Scrotal skin graft In this technique, the penile skin is used to create the outer vagina, whilst the skin of the scrotum is used to create the vaginal canal. Mardirossian Facial Aesthetics is proud to share before and after pictures that showcase the results we have helped patients in Jupiter, West Palm Beach and Lake Worth, FL, achieve. Transgender rhinoplasty doesnt differ from standard cosmetic rhinoplasty. There is no "correct" way to heal after top surgery. FFS is tailored to each person and can encompass up to every aspect of the face and neck. Because FFS is such an important procedure, it is paramount to work with only the most expert surgeons. Some chins call for a chin reduction. Life & Style has affiliate partnerships so we may receive compensation for some links to products and services. FFS Surgery Before and After, Procedures, Recovery and Post-Op Care. Payments Made Directly to Hospital. We do not digitally alter or artificially overexpose our clinical photos. No number of words can express our appreciation to all of the contributors of this before and after FFS gallery. You may find it painful to chew solid food for a few days. (Russian) Post-FFS photo of Lynn: March 29, 2000. To learn more about facial feminization surgery, contact us today atMardirossian Facial Aesthetics. Proc, Still swollen but beautiful results coming through, Facial feminization surgery - before and 22 months, Cheek reduction surgery - before and one month aft, Permanent upper and lower lip augmentation with fa, Facial feminization surgery - detail from yesterda, Voice feminization- before and 3 months after! We believe that this makes it easier to evaluate the facial changes objectively and without distractions, as these facial changes are the only that matter. You may still have to pay out of pocket. This encompasses everything from facial procedures to bottom surgeries. If you are already on the transition path or just exploring options, our professionals will help you set the benchmarks in order to make the best decision for you. Before and after photos are not guarantees that your results will be the same or even similar: Surgical results can vary greatly from one individual to another and thus these photos are not intended to represent the results that every patient can expect. Facial Feminization Surgery. Fields marked with an * are required. If you have more questions or would like to schedule a free consultation with Dr. Tran, please contact us via our website, Tran Plastic mobile app or call us today at 714-839-8000. When multiple surgeries are desired, the surgeon will plan a staged approach. The course of recovery for the different procedures can vary, and it can be influenced by your general state of health and your self-care after surgery. The upper lip often curls more upward. The TikTok star and trans activist provided an update on how she is doing post going under the knife for facial . The non-verbal communication a face transmits is worth a thousand words. Administering cosmetic fillers may take an hour or less, while complex facial surgery may take several hours. At Another Johns Hopkins Member Hospital: The Center for Transgender Health Team at Johns Hopkins, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, More about the Center for Transgender Health, LGBTQ Health Care: Answers from Expert Paula Neira. The cheapest caesarean section is 48,000 baht (year 2020) including sterilization 53,000 baht. Unfortunately, not every insurance company covers Facial Feminization Surgery, unless deemed to be a medical necessity. Facial feminization surgery cost: Fat Graft. A tracheal shave reduces the appearance of the Adams apple. If you are a human seeing this field, please leave it empty. A metoidioplasty is a method of constructing a new penis, or neopenis. Each area of the face is addressed in separate procedures: Forehead procedures contour the forehead by shaving down hard angles and reducing the prominence of the brow bone. In general, you can expect to go home after surgery. When bathing or showering, be sure to use unscented soap, and never allow the water to directly spray the surgical area. Sona Avedian. When developing a surgical plan Dr. Spiegel works with each patient to discuss their lifestyle, recovery timeframe, and aesthetic desires to make sure we are offering a plan that fits. Before. are rarely able to fully convey the magnitude of the profoundly positive impact FFS has on their lives. Our FFS case analysis in Marbella includes a FFS before and after photographic simulation that gives you an idea of potential results. Rhinoplasty for facial feminization may include reducing the overall size of the nose and its angles. Before and After 1 month surgery, Facial Feminization Surgery, FFS,Forehead Shaving,Rhinoplasty, Hair Line Lowering, Chin Forward Sliding. Healthline Media does not provide medical advice, diagnosis, or treatment. Most facial plastic surgeries involve a day or so in the hospital for observation and to ensure you are healing properly before you are released to go home. In recent years, a new method of coronal incision (along the top of the head) has been pioneered by the FacialTeam in Spain. Call us at 617-566- 3223. Your access to affirming care and your ability to pay will also affect when you can get top. Examples of female facial traits include a higher brow bone, larger eyes, more delicate nose, less pronounced Adam's apple, and a narrower jaw.. Theyll let you know if you need to stop taking them for the procedure. 51325160_1862245780552913_51554091556111 1/3. +1.415.877.6585 SAN FRANCISCO. Facial feminization surgery, or FFS, is a series of plastic surgery procedures designed to create a more feminine appearance of the face for patients undergoing gender affirmation treatment. To learn more about facial feminization surgery, contact us today at Mardirossian Facial Aesthetics. Well be happy to answer your questions or help you schedule a consultation. Please be sure that you understand that YOUR actual results will likely vary significantly from other patients results, including their before and after photos, even if you feel that you look very similar to another patient in their BEFORE images, because you are a unique person. When developing a surgical plan Dr. Spiegel works with each patient to discuss their lifestyle, recovery timeframe, and aesthetic desires to make sure we are offering a plan that fits. It also helps to reach out to former patients of the surgeons that interest you. Trans rights activist and content creator Dylan Mulvaney has gotten facial feminization surgery. Never stop taking medications with approval from a doctor. 617-566-3223. FFS mostly focuses on bone structure and nose shape. Let yourself be convinced by the women who have already experienced this change. "Facial feminization part 1," Dylan, 26, captioned her . FFS is ideal for trans women and non-transgender women who want a more feminine facial appearance. The goal is to soften masculinized features into a shape more typically . The body procedures we offer include the following: Gender Affirming Male Before and After Pictures. Though the procedures are largely safe, it is important tocall your doctor right away if you develop a fever, severe pain or other signs of infection, or if you have any other concerns. Doctors and nurses take good care. We are committed to a diverse representation of people of different ages, ethnicities and nationalities in this gallery of FFS outcomes. Its only recommended by some surgeons in certain cases. A former US Marine named Matthew has recently underwent an amazing transformation after taking hormone therapy to turn into 33-year-old beautiful Sona Avedian. Facial feminization surgery (FFS) involves a comprehensive set of procedures to make your face appear more feminine. Transgender Facial Feminization Surgery Photos, Transgender woman treated with Transgender Facial Feminization Surgery, Patient treated with Cheek Augmentation, Facial Feminization Surgery, Facelift, Neck Lift, Rhinoplasty, Septoplasty, Transgender, Patient treated with Facial Feminization Surgery, Transgender Facial Feminization Surgery, customized infraorbital rim implant in transgender female, Patient treated with MTF Facial Feminization Surgery, 25-34 year old woman treated with MTF Facial Feminization Surgery, Woman treated with MTF Facial Feminization Surgery, More about Transgender Facial Feminization Surgery. Please reach out and let us know other ways we can help. For this reason, we only use facial feminization before and after results of patients that had surgery at Facialteam. Ama, Before and 10 months after facial feminization sur, Simultaneous forehead contouring and cheekbone red, Before and 1 year after FFS. Your surgeon might have other requirements based off of the procedure that youre getting. Aggressive reductions risk exposing or severing the nerve. She thanked her face and said that while it "did me good," it also "sparked sadness far too often. "I wanted to reclaim my body in a positive way, and now you've taken that and you turned it into something really ugly," Mulvaney said, and urging Jenner to think back to her own early days of transition. These Celebs Love Posting Naked Photos, Brad Pitt and Angelina Jolie's Teen Daughter Shiloh's Transformation, Brit Awards 2023 Best, Worst Dressed Celebs: Red Carpet Photos, Her Swimsuits Don't Lie! Christina Aguileras Best Swimsuit Pictures, Scheana Shay: Why Husband Brock Took a Step Back From 'Pump Rules', VPRs Scheana Never Meant to Hurt Katie With Raquel, Tom Hookup, VPR's Raquel Leviss Reflects on Posting 'Polarizing' Tom Schwartz Photo, Why Love Is Blind's Deepti Is 'Not Ready' for a 'Serious Relationship', Summer House's Paige Explains Why Long Distance Works For Her and Craig, Summer Houses Carl, Lindsay Are Ready for Marriage, Babies, Jodie Woods Skipped Awkward Phase, Sister Jordyn Reveals, Jordyn Woods on Growing Up in the Public Eye: Believe in Yourself, Jordyn Woods Has Inseparable Bond With Boyfriend Karl-Anthony Towns. FFS for most patients is not remembered due to the pain suffered, but for discomfort related to swelling. It is important to follow the doctors advice for the weeks following a tracheal shave. Welcoming Dr. Jacob Tower to The Spiegel Center! It may be an option to ask them. The forehead is accessed through an incision in the scalp. You may experience some throat pain or discomfort. Do not shave or use hair-removal processes such as waxing until your doctor clears you to resume these practices. We so much appreciate, 2 months after VFS: voice steadily improving. In addition to plastic surgery, facial feminization procedures include nonsurgical treatments such as cosmetic fillers, botulinum toxin, fat grafting and liposuction. For people in whom hormone therapy is not enough to achieve desired gender-affirming changes to theface, surgery can help. But its hard to put into words. Make sure to tell your surgeon about any other medications you regularly take. She does more than 150 a year. The doctor said very encouraging. See Shakira's Hottest Bikini Pictures, Shes a Genie in a Bikini! This year, Mulvaney became both an advocate for trans rights and a target for right wing anti-trans figures. Facial feminization surgery: Current state of the art. Ultimately theyve all voiced to me that they see what Im doing is for good. The answer is more complicated than you may think but the question itself may be the wrong one to ask. Please note that this form cannot be used to reset your Google or Facebook password. Rachael ffs By Dr Bart van de Ven The procedures were performed over 2 surgery dates (May 27 and September 21 2021) Louise ffs By Dr Bart van de Ven The procedures have been performed over 2 surgery dates (June 4 2020 and October 22 2020). Beautiful Dylan! one user wrote. Top editors give you the stories you want delivered right to your inbox each weekday. Staying in the hospital: Your procedure may be performed in a hospital or outpatient center. . Nude Selfies! ", To her new face, Mulvaney said she couldn't wait to meet it, and to "start seeing the outside match the inside. While full healing can take up to 12 . For patients who are only having a brow lift, the surgeon can make four or five small, one-centimeter incisions in the hairline or an incision around the brow line. My life suffered dramatically because of this and trying my best to recover. Bruises, including black eyes, may take four to six weeks to clear up. View the amazing before and after transformations of our patients who had reconstructive surgery with Dr. Christopher Salgado in Miami. The coronal incision hides the incision scar within the bulk of the persons head hair. The doctor may recommend a soft or liquid diet until you can swallow food comfortably. , you can hear first-hand the unique stories about the effect of facial gender confirmation surgery. Select a procedureAesthetic SpecialsBody ContouringBotox / Dysport / Xeomin / JeuveauBreast ProcedureElectrolysisExcision & ScarsFacial Feminization SurgeryFacial SurgeryHair GraftingInjectables/FillersLaser ServicesRhinoplastyVocal FeminizationMiscellaneous, Please choose an optionFamily and friend recommendationFacebookGoogle/Search EngineInstagramPinterestRadioTikTokTwitterTVYouTubeAnother website or source, * Preferred Method of Contact? DOI: Bellingua RJ, et al. Facial feminization surgery: The forehead. after Facial Feminization Surgery, the results of Rodrigo Alves, aka Roddy, are al. If you receive forehead work, your surgeon will anchor the eyebrows in place. The Center for Transgender Medicine and Surgery (CTMS) offers services addressing the entire body. Transitioning isn't just about 'top surgery' and 'bottom surgery.' There are several other procedures surgeons can . A major moment! Contact Us. Soft tissue procedures can be performed in conjunction with the core FFS procedures listed above. The jaw bone contains a crucial nerve. Details such as the quantity of cases, quality of the collages and consistent transparency in the comparisons can be helpful so patients may get a realistic idea of what is possibleand not. as well as other partner offers and accept our. Phone *. We will discuss these in detail during your initial consultation. The Lip Lift is commonly combined with lip enhancement or augmentation. The most common approach is to cut along the hairline, which allows for the scalp and hairline to be physically moved forward, lowering the entire hairline. Before and After 1 month surgery, Forhead . TikTok star and influencer Dylan Mulvaney debuted her new look after undergoing facial feminization surgery in late 2022. Surgeons typically approach the chin and jaw through incisions within the mouth, along the gum line. Her video of day 1 of being a girl, posted on March 12, was viewed 9 million times. Learn more about Forehead (Type 3 Cranioplasty) and Contouring. All Facial Feminization Transwomen GCS Breast Augmentation. This is highly dependent on the viewers perception and does not necessarily correlate with the level of aggressiveness of the techniques performed. As we dont do makeup or hairstyle but surgeries, we think our surgery results should speak for themselves. Penile-peritoneal vaginoplasty (SRS-PPV) technique This technique is the most advanced and the latest innovation in neo-vaginoplasties for trans women. Using a highly individualized approach, the plastic surgery team works with the patient to develop a plan that best meets the individuals needs and preferences. FFS is commonly pursued by transgender women or assigned male at birth (AMAB) non-binary trans people. Price Estimate: (2.3-4 million KRW, roughly 2000 - 3500 USD) Example 7 - Full FFS + hair transplants - Left: before surgery / Right: 40 days after lipofilling of cheeks and upper lip + slight revisions of eyebrows, nose, upper lip and chin, and 14 months after full FFS with hair transplants. Facial feminization surgery (FFS) includes a series of plastic and craniofacial surgical procedures designed to feminize the face. Specific areas of the face we focus on vary from person to person. First clinical follow-up: This usually occurs within five days of surgery, and will be scheduled before you leave. A post shared by Dylan Mulvaney (@dylanmulvaney). Therefore no surgical procedures or rejuvenation treatments will get the exact same results as others even if patients think they are similar and even if the procedures are performed by the same Plastic Surgeon. Jana Marie ffs By Dr Bart van de Ven Chin recontouring with lateral jaw shave and liposuction under the chin if needed, Forehead recontou. Facial feminization surgery is a vital component of the male-to-female transition, offering many physical and psychological benefits for the transwoman. The procedure may include reducing the prominence of the bony ridge above your eyes and reshaping the hairline. Minor edits that do not affect the depiction of results may have been made at the patients discretion in the social photos they have provided. FFS procedures can reshape the forehead, brows, nose, cheeks and jaw as well as minimize the appearance of an Adams apple (tracheal shave). In addition to the cost of the jawline surgery, which is estimated as anywhere from $6,500 to $56,000, you will also need to take time off from work to heal. Before and After. Performed by Dr. Philip Young. Before and after facial feminization surgery. Facial feminization surgery (FFS) encompasses a series of surgical interventions designed to make your face appear more feminine. Chin reduction osteoplasty - $3300 - 1.5 hours. A file photo of Dylan Mulvaney, a well-known figure in the trans rights movement, showing her before surgery she underwent in December 2022. Name *. Facial Feminization Surgery is a set of surgeries focused on a single objective. The facial feminization score has previously been shown to be correlated with a standard quality-of-life assessment (Short Form-36 scale). Sometimes the incision is made right at the Adams apple. This makes a surgical procedure unnecessary. 1. Transgender Facial Feminization Surgery Before & After Pictures - RealSelf Historically, FFS hasnt been covered by health insurance or government healthcare. The photos below feature a handful of our patients before and after surgery. Here are some photos showing the results of vaginoplasty. Anesthesia and other medications that will be administered before and after surgery; Physician surgeon fee; Insurance Issues & Financing. We are here to listen. By clicking Sign up, you agree to receive marketing emails from Insider Here are some basics for recovery after facial surgery: Bruising and swelling: These are common side effects after facial plastic surgery. All the surgeries in this FFS gallery were performed by Dr. Javier Rossi and his team in Buenos Aires, Argentina. Facial feminization surgery may be part of the treatment approach for a person who desires a more feminine facial appearance. Celebrities Who Admit They've Had Work Done Over the Years, Streaking! For this reason, people with a larger brow protrusion require a more involved procedure. Click below for a free consultation: First, we determine if the surgical option is appropriate for you. Occasionally, this may not be possible, in which case the virtual images are sent via email. Oh My! Last medically reviewed on April 19, 2018, Forehead reduction surgery, also known as hairline lowering surgery, is a cosmetic procedure used to shorten the height of the forehead. The procedures can also be appropriate for cisgender women who desire more feminine facial features or gender nonbinary people seeking a more feminine facial appearance. Have a question regarding your surgical plan? FFS usually does not happen in one operation. Dylan Mulvaney is keeping fans in the loop on her post-surgery recovery. Soft tissue work, such as face-lifts and neck lifts, can be incorporated when necessary. Facial Feminization Surgery: Before and After Gallery. Facial Feminization Surgery (FFS) involves plastic surgery procedures that create more classically feminine looking facial characteristics. Forehead work is often paired with procedures to alter the hairline in order to counteract the effects of receding hairlines or male pattern baldness. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, What to Know About Having a Baby Who Is Intersex. The incisions for an eyelid lift can either be hidden in the crease of the eyelid or placed behind it to minimize visible incisions. Forehead reconstruction requires an incision that goes across your head from ear to ear. Facial feminization surgery (FFS) includes surgical procedures that alter the structure of your face to create more feminine features. We avoid using tertiary references. be aware that some answers may depend on your approach .. a more or less aggressive one. This may include: But in most cases, these procedures arent fundamental to how people perceive the gender of a face. Lip Enhancement. Some cases may seem to have more dramatic results and others look more subtle. Colonvaginoplasty can be performed in two ways:Open technique and Laparoscopic technique. Feminizing surgery includes several options, such as top surgery to increase the size of the breasts. Bilingual Assistants & Land Transportation from and to the airport, medical appointments and surgery. Even though the majority of patients are transgender, many female patients want to change their masculine bone structure and . We know that before and after photos are the first thing that many of us want to find. Special care should be taken to not impact the nose for several weeks after surgery. DOI: All About Buccal Fat Removal for Thinner Cheeks, How to Heal and Reduce Scarring After Top Surgery, Everything You Need to Know About Voice Masculinization. Dr. Deschamps-Braly recommends waiting at least six (6) months after your surgical procedure before pursuing a facelift or any other facial . Insurers often classify FFS as an elective cosmetic procedure. In addition, staging provides ample time for recovery between operations. In these cases, the front of the brow bone is entirely removed, temporarily exposing the sinus cavity behind it. Surgeons require that people stop taking hormone replacement therapy two weeks before surgery and refrain for two weeks after surgery before starting again. After Facial Feminization Surgery: FFS Recuperation and returning back to normal. Plastic & Cosmetic Surgery Results Can Vary Significantly Between PatientsEvery patient is a unique individual and every surgery has unique aspects. The results speak for themselves; I am really amazed with my new look after the surgery at the Facial Feminization Center. A surgical procedure called a chondrolaryngoplasty, or tracheal shave, can reduce the size of an Adams apple and create a smoother neck profile. Translators during hospitalization to better communicate with the nurses. Still have to pay to fix my eyebrows and hairline in 6 months from now. The interviews show real emotion and speak of so many personal challenges. Your satisfaction with Facialteams FFS results is a valuable indicator that we are doing a good job. Feminization Surgeries. This page gathers the FFS surgery results of this website. Its well known that a smile beautifies, so we think in this case it would be as illicit a resource as digital retouching. One of my familys biggest concerns was that I wouldnt find success as a trans person or I wouldnt find love, or I would face quite a bit of hate, Dylan added. After. Masks are required inside all of our care facilities. An Adams apple that is still prominent after the procedure, Removal of too much cartilage, which can damage the vocal cords. This is because the incision is far from the hairline. We won't post to any of your accounts without asking first. These can include mastectomy and phalloplasty/bottom surgery or breast augmentation, facial feminization, and vaginoplasty/bottom surgery. To access the larynx, the surgeon makes an incision in your neck. Cheek augmentation is a less common procedure. The removed bone is then contoured separately and replaced, so it lies flat. I just constantly have to check in with myself and say, Dylan, are you doing what you want to do? Mandibular angle shaving - $1650 - 1 hour. I somehow managed to publicly transition while simultaneously finding success and I still dont fully know how its all come together but Im proud of the strength and softness Ive shown, Dylan expressed, adding that shes the happiest shes been in a long time., Despite having countless adoring fans, Dylan is no stranger to online hate and transphobia, but she doesnt let that stop her from sharing her story. The surgeon will attempt to minimize the appearance of the scar by placing it in a less obvious area or within the natural skin folds of the neck. . We do not digitally alter or artificially overexpose our clinical photos. Several procedures can be recommended to revise the contours of the jaw and chin: FFS jaw surgeryrequires making an incision inside the mouth, which will be closed with dissolvable stitches. Please choose an optionPhoneEmail, * May we leave a message? In addition, we have not given preference to faces based on beauty or popularity, which are subjective in any case. Many major medical insurances in California, including CalOptima, cover for vaginoplasty as part of gender confirmation surgery. Mulvaney, 25, became well known on TikTok for viral videos including a memorable moment from 2020 where she attempted to feed bread to a buffalo out of her car window. However, FFS can have more impact on a persons mental health and social well-being than genital surgeries such as vaginoplasty and phalloplasty. ENQUIRE NOW. FFS may be part of an overall plan of gender affirmation, aligning the appearance of the face and body with a persons gender. Facial Feminization Surgery (FFS) with Dr. Spiegel offers patients a highly customized plan to meet their feminization goals in a warm and friendly environment. For a better experience, please enable JavaScript. You may have temporary restrictions on heavy lifting, vigorous exercise or other activities. But its hard to put into words. Surgical techniques and analysis of results. 25-34 year old woman treated with Facial Feminization Surgery, 35-44 year old woman treated with Facial Feminization Surgery, 45-54 year old woman treated with Facial Feminization Surgery, 18-24 year old woman treated with Facial Feminization Surgery, 45-54 year old male treated with Facial Feminization Surgery, 18-24 year old female treated with Facial Feminization Surgery, 55-64 year old woman treated with Facial Feminization Surgery, 25-34 year old male treated with Facial Feminization Surgery, Woman treated with Facial Feminization Surgery, Facial Feminization: Rhinoplasty, Brow lift, Brow Bone Reduction, Lip Augmentation, Hairline Lowering. Transwomen Facial Feminization Surgery (FFS) Breast Augmentation Body Feminization Procedures Genital Confirmation Surgery (GCS) Orchiectomy. Learn more about the procedure, potential side. Lip lift and augmentation. Rhinoplasty work is particularly delicate. From her hospital bed she told her fans she loved them and thanked them for supporting her. If youre going under general anesthesia, this includes fasting. Out-of-pocket costs for FFS commonly range from $20,000 to $50,000 and above, depending on the surgeon and the number of component procedures performed. And they know that, no matter my gender or what Im doing on the Internet, my heart and intentions are good, she explained in the same interview. The coronal incision method is slowly being incorporated into other surgeons practices. . A surgeon can reconstruct the forehead by thoroughly measuring the existing bone structure and carefully working around the frontal sinuses behind the bone of your forehead. Facial feminization surgery reviews are rarely able to fully convey the magnitude of the profoundly positive impact FFS has on their lives. For patients having forehead and hairline contouring, the brow can be lifted through the same incision made in the scalp. Facial Feminization Surgery Photos. Browse Facial Feminization Surgery before & after photos shared by doctors on RealSelf. Give us a call! She also wrote two love letters: one to her old face, and one to her new one. In October, Mulvaney responded to comments made by Caitlyn Jenner, who called Mulvaney an "absurdity," and accused her of "exposing" herself in public. 2005-2023 Healthline Media a Red Ventures Company. This website is not a guide to treatment and does not replace seeking medical advice regarding your particular medical condition or health concerns from your physician, other healthcare professional or us. Technical and clinical considerations for facial feminization surgery with rhinoplasty and related procedures. Let's Start your journey from here. The 10 hour operation was performed by Douglas Ousterhout, M.D., D.D.S., at the Davies Campus of the California-Pacific Medical Center in San Francisco. References. Cheek augmentation can involve cheek implants or fat grafting. Voice masculinization is a way to modify your pitch, articulation, and other aspects for a more masculine, though not necessarily or exclusively male, You may be able to get top surgery as young as age 16. I paid about $15k on Yanhee, and had to do revision for all the procedures in another hospital and spent so far another $12k. In these FFS patient testimonials, you can hear first-hand the unique stories about the effect of facial gender confirmation surgery. Make sure to ask as many questions as possible to get a sense of each surgeons variations in their technique, as well as their bedside manner. We dont have the person wear much more makeup or a fancier hairstyle in the after picture than in the before. In this procedure, bone and protrusions are shaved down and smoothed. About a week before Abby underwent facial-feminization surgery, she experienced one of those dreams that stay with you long after waking, like a prophecy.
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