Chapter 25 - Consultation with Stephen

Setting up the appointment with Stephen was easy enough as the patient information didn’t really change. I just introduced myself on the phone to the receptionist as PJ Beaufort and requested a follow-up consultation with Dr. Stephen Gold and got one scheduled for later in the week. Going to the appointment was a different situation entirely as it seems they keep internal records of their patients, including photographs. I had to whisper shout at the receptionist and pull out my new driver’s license to prove that I was the same person that had been here earlier in the year. And even with that, she didn’t look fully convinced.

When Stephen walks into the consultation room he immediately puts on his professional smile and starts to apologize for coming into the wrong room. I have to stand up and grab his arm as he’s almost out of the office before I can even tell him that he has the right room. Thankfully Stephen knew about my play in college, making it easy to convince him that I was me underneath all this femininity.

“Let me get this straight Jamie, you have to dress and act like a woman for nearly the next year or the company you are at will prosecute you? And you’re working for a man who you were trying to get fired for sexual harassment and sexual ****?” The look on Stephen’s face says he is having a hard time believing the story even as I sit here before him dressed up and sounding as I am.

With a deep sigh I lean forward and say “Yeah, that’s basically it. I swear I have so many lies and stories going around me that it’s hard to keep track of them all but that’s the gist. To the HR department and on any corporate records, I’m transitioning from male to female. The HR director is the one that blackmailed me, so he knows the truth as does my boss and Grace. The HR secretary believes I really am transitioning and is helping me with the transition, as is my gender therapist whom I’m required to see. To everyone else, I’m a woman. I even have to play this part at home since my gender therapist will make unexpected visits to check up on me. Plus, I have to keep these damned breast forms on for days at a time, so it’s not like I can go out as me. And by the way, just to make it easy, call me Paris while I’m dressed like this, okay?”

Stephen’s face still reads that he doesn’t believe everything I’m saying but he at least nods and accepts it like a good friend. “Okay Paris, I can do that. So, is this consultation part of the ruse? You know this firm specializes in male to female transitions, though it sounds like you don’t actually want surgical changes. Do you want notes talking about it though?”

I break out laughing, covering my mouth with one hand and holding up the other to stop Stephen’s line of questioning. When I can finally talk calmly, I respond, “No. God, no! This is just to take advantage of the one benefit I get out of all this. I have real medical insurance now and can get the, um, what did you call it? Sepopastey? The sinus surgery?”

Stephen takes a moment to laugh himself before correcting me. “Septoplasty. Yes, we can set that up. It should be an easy procedure. You know though that you’ll be under general anesthesia, right? That means you’ll be stripped down under a drape and gown. We’ll have to have the breast forms off.”

I hadn’t thought of how I’d come into the surgical procedure and had just assumed I could do it as myself. My male self. But Stephen mentioning my breast forms reminds me that I don’t really have any male self to present as now. Even without the breast forms on, I don’t have any male clothes and have to keep my body hairless. At the same time, I can’t present as female as they’ll see my genitals and lack of breasts. Shrugging I say hesitantly, “Umm, I guess so? I’d only been thinking of the surgery as my old self. As Jamie. But I’ll have to come as Paris. And I won’t even be able to hide as a woman, I’ll have to let everyone know that I’m transitioning from male to female. Right?”

Stephen smiles comfortingly and even reaches forward and lightly pats my knee, “Hey, don’t worry about it Paris. Remember, we work with many transitioning people. You coming in like this will actually make more sense to our team than you coming in as Jamie. You’ll be treated with complete respect. If I’m honest, they’ll probably ask you questions on how your transition is going and about your beauty regimen as you are quite striking already without any work from us.”

I feel a lot better about it after Stephen’s explanation. As he pulls out my paper record and goes over the specifics with me about the procedure, the anesthesia, the minimal surgical work, the healing, and any medications used before, during, and after the procedure, I grow curious about what a transitioning person would go through. When it looks like Stephen is done, I lean forward and let curiosity take over, “Hey, if you have the time, could you walk me through what a transitioning person would use you guys for? My gender therapist has hinted at it, and I honestly have no idea and I’m afraid it’s going to sound odd that I know about this stuff.”

Stephen checks his schedule and confirms with a medical aid that he doesn’t’ have an upcoming appointment. He then pulls out another medical folder and makes another printout of my medical records. “Here, lets show you realistically what it would look like. And don’t worry, no one will mix these up as they’ll be easy to tell apart. We’d start with a consultation much like we had before. Pure medical information to get us a baseline. The only additional questions would be from your gender therapist and or mental health team. Insurance wise, we’d need their go ahead.”

Stephen shows me the mental health consultation form. The Sculpted Dream system is so integrated with my insurance and other medical records that the form actually printed out with Suzy’s information on top. “Once we have this returned to us from your team, we’d then discuss what your goals are. Let’s play this out.” Stephen clears his throat and sits up a little straighter, his voice shifting into a more professional tone, “Miss Beaufort, we have your transcripts from Dr. Martin and she’s excited about approving you for gender affirming surgery. I’m assuming, since you haven’t had any work done, that you’re not ready for a full transition at this time, correct?”

Playing along, I also sit up straighter and clear my throat before answering, “That’s right Dr. Gold. I want to look as feminine as possible but not become a full woman down there just yet. What procedures would you suggest?”

It’s clear that while Stephen knows all about these procedures, it’s not his specialty. But he’s still through in what can be done. “The most obvious and overt changes we can offer would be breast implants and facial feminization. We could use your current breast forms as guides. They seem to be a good D cup. Assuming that your gender-affirming hormone therapy continues to work, I’d suggest staying at that size as with the implants you’d likely grow into an E cup. Or a double D cup if you prefer that nomenclature. For facial feminization surgery we can of course include your septoplasty, but the real treat is going full bore. We’d start with forehead and hairline contouring where we’d shape your forehead giving a more oval or heart shape to the face. We can even reduce your brow ridge. Your scalp can be lowered which gives you a far less masculine look. Next, we’d go for a brow lift and maybe an eyelid lift. These help open your eyes more naturally and are done through the same incisions as your forehead contouring. Many people need a radical rhinoplasty, or nose surgery, but your nose is actually quite feminine as is and we’d only do a little touch up by reshaping the bridge a bit.”

Stephen reaches forward and gently grips my lower face, turning it so he can look more closely at my ear and jaw line. “Many in your position need jaw contouring and even a chin reduction which is major surgery with major healing time, but your jaw is beautiful as is.” After a quiet knock on the door someone walks in and whispers something in Stephen’s ear. They whisper back and forth several times, all the while Stephen is holding my face gently, not letting me turn or even sit back. Finaly Stephen speaks up loud enough for me to hear, “No, she’s a patient. She’s just beginning her transition and I’m going over different options. We’re talking facial feminization right now, but I’ll keep you in the loop should she decide on anything in your area.”

As the man walks out and closes the door behind him Stephen turns back to me as if he hadn’t been awkwardly holding my face for several minutes and just picked up where he left off, “Where was I? Oh, yes. Your jaw. I’d simply do a little fat grafting so soften up the jaw angle back here and your chin, but just a touch. Then we’d move on to your trachea and do a little shaving. Our specialized procedure not only reduces your Adam’s apple prominence but also takes the hard edge off of your voice. Most of our clients, even those with beautiful voices like yours, love that effect!”

Stephen turns my face back and I can understand better why people fall for their plastic surgeons as he has a very gentle and intimate touch. “The last real surgical part is also where we shine and that’s a little liposuction and fat grafting. In normal speech, that’s moving the fat around on your face. It’s truly more art than science but our surgeons are experts at it and it’s an amazing transformative effect. But we don’t stop there.”

Stephen pulls out some pamphlets and lays them out on the table between us, “There are a whole host of injectables and fillers that we can add since there are limited fat deposits to work with, although we do have a new sterile non-reactive additive we can put into the fat that works really well. These would be used to augment your lips, or to shape the contours around your mouth and eyes. If we use the artificial fillers, they last a few months. If we use your fat and the additives, it can last much much longer.”

Just as I pick up one of the pamphlets there’s another knock at the door and an older woman walks in. Just like the man before, she walks up to Stephen and they start talking quietly to each other. I don’t want to even appear like I’m eavesdropping, so I just continue to read the pamphlet I picked up, which happens to be all about lip plumping. The last few pages are full of women’s beautiful full plump lips, and I have to adjust my position as I feel myself growing hard under my gaff. I’m startled back to the present as the woman is suddenly crouched down next to me, looking at the pamphlet in my hand. “Just starting your transition dear? Well, lips are my specialty, and I think your with full face, along with some feminization techniques that Dr. Gold will go over, you would make these lips look fantastic. They’re not the over-the-top clown like bimbo porn style lips but are very large, very plump, very kissable, very sexy lips. They’d be adorable on you and would drive any boyfriend crazy!”

The lips she points out do look amazing, though I can’t imagine having lips like that on myself. Nor what effect it would have in the office as I’m sure every man there would be imagining my lips… nope, not going to think about that. I push the thought out of my head before it can fester and turn back to Stephen.

I’m blown away with all this information. I had no idea that just working on someone’s face would be so in depth with so many different procedures. But even as I try to digest all of it, Stephen goes on, “We can also work with hair removal. We used to do this with laser or electrolysis, but we use a new patented technique that’s a combination of a chemical depilatory and a high intensity but broad focused laser that is amazing at targeting hair follicles and nothing else. And finally, if needed, we have several ways we can deal with skin resurfacing, but you wouldn’t need that as your soft skin is perfect and feminine as is.”

We continue to discuss other procedures they could provide to a transitioning woman including removing their lowest ribs to accommodate a thinner waist, lower body lifts including a butt lift and even work on thighs and hips, and several techniques on nipping their waist in. They even can provide the bands around the stomach that prevent you from eating too much, basically forcing you to eat like a rabbit.

While he goes over all these different procedures, Stephen shows me various before and after photos and I’m amazed with the healing that they accomplish considering just how much work is being done. He also shows me the paperwork that would accompany it, and I see what he meant in that my medical record with just the septoplasty was tiny compared to this version with dozens of pages of procedures.

While he goes over everything with me, we’re constantly interrupted by various surgeons and other staff members looking for advice from Stephen. Each is introduced to me as a client that’s here for a simple plastic surgical procedure but am looking at feminization surgeries as I’m ‘obviously’ transitioning. And each one of them offers advice on what procedure would make me look better.

The last surgeon actually needed Stephen to come into their procedure room as he was having trouble with some new skin grafting technique. Stephen excused himself and said he’d be back in a few minutes.

He wasn’t gone for more than two minutes before there was another knock on the door. A stunningly beautiful woman walks into the room and right up to me. “Good afternoon, Paris! Dr. Gold has told me all about you! I’m Dr. Amelia Montgomery, the head surgeon and lead partner here at Sculpted Dream. I wanted to introduce myself as I want to be on a first name basis with all of our clients that are transitioning.”

With a closer look I can see that she’s had cosmetic procedures done on herself, but they’ve been done flawlessly as at first glance she looks no older than twenty-eight years old, though she must be in her forties or fifties. When she looks at the table she picks up the thick faux medical records that Stephen was making, with all the top end feminization procedures. “Oh my, it looks like you’re truly ready to take the next step. I see that Dr. Gold has gone over everything, and I have to agree with his notes that these will indeed give you the most feminine of faces and bodies. You’re already beautiful as you are of course, but you’ll be stunningly beautiful after we get done with you!”

Before I can correct her and let her know that we were just going over what was possible, Stephen walks back in. Dr. Montgomery tells him that she was just introducing herself to me as several of the other surgeons had told her about the beautiful woman getting a consult from him. “I have all the faith in the world that you can lead her through her transition Dr. Gold. But you’ll have to excuse me, I have another appointment and really just wanted to step in and introduce myself.”

And with that, Dr. Montgomery strides out of the room. Stephen turns back to me with a sheepish grin, “Hey, sorry for not correcting her. But if she even thinks that I’m bringing in a client with all these procedures it’s great for my career. If you were approved for all of this by your gender therapist and your workplace, your insurance would cover almost everything. You’d pay the same two-thousand-dollar deductible you’ll pay for your septoplasty, but where we’ll bill your insurance thirty thousand dollars and after discounts get paid about twenty thousand for a septoplasty, all of these procedures would entail us billing around half a million and likely getting paid almost all of it. It's no wonder she stopped by! Now, lets get the scheduler and get your procedure on the books.”