Prizm News / May 7, 2019 / By Staley Munroe
A Q&A With Dr. Vartan Mardirossian
By Staley Munroe
As a double Board-certified facial plastic and reconstructive surgeon, Dr. Vartan Mardirossian is certainly no stranger to wielding his talents to transform lives. As one of the most sought after doctors for facial feminization surgery (FFS), he knows well that these surgeries do not merely represent a physical change, but are also intricately tied to a more full expression of our trans siblings’ authentic identity. With more and more companies now covering FFS in their healthcare offerings, these advancements of physical and mental health have become distinctly more attainable. We chatted with Dr. Mardirossian about how he approaches the delicate and life-changing work of facial plastic surgery.
How did you come to specialize in FFS?
I started doing this type of surgery in Boston with my mentor, and got exposure to the patient population and procedures. I was impressed by the bravery of the patients. It really does take a lot of courage.
How should a candidate approach vetting FFS surgeons?
You have to ask about their background and training: How did they start? How long have they performed surgeries? What is their level of expertise? Then, you have to get a sense of individual chemistry. In my opinion, to be a good doctor, you have to be a good person. But to find out if they’re a good person, you have to get to know the doctor in person. Seeing what they present on social media is just not enough.
What are some common misconceptions patients may have about getting FFS?
Some patients may think certain options aren’t realistic for them, or may have a misconception about the risks. But overall, the trans community is largely well-researched heading into an operation. However, within the general population, some people don’t want to do business with me because I perform these surgeries and work with these communities.
Tell us about your particular approach to a consultation. How do you help individuals with their aesthetic choices?
You really have to listen to what the patients want. That’s the hardest thing in our day and age. Everyone is a big talker, but you have to give the patient the opportunity to voice their concerns and actually say what it is they want. I start by asking what they are thinking and then I open my ears. If they ask me for my opinion, I give it to them based on what I think is best for that particular patient. But I never push procedures on them. In the end, you have to do the right thing for the patient in front of you.
There are differing (and passionate) opinions about going overseas to acquire FFS at a lower cost. What advice would you give readers considering that route?
I am not personally against going overseas. People need to judge for themselves where they are most comfortable. In the United States, our medical care is timely and patient-centered. We have Boards and certifications that just aren’t available elsewhere. Of course we still have issues, but people come from all over the world to be treated here. With regards to overseas work, if there are complications with care, options may be limited. If you’re going overseas, you have to look carefully at the surgeon’s credentials.
Which key procedures do you find to be the most effective in feminizing a patient’s facial features? Reducing the forehead is probably the most notable operation. Additional options include forehead contouring, chin contouring, and adjusting the cheeks, lips, and nose. Of course, it really does all depend on the type of face.
What are your feelings about more insurance providers and companies expanding their healthcare policies to classify FFS procedures as “reconstructive” rather than “cosmetic”?
My experience with insurance has been very disappointing. Many times, insurance providers may claim to cover procedures, but once you look closer, they don’t. Commercial insurance does not keep up with the company benefits provided by more progressive employers like Google, Microsoft, and Boeing. There is a lot of talk, but not a lot of change actually happens. There is definitely still room for improvement.
What is the future of FFS? Are there any new breakthrough procedures on the horizon?
Forehead work and mandible work are making huge strides. One possible expansion is pre-procedure imaging using 3-D holograms of a patient’s face as opposed of the 2D printed images currently used. The more you do a procedure, the more you notice that small things really do matter. The devil is in the details.
What advice would you give to other surgeons considering expanding their practice to include FFS procedures?
I would tell them to start humble and old school: read the latest research, attend meetings, go to cadaver dissection courses, and talk with doctors currently performing these operations. You have to study, you have to work, and you have to travel the world to see how others are doing it. Those are the keys to being successful for your patients.
Any final words of advice?
Be careful of what you see on social media. It’s a great tool for gathering info, but it can be deceptive and misleading when it comes to people presenting themselves as experts.