1
|
Rodman R. Developments in facial feminization surgery. Curr Opin Otolaryngol Head Neck Surg 2022; 30:249-253. [PMID: 35906977 DOI: 10.1097/moo.0000000000000811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Facial feminization surgery (FFS) is being performed by facial plastic surgeons with increasing frequency. As insurance companies expand benefits to cover these procedures, more and more institutions are developing programs to treat transgender patients. The purpose of this review is to summarize recent literature on the subject so that those interested in this subject may have a framework to analyze these works. RECENT FINDINGS The most significant findings are that FFS does appear to be safe with low complication rates, despite long operative times due to multiple procedures performed. Much of the recent literature is reviews of each practice's techniques. This is valuable to educate those interested in beginning to perform these surgeries. Further, these reviews can eventually be compiled into a standard of care. Virtual surgical planning is currently being used by some departments, but its value is yet to be determined. SUMMARY FFS is performed with increasing frequency. Current literature reviews best practices with the goal of eventually establishing a standard of care.
Collapse
Affiliation(s)
- Regina Rodman
- Face Forward Houston, a private practice, Houston, Texas, USA
| |
Collapse
|
2
|
Facial Feminization Surgery: Key CT Findings for Preoperative Planning and Postoperative Evaluation. AJR Am J Roentgenol 2020; 217:709-717. [PMID: 33377802 DOI: 10.2214/ajr.20.25228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Facial feminization surgery is an increasingly performed component of gender affirmation surgery for transgender women. Preoperative facial CT is performed to plan the adjustment of the patient's masculine characteristics to feminine and to plan operative navigation around specific readily identifiable anatomic structures. In the upper face, surgery is performed to reduce the prominence of the brow and increase the nasofrontal angle; the radiology report should indicate the frontal sinus and supraorbital foramen anatomy. In the midface, rhinoplasty is performed to increase the nasofrontal and nasolabial angles; the radiology report should indicate the presence of a dorsal hump and septal deviation or spurring. In the lower face, the prominence of the chin and squareness of the jaw are adjusted via genioplasty and mandible contouring, respectively; the radiology report should describe the location and potential anatomic variations of the inferior alveolar nerve and mental foramina as well as the presence of dental abnormalities that directly inform the surgical approach. CT may also be performed if there is clinical suspicion for postoperative complications such as hardware fracture or osteotomy through the supraorbital or mental foramen. Familiarity with these findings will facilitate improved communication between radiologists and surgeons, thereby contributing to the care of transgender women.
Collapse
|
3
|
Callen AL, Badiee RK, Phelps A, Potigailo V, Wang E, Lee S, Talbott J, Glastonbury C, Pomerantz JH, Narvid J. Facial Feminization Surgery: Key CT Findings for Preoperative Planning and Postoperative Evaluation. AJR Am J Roentgenol 2020:AJR.20.25528. [PMID: 33377414 DOI: 10.2214/ajr.20.25528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Facial feminization surgery (FFS) is an increasingly performed component of gender affirmation surgery for transgender women. Preoperative facial CT is performed to plan the adjustment of the patient's masculine characteristics to feminine, and to plan operative navigation around specific readily identifiable anatomic structures. In the upper face, surgery is performed to reduce the prominence of the brow and increase the nasofrontal angle; the radiology report should indicate the frontal sinus and supraorbital foramen anatomy. In the midface, rhinoplasty is performed to increase the nasofrontal and nasolabial angles; the radiology report should indicate presence of a dorsal hump and septal deviation or spurring. In the lower face, prominence of the chin and squareness of the jaw are adjusted via genioplasty and mandible contouring, respectively; the radiology report should describe the location and potential anatomic variations of the inferior alveolar nerve and mental foramina, as well as presence of dental abnormalities that directly inform the surgical approach. CT may also be performed if there is clinical suspicion for postoperative complications such as hardware fraction or osteotomy through the supraorbital or mental foramen. Familiarity with these findings will facilitate improved communication between radiologists and surgeons, thereby contributing to the care of transgender women.
Collapse
Affiliation(s)
- Andrew Lawrence Callen
- University of Colorado Anschutz Medical Campus, Department of Radiology, 1201 Larimer St, Denver, CO 80204, Phone: 720-848-1130
| | - Ryan K Badiee
- University of California San Francisco Division of Plastic and Reconstructive Surgery, 505 Parnassus Ave, San Francisco, CA 94143, Phone: 415-353-3526
| | - Andrew Phelps
- Oregon Health Sciences University Department of Radiology, 3181 SW Sam Jackson Park Rd, Portland OR 97239, Phone: 503-418-0990
| | - Valeria Potigailo
- University of Colorado Anschutz Medical Campus, Department of Radiology, 1201 Larimer St, Denver, CO 80204, Phone: 720-848-1130
| | - Eric Wang
- University of California San Francisco Division of Plastic and Reconstructive Surgery, 505 Parnassus Ave, San Francisco, CA 94143, Phone: 415-353-3526
| | - Solomon Lee
- University of California San Francisco Division of Plastic and Reconstructive Surgery, 505 Parnassus Ave, San Francisco, CA 94143, Phone: 415-353-3526
| | - Jason Talbott
- University of California San Francisco Department of Radiology and Biomedical Imaging, 505 Parnassus Ave, San Francisco, CA 94143, Phone: 415-353-2573
| | - Christine Glastonbury
- University of California San Francisco Department of Radiology and Biomedical Imaging, 505 Parnassus Ave, San Francisco, CA 94143, Phone: 415-353-2573
| | - Jason H Pomerantz
- University of California San Francisco Division of Plastic and Reconstructive Surgery, 505 Parnassus Ave, San Francisco, CA 94143, Phone: 415-353-3526
| | - Jared Narvid
- University of California San Francisco Department of Radiology and Biomedical Imaging, 505 Parnassus Ave, San Francisco, CA 94143, Phone: 415-353-2573
| |
Collapse
|