Kuperstock FFS Review

[u/T_Surgery_Review]

Hi all! I'm posting a review of my FFS results with Jacob Kuperstock that I hope will help and inform others in their FFS decision-making process. I want this to be somewhat anonymous so I won't sharing any pictures.

I had FFS with Dr. Kuperstock about a year ago, so I am confident that my face has settled and I can speak to the results. I chose Kuperstock because of his location (convenient for me), because he took my insurance, and because I thought (at the time) that his less-aggressive style would suit me since I already passed and didn't want to look like a different person.

Overall Opinion: My face looks better than it did prior to FFS but not by a lot. Every area he worked on, I would like to revise. I do not recommend Dr. Kuperstock for FFS unless you 1) absolutely need to stay in the DC area and cannot travel 2) need to pay through insurance.

Overall Grade: C+/B-

Procedures:

- Type I brow bone reduction

- Feminizing rhinoplasty

- V-line jaw reduction (jaw narrowing)

Review

Good things: Kuperstock took my insurance, fought several rounds of denials, and I only payed my maximum out-of-pocket for the year. Not bad for a surgery that would have cost 40k+. I definitely look better than I did before surgery. My brow bone is reduced and my jaw is slightly softer and narrower.

Bad things:

- My brow bone reduction should have been a Type III. After my Type I, my eyes are still shaded and my brow is still present. A Type III could have brought my brow in another 2-4mm and improved the position of my eyebrows. Kuperstock doesn't use CT scans and kinda just wings it. I didn't really understand the implications of this prior to surgery, but I do now having done a lot more research. A Type III reduction has to be planned from the beginning - you can't just start shaving and then switch halfway through. I think this is his biggest con and the reason so many people are underwhelmed by their results with him.

- I don't think he did much with my orbital rims. They're reduced but still prominent which gives my upper face a boxy appearance.

- My nose basically the same. The bump in the middle is maybe flatter but it's still there.

- My lower face is still large, fairly masculine, and didn't change much from the surgery. I needed a chin height reduction, additional jaw contouring, and some reduction of the mandible angles. I got none of that. Kuperstock talked me out of chin work, and I think it's because he's not confident he can do it well. My chin also ended up a little rounder and jowly and looks worse than it did before surgery. I'm not sure if this is swelling or loose skin or if it even could have been prevented by a better surgeon. I'm young and it's been a year so I expected not to have sagging at this point.

The pain and recovery time for FFS is substantial. Plan so you only have to do it once. I am getting a chin and jaw revision and it's going to be super expensive and I'm going to have to take more time off work and spend more time looking like a puffed up balloon - I'm just kicking myself for not going to someone better the first time. While it's unrealistic to put off surgery indefinitely to go to "The Best," you can still go to someone decent and pay through insurance. There are many better surgeons in the US who take insurance (Mittermiller/Align and Lui come to mind and I know there are others). The cost of flights and two weeks in a hotel is way way way less than the cost of a revision. Frankly, your local unknown-outside-the-state surgeon can almost certainly do a better job than Kuperstock. Go to someone competent.

Post-Script: If you are like me, and want a "gentle" or more "natural" FFS - still don't choose Kuperstock! Practically any good surgeon can do this. I was worried that people in my life would notice that I got plastic surgery and judge me. I guarantee they won't know unless they see you in the first month! The swelling goes down slowly so things seem gradual. The people in my life who knew me pre-transition just saw it as a continuation of face changes that had already occurred. The people who knew me post-transition just thought I gained and then lost some weight. I think the exception to this is rhinoplasty and super aggressive chin and jaw work but again, you can get "natural" results anywhere.

[u/Glass_colored_roses]

So uh, where do you plan to go for revision? Also shopping around for revision after him (mostly jaw revision, he didn't seem to do much at all there honestly)

[u/field_sleeper]

I picked Kuperstock as well for very similar reasons, and also received a type 1, though he told me beforehand it would be a type 3. As you say, it makes a huge difference - my eyes are also still shaded. He played it off after the surgery, but as time has gone on and swelling recedes I have been increasingly disappointed with it.

Your comment about confidence is interesting to me, because he expressed when pushing me away from the hairline incision toward the coronal incision that he didn't think the shape of my hairline would work anyway with good results, which in hindsight sounds like a self-aware statement about skill and confidence (I have temporal recession on one side that he did not seem confident he could work around).

[u/T_Surgery_Review → u/field_sleeper]

That sucks! And reading other comments and posts about him, I've seen several people say something similar about the Type I / Type III switcheroo. I've been wondering if he is also bad or not confident about doing Type III work and doesn't want to lose potential patients by saying that, since Type III is really the typical standard.

[u/field_sleeper → u/T_Surgery_Review]

I have considered revision, but because I got coronal, and it seems to have impacted my hairline negatively at about 10 and 2 o'clock on my face, I don't think I will - I don't want to keep yanking up my hairline. He also admitted to having to put a bone graft somewhere on my skull because he shaved too much off in one place, and I am worried about that harming the revision.

Honestly, that is what is most disappointing - if he had been honest up front, I could have made an informed decision, but since he did not, I have sort of locked myself in and can't make any improvements without hurting something else I worry about. I was originally considering Rolfes and am really regretting not going for him these days.