wide faces can be significantly slimmed with these techniques along with cheekbone reduction surgery.

How is the surgery performed?

V line jaw surgery is performed under general anesthesia to ensure your comfort and safety.   Incisions are made inside the mouth and completely hidden.  The cheekbone and jaw bone are accessed while identifying and preserving important nerves such as the infraorbital and mental nerves.  Through those openings, Dr Keojampa will reshape the jaw using advance V line jaw reduction techniques such as a T osteotomy for chin narrowing and resection of the mandibular angle.  The goal is to contour the jaw to a more feminine and soft appearance.  We use the most advanced technology to cut and contour the bone with an Ultrasonic Scalpel for Bone Contouring  the Sonopet  to perform osteotomies with the highest precision and safety.   The Sonopet is the most advanced Ultrasonic scalpel used by craniofacial and neurosurgeons as it selectively targets bone without injuring the surrounding nerves and soft tissue.

During your consultation, we perform 3D CT scans for presurgical planning.

3D Virtual Surgical Planning. We are one of the few practices in the world to use extensive 3D virtual surgery planning along with mapping of critical nerves and important structures.  Shown below is the path and location of the inferior alveolar nerve and mental nerve.  This advanced technology allows us to be maximally aggressive but also maximally safe when performing osteotomies and bone contouring.

V line Surgery – Why Choose Dr Keojampa?

  • Dr Keojampa is one of the few surgeons in the world trained in specifically Facial Feminization Surgery and V line surgery which is highly complex craniofacial surgery.  This experience translates to intricate knowledge in the some of the most advanced surgeries performed anywhere in the world.
  • Dr Keojampa is board certified and specialized in Facial Plastic Surgery.  He is a face specialist and does not dilute his expertise in any other area.  Trust your face to a facial plastic surgeon.
  • Dr Keojampa formerly served as a Clinical Assistant Professor and Clinical Instructor at both Harvard Medical School and Boston University School of Medicine.  He has worked as an educator, teacher and involved with training future surgeons.

V line Jaw Surgery Consultations

Based in both the Greater Los Angeles and San Francisco Bay area, we provide in office consultations and skype consultations for patients interested in facial feminization surgery.  We routinely have patients travel out of state and internationally to our center for advanced jaw reduction surgery. 

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Facial Feminization Surgery FFS Insurance Coverage

Facial Feminization Surgery FFS Insurance Coverage

Yes, we are one the few FFS centers that will accept health insurance if your health insurer provides coverage for FFS and willing to sign a letter of agreement to work with our center. We will work with your insurance to determine coverage which sometimes can cover as much as 100% of the cost.  FFS insurance coverage is NOT common and often many insurers will place an exclusion from their health plans.  Our practice is considered out-of-network with all insurance providers.

Facial Feminization Surgery Insurance Coverage

We have had success obtaining insurance coverage for Facial Feminization Surgery from health plans of large technology companies such as Apple, AT&T, Amazon, T-mobile, Dell, Boeing, Oracle, Google, Microsoft, Starbucks along with select health insurance plans from Massachusetts.  Most other insurance plans do not cover FFS and consider it as cosmetic surgery.  These are usually self-insured employer health  plans.  Insurances are constantly changing and we cannot make any guarantees concerning insurance coverage or approval.

Why should Facial Feminization Surgery be a covered benefit for a transgender patient?

We feel privileged that the #transgender community entrusts us with their gender transition and facial gender confirmation surgery. We feel FFS facial feminization surgery is reconstructive surgery and not cosmetic surgery to align one’s outer appearance to one’s identified gender.

Facial Feminization Surgery is a critical part of a transition timetable for a transgender patient who has decided to live full time as female.  Most patients first begin working with a therapist before and after starting hormones.  After being on hormones for an extended period of time, patients will make the transition to go “full time” and it can be essential to undergo FFS to increase acceptance of their new gender.  The importance of “passing” and the role of facial features play an important part of how the general public and others perceive transgender patients. The therapeutic goal of transgender surgeries is to allow a transgender individual to successfully function socially as a member of their desired gender.

One of the most important components of the gender identification is the face and why we feel Facial Feminization Surgery should be considered a medically necessary procedure. Although it is clearly possible to transition from male to female without facial feminization surgery it can be extremely difficult for many individuals if their facial features are distinctly masculine. Even individuals that develop extremely feminine bodies as a result of hormones often find it extremely difficult to gain acceptance if their facial features are extremely masculine. The degree of acceptance individuals attain is often directly correlated with how “congruent” their gender.

Facial Feminization Surgery can affect the quality of day-to-day life far more than any other therapeutic procedure for a transgendered individual, often more so than Genital reassignment surgery.  Facial features that are distinctly masculine can cause individuals to appear always “male” without surgery.  Facial feminization surgery may have a far more profound effect on the quality of life of a transgender individual than genital reassignment surgery and why most patients elect to undergo FFS first and genital reassignment surgery after.

Guide to get your Facial Feminization Surgery surgery covered by insurance

Will insurance cover my surgery? And if it does, how much will I have to pay?

Below are some guidelines to help answer these questions.  First step is to reach out to us for a consultation.

We have an Insurance Concierge who can work with your insurance and will help you through  the insurance approval process until approval is achieved, or until the point where it is clear that you do not have coverage.

To help us , we need the following information from you:

Full Name
Date of Birth
Procedures you are looking to have covered
A scanned copy of your insurance card (front and back)

If available, Facesheet stating which FFS procedures are covered

Scenario 1: Your insurance carrier does not cover the cost of Facial Feminization Surgery.

What You Can Do:

Pay out-of-pocket for the procedure.
Finance your procedure with CareCredit.
Finance your procedure with a loan. There are several lenders who offer loans specifically for plastic surgery procedures.

Scenario 2: Your health insurance covers Facial Feminization Surgery.

What we will need from you for authorization approval:

a letter from a mental health provider stating that you meet WPATH guidelines for surgery
notes from your consultation with Dr. Keojampa which we will have ready 1-2 weeks after your consultation
There may be additional requirements based on individual circumstances such as a letter of agreement between our center and your health insurance company.

The process of obtaining all the necessary approvals for insurance coverage for facial feminization surgery can take several months depending on your insurer.

Gender Confirmation Surgery with Related Services – Examples from AT&T Benefits Insurance

Effective January 1, 2017 or as soon as administratively feasible thereafter, benefits provided under the AT&T self-insured medical
programs (currently administered by BCBS or UHC, depending on your program) will include coverage for gender confirmation
services based on the recommendations for medical standards of care issued by the World Professional Association for Transgender
Health (WPATH). The services currently included under this coverage are listed below.

Note: Members who meet the criteria for gender confirmation services may elect to have some or all appropriate services listed.
For example, an individual may choose to just have breast modification, but not the full male to female / female to male surgeries.

Facial Feminization Surgery Coverage
Covered Services

Primary Sexual Characteristic Services
Female to Male Surgeries
Male to Female Surgeries1
Secondary Sexual Characteristic Services
Reduction thyroid chondroplasty or trachea shaving (reduction of Adam’s apple)
Blepharoplasty (rejuvenation of the eyelid)
Brow lift
Calf implants
Cheek implants
Chin or nose implants
External penile prosthesis (vacuum erection devices)
Face lift (rhytidectomy)
Facial bone reconstruction/sculpturing/reduction, includes jaw shortening
Forehead lift or contouring
Hair removal (may include donor skin sites) or hair transplantation (electrolysis or hairplasty)
Laryngoplasty
Lip reduction or lip enhancement
Liposuction/lipofilling or body contouring or modeling of waist, buttocks, hips, and thighs reduction
Neck tightening
Pectoral implants
Redundant/excessive skin removal
Rhinoplasty (nose correction)
Skin resurfacing

Voice modification surgery
Voice (speech) therapy or voice lessons
Treatment with hormone therapy or secondary sexual characteristic surgeries for individuals under
the age of majority (18 years old) i.e. puberty-suppressing hormones or masculinizing /feminizing
hormones
Abdominoplasty

Testicular expanders

Commonly used Insurance CPT codes for Facial Feminization Surgery

21139 Reduction Forehead; Contouring & Setback, Anterior Frontal Sinus Wall
67900 Repair, Brow Ptosis, (Supraciliary/Mid-Forehead/Coronal Approach)
61782 Stereotactic computer-assisted (navigational) procedure; cranial, extradural
14041 Scalp advancement
15776 Hair Transplants; > 15 Punch Grafts
15876 Suction Assisted Lipectomy; Head & Neck
20926 Tissue grafts, other (eg, paratenon, fat, dermis)
21122 Genioplasty; Sliding Osteotomies, 2+ Osteotomies
21195 Reconstruction, Mandibular Rami &/or Body, Sagittal Split; w/o Int Rigid Fixation
21209 Osteoplasty, Facial Bones; Reduction
21270 Malar Augmentation, Prosthetic Matl
Modifiers: -50 Bilateral Procedure
31599 Tracheal Shave
40652 Lip Lift
30410 Rhinoplasty; Primary; Complete
30520 Septoplasty
30140 Turbinate Resection w/ Submucosal Approach
Modifiers: -50 Bilateral Procedure

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What to expect during your Facial Feminization Surgery Consultation

Facial Feminization Surgery Consultation with Dr. Keojampa 

  • First step of the consultation is reaching out to our office by either completing a consultation form or calling our office.
  • Our experienced office staff will then promptly contact you by email or phone to schedule the desired consult type.  We offer both remote skype consults for our out of town and international patients.  We encourage patients to schedule an in office consultation to see Dr. Keojampa as CT Imaging of the Face and Neck can be performed before the consult  to give the most detailed and accurate recommendations
  • We provide a warm and inviting environment.  Our staff are experienced in treating transgender patients and will not misgender you
  • Costs and Fees are determined after the consultation.  Costs vary with the procedures desired and with estimated operating room and Anesthesia time.
  • In office consultations last 1 hour or more.  During the consultation, CT scans of the Face and Neck are performed and results are reviewed immediately.  Detailed facial measurements are taken.
  • With advanced 3D scanning technology, we can get high-quality 3D images of your entire face and jaw. The images are so accurate that we can use them to create custom surgical guides and for real-time stereotactic image navigation during surgery.
  • Benefits of 3D Scanning
    Our 3D CT scanner offers a variety of benefits over traditional X-rays, including the following:

     

    • More detailed images
    • Fewer surprises or complications during surgery
    • More accurate treatment planning for face and jaw surgeries
  • We discuss your desired goals in detail and take a complete history and examination
    • Typical questions we ask during your consultation include
      • When and how long have you been on hormonal replacement therapy?
      • Have you had or considering sexual reassignment surgery?
      • What do you expect from FFS surgery?
      • What support systems do you have such as a therapist, family or friends to help after surgery?
  • Dr Keojampa will explain in detail all the procedures recommended along how each procedure is performed.
  • Where do our patients come from and who are our typical patients?
    • Our patients come from Los Angeles, San Francisco, Out of State, and Internationally.
    • Our patients range from middle age to sixties and now more commonly younger patients in their early 20s.  Due to public awareness, transgender patients are transitioning to their true gender earlier.  Our older patients typically have always known their true feminine gender but have suppressed those feelings for years by getting married, having children, and pursuing hyper-masculine careers such as the military and athletics.

Facial Feminization Surgery Office and Surgery Location

  • We have offices located in Los Angeles in the beautiful suburb of Marina del Rey and San Francisco. Our office has panoramic views of the Pacific Ocean to provide a calm and relaxing environment during your Facial Feminization Surgery Consultation
  • Attached to our Los Angeles office is Admiralty Surgery Center, a Joint Commission accredited Ambulatory Surgery Center
  • FFS surgery in Los Angeles are performed at Admiralty Surgery Center or St John’s Health Center in Santa Monica
  • FFS surgery in San Francisco are performed at Austin SF Surgery Center,  St Francis Memorial Hospital or Alma at Addison Surgery Center in Palo Alto
  • After surgery, for forehead only cases, most patients are able to return back to home or hotel room to recover.
  • For longer cases lasting > 5 hours or involving Forehead, Midface, and Jaw surgery., patients are admitted to an Acute Surgical Care facility.  All our nurses have extensive experience caring for transgender patients and will correctly address you by your correct gender.

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Facial Plastic Surgery – Why Choose Dr Keojampa | Los Angeles and Marina del Rey California

Facial Plastic Surgery – Why Choose Dr Keojampa?

  • Dr Keojampa is one of the few surgeons in the world trained in specifically Facial Feminization Surgery which is highly complex craniofacial surgery.  This experience translates to intricate knowledge in the some of the most advanced surgeries performed anywhere in the world.
  • Facial Feminization Surgery techniques work extremely well for both men and women.  These same advanced techniques help to rejuvenate and make your results dramatic and natural.
  • Dr Keojampa is board certified and specialized in Facial Plastic Surgery.  He is a face specialist and does not dilute his expertise in any other area.  Trust your face to a facial plastic surgeon.
  • Dr Keojampa formerly served as a Clinical Assistant Professor and Clinical Instructor at both Harvard Medical School and Boston University School of Medicine.  He has worked as an educator, teacher and involved with training future surgeons.
  • What procedures does Dr. Keojampa offer?
    • Facial Feminization Surgery
    • Nasal surgery such as Rhinoplasty, Septoplasty, and Sinus Surgery
    • Eyelid surgery
    • Facelift
    • Forehead and Browlift
    • Chin Augmentation and Reduction including Asian V-line techniques
    • Ear surgery such as otoplasty “ear pinning”
    • Neck and chin liposuction
    • Botox
    • Fillers such as Juvaderm, Belotero, Radiesse, Voluma
    • Lip Lift
    • Treatment of the Aging Face

 

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Facial Feminization Surgery | Forehead Reduction Cranioplasty Type 3 | Los Angeles | California | Dr Keojampa

How is a Type 3 Feminizing Forehead Cranioplasty performed?

Using either a bicoronal behind the hairline incision or pretrichial hairline incision, the forehead browbone and orbital rims area are exposed. Using CT stereotactic image navigation, the borders of the skull and brain are measured.

The lateral forehead and orbital rims are maximally shaved down to setback the forehead and enlarge the orbital space.

A bone island over the frontal sinus is created with stereotactic image navigation measurements. The central forehead bone is temporarily removed and contoured to fit and setback with the rest of the forehead bone.

If needed, a small titanium microplate was used prior for fixation prior.  We are currently using resorbable Sonicweld fixation plates which disappears after about 12 months leaving no permanent hardware.    This is the only way to safely and maximally reduce forehead prominence and bossing which is a telltale sign of masculinity. We are one of the few centers in the world that perform this procedure routinely for #transgender patients. Surprisingly, this procedure is not painful with quick recovery. #facialfeminizationsurgery #ffs #hairlinelowering #Cranioplasty #craniofacialsurgery #facialplasticsurgery #plasticsurgery #losangeles #california #drkeojampa

We strive to perform Type 3 Forehead contouring and setback on every FFS patient. The only reason to not perform a Type 3 Forehead is because the patient does not desire maximal set back of the frontal forehead bossing or the patient has an absent frontal sinus. About  5%  of the general population never develop a frontal sinus which limits the amount the forehead can be setback because the posterior border is the brain.

We perform pre-surgery CT Imaging of the Face and Skull for every patient during the personal office consultation to determine with the highest accuracy how much the forehead can be set back and reduced.  We are able to clearly see the frontal sinus and thickness of the forehead bone. This CT Imaging is also used during surgery for real time Stereotactic Imaging Navigation to help us plan with pinpoint accuracy the bone cuts.  We then temporarily remove the anterior table of the frontal sinus bone and set back the skull. This stereotactic imaging navigation is the same technology to assist neurosurgeons, craniofacial, and ENT surgeons to pinpoint the exact location of critical areas of the brain and skullbase.

If hairline contouring or lowering is needed, we perform a pretrichial incision at the hairline. For patients who do not need hairline lowering, the incision is placed and hidden in the hair bearing scalp (bicoronal incision).

Dr. Keojampa explains Facial Feminizing Forehead Reduction Cranioplasty Type 3 and Hairline Feminization

Facial Feminization Surgery - Forehead Reduction Cranioplasty Type 3

Facial Feminization Surgery Consultations

Based in the Greater Los Angeles region, we provide in office facial feminization consultations and skype consultations for patients interested in facial feminization surgery who are unable due to location to come to our office for the initial consultation. Requests for in office or skype consultations can be made by calling our office (310) 823-4444, sending an email to frontdesk@delreymd.com or using the consult request form. https://goo.gl/forms/G7gYURAGVkK5g9DA3

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Frequently Asked Questions

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Dr Keojampa is one of the few surgeons in the world who has received training in specifically Aesthetic Craniofacial Surgery and Facial Feminization surgery with Dr Jeffrey Spiegel. He has expertise in advanced procedures such as forehead reduction cranioplasty type 3 and V line jaw surgery. Picture with Dr Keojampa and Dr Spiegel taken by one of our FFS patients circa 2006 over a decade ago.  Dr. Keojampa is one of the busiest facial feminization and craniomaxillofacial surgeons in the world, performing on average of three feminization surgeries weekly.

How much do consultations cost?

We highly encourage our patients to visit our office in beautiful Marina del Rey/Los Angeles or  San Francisco Bay for an in-person consultation with Dr. Keojampa.   In office consultations are $800 which includes a 3D CT scan.   High-resolution 3D CT imaging (“CAT scan”) of the skull and face are performed during the consultation.

3D CT Imaging is important to provide 3D visualization of the facial bones and structures and what modifications can be performed. Computer imaging will provide a preview of the results along with accurate communication for the results you desire.  For patients who are not local to our offices, Video consultations can be scheduled and cost $800.  Fees will be applied to surgery if you choose to proceed with Dr. Keojampa.

Where does Dr. Keojampa perform FFS?

Dr. Keojampa performs surgery at the following surgical centers.

SAN FRANCISCO BAY AREA

Austin SF Surgery Center in Downtown San Francisco

LOS ANGELES | MARINA DEL REY

Admiralty Surgery Center – Marina del Rey

Both have received AAAASF accreditation with Medicare deemed status which is the highest level of certification.

How much does FFS cost?

Costs are determined after either an office or skype consultation and are based on the procedures recommended.   Our office will provide you with a cost analysis after your consultation.

Does Dr. Keojampa accept medical insurance?

Our practice, Keojampa MD, is NOT contracted with any insurance providers and is considered out of network.

We are one of the few Aesthetic Craniofacial surgery centers that will accept health insurance if your health insurer provides coverage for craniofacial surgery.  Your insurer MUST sign a letter of agreement or single case agreement to guarantee payment for services otherwise the full payment for surgery will be required in advance.  A letter of agreement is a binding legal contract and will state the intent to pay for the agreed upon charges covered under the pre-approval.

We have had success obtaining insurance coverage for Facial Feminization Surgery from health plans of large technology companies such as Apple, AT&T, Amazon, T-mobile, Dell, Boeing, Oracle, Google, Microsoft, Starbucks along with select health insurance plans from Massachusetts. Most other insurance plans do not cover FFS and consider it as cosmetic surgery.  Insurances are constantly changing and we cannot make any guarantees concerning insurance coverage or approval.

How soon can I book a surgery date?

On average, Dr. Keojampa is booking 12-18 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery.  Our practice is one of the busiest Aesthetic Craniofacial surgery centers in the world.  Sometimes surgery cancellations do occur and at which time we can offer an earlier date.

Preoperative Exam and Necessary Testing

During your presurgery visit, a complete preoperative physical examination along with a personal, family, and medication history are reviewed.  CT Scans of the Skull and Face are performed.  CT scans are superior to regular X-rays as it allows 3D reconstruction and can be used during surgery for stereotactic image navigation.   Depending on your age and medical history, further testing such as a CBC or EKG is requested along with medical clearance by your primary care physician.

What are medications to avoid before surgery?

We recommend stopping any medications that can increase the risk of bleeding 7 days before surgery.  This includes aspirin, ibuprofen blood thinners such as coumadin, and herbal supplements such as Vitamin E and St John’s Wort.  We also request patients to stop estrogen hormone replacement therapy 1 week before surgery as it increases the risk for DVT or deep vein thrombosis.  Most patients can restart 1-2 days after surgery when fully ambulating and walking.

What to Expect on Surgery Day

Once arrived at the hospital or ambulatory surgery center, Dr. Keojampa will meet with you to review your goals and reaffirm the plan for surgery.  You will meet our anesthesiologist who will keep you comfortable during surgery.  Our anesthesiologist is in charge of delivering general anesthesia in the operating room and tracking your vital signs (blood pressure, heart rate, EKG, oxygen saturation, and etc.)

After Facial Feminization Surgery

After the completion of your facial feminization surgery, our anesthesiologist will wake you up from surgery.  A head wrap will be placed and you will be transferred to the recovery room.  Most patients recover over 2-3 hours and then transferred either to an aftercare surgical care facility.

Consultation with Dr. Keojampa

  • First step of the consultation is reaching out to our office by either completing a consultation form or calling our office.
  • Our experienced office staff will then promptly contact you by email or phone to schedule the desired consult type.  We offer both remote skype consults for our out of town and international patients.  We encourage patients to schedule an in office consultation to see Dr. Keojampa as CT Imaging of the Face and Neck can be performed before the consult  to give the most detailed and accurate recommendations
  • Costs and Fees are determined after the consultation.  Costs vary with the procedures desired and with estimated operating room and Anesthesia time.
  • In office consultations last 1 hour or more.  During the consultation, CT scans of the Face and Neck are performed and results are reviewed immediately.  Detailed facial measurements are taken.
  • With advanced 3D scanning technology, we can get high-quality 3D images of your entire face and jaw. The images are so accurate that we can use them to create custom surgical guides and for real-time stereotactic image navigation during surgery.
  • Benefits of 3D Scanning
    Our 3D CT scanner offers a variety of benefits over traditional X-rays, including the following:

    • More detailed images
    • Fewer surprises or complications during surgery
    • More accurate treatment planning for face and jaw surgeries
  • We discuss your desired goals in detail and take a complete history and examination
    • Typical questions we ask during your consultation include
      • When and how long have you been on hormonal replacement therapy?
      • Have you had or considering sexual reassignment surgery?
      • What do you expect from FFS surgery?
      • What support systems do you have such as a therapist, family or friends to help after surgery?
  • Dr. Keojampa will explain in detail all the procedures recommended along how each procedure is performed.
  • Where do our patients come from?
    • Our patients come from Los Angeles, Out of State, and Internationally.
  • After surgery, for forehead only cases, most patients are able to return back to home or hotel room to recover.
  • For longer cases lasting > 6 hours or involving Forehead, Midface, and Jaw surgery., patients are admitted to an Acute Surgical Care facility.  All our nurses have extensive experience caring for transgender patients and will correctly address you by your correct gender.

Why Choose Dr Keojampa?

  • Dr Keojampa is one of the few surgeons in the world trained in specifically Facial Feminization Surgery which is highly complex craniofacial surgery.  This experience translates to intricate knowledge in the some of the most advanced surgeries performed anywhere in the world.
  • Facial Feminization Surgery techniques work extremely well for both men and women.  These same advanced techniques help to rejuvenate and make your results dramatic and natural.
  • Dr Keojampa is board certified and specialized in Facial Plastic Surgery.  He is a face specialist and does not dilute his expertise in any other area.  Trust your face to a facial plastic surgeon.
  • Dr Keojampa formerly served as a Clinical Assistant Professor and Clinical Instructor at both Harvard Medical School and Boston University School of Medicine.  He has worked as an educator, teacher and involved with training future surgeons.
  • What procedures does Dr. Keojampa offer?
    • Facial Feminization Surgery
    • Nasal surgery such as Rhinoplasty, Septoplasty, and Sinus Surgery
    • Eyelid surgery
    • Facelift
    • Forehead and Browlift
    • Chin Augmentation and Reduction including Asian V-line techniques
    • Ear surgery such as otoplasty “ear pinning”
    • Neck and chin liposuction
    • Lip Lift
    • Treatment of the Aging Face
    • Aesthetic Orthognathic Surgery – Double Jaw Surgery
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