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Pokrowiecki R, Šufliarsky B, Jagielak M. Esthetic Surgery of the Chin in Cis- and Transgender Patients-Application of T-Genioplasty vs. Single-Piece Segment Lateralization. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:139. [PMID: 38256399 PMCID: PMC10818947 DOI: 10.3390/medicina60010139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/16/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Correction of lower face asymmetry still remains challenging in maxillofacial surgery. This report describes techniques for the lateral transposition of the symphyseal segment to restore lower face symmetry while maintaining gender-related features in cis- and transgender patients. Materials and Methods: A retrospective review of medical records of 31 patients who attended for esthetic corrective surgery after orthodontic camouflage or orthognathic treatment, or during facial feminization of the lower face between June 2021 and June 2023 was performed. Result: All patients underwent lateralization genioplasty (with or without advancement or setback), either with or without narrowing T-osteotomy supplemented with necessary procedures in order to obtain proper facial balance and desired esthetical effects, such as bichectomy, liposuction, and face and neck lift. The mean asymmetry of the chin was 5.15 mm and was surgically corrected either by single segment lateralization or T-shape narrowing genioplasty depending on the gender and esthetical requirements. No complications were reported. Conclusions: Lateral shift genioplasty serves as a powerful tool in primary and secondary corrective surgery for lower face asymmetry that maintains gender-specific facial features. It may serve either as an additive to orthodontic camouflage or a way to correct previous orthognathic surgery pitfalls. The surgeon performing esthetic genioplasty associated with gender-specific expectations must be trained in facelift and facial liposculpting techniques in order to provide the best results and properly choose the right procedures for the right patients.
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Affiliation(s)
- Rafał Pokrowiecki
- Prive Esthetic and Facial Feminization Surgery Centre, 02-640 Warsaw, Poland
| | - Barbora Šufliarsky
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia;
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Donaldson L, Wulu J, Garcia-Rodriguez L. Gender Affirmation Surgery of the Face for the Transfeminine Patient. Facial Plast Surg 2023; 39:569-574. [PMID: 37196665 DOI: 10.1055/a-2095-6292] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
This article discusses the aspects of facial feminine affirmation surgery including forehead reconstruction, midface feminization, and lower face/neck feminization. We will present a brief history of gender affirmation. We discuss the anatomical differences between born XY males and XX females and discuss the subsequent procedures that aim at feminizing the face. The effects of silicone injections are also discussed as this was a trend in the past to feminize the face. Understandably so we discuss the anatomical differences as being a fluid expression and differences based on ethnic background.
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Affiliation(s)
- Lane Donaldson
- Department of Otolaryngology, Division of Facial Plastic Surgery, Henry Ford Health, Detroit, Michigan
| | - Jacqueline Wulu
- Department of Otolaryngology, Division of Facial Plastic Surgery, Kaiser Permanente, Largo, Maryland
| | - Laura Garcia-Rodriguez
- Department of Otolaryngology, Division of Facial Plastic Surgery, Henry Ford Health, Detroit, Michigan
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La Padula S, Coiante E, Beneduce N, Valentini V, D'Andrea L, Giudice GL, Pensato R, Ungerer L, Hersant B, Meningaud JP. Assessment of deep plane facelift in facial feminization surgery: A prospective pilot study. J Plast Reconstr Aesthet Surg 2023; 85:425-435. [PMID: 37579653 DOI: 10.1016/j.bjps.2023.07.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/03/2023] [Accepted: 07/16/2023] [Indexed: 08/16/2023]
Abstract
Facial feminization surgery (FFS) is often the first procedure requested by patients wishing to undergo gender-affirming surgery. This study aims to evaluate the applicability and effectiveness of deep plane facelifts in FFS. The authors conducted a prospective study that included patients who requested a deep plane facelift as a standalone procedure to achieve a more feminine facial appearance as the only procedure of FFS. These patients underwent deep plane facelifts to achieve a more feminine oval face shape and increased tissue projection of the zygomatic-malar region. To assess the effectiveness of the procedure and patient satisfaction, the Face-Q scales, Face and Neck lift Objective Photo-Numerical Assessment Scale, the Satisfaction With Life Scale, and the Subjective Happiness Scale were applied preoperatively and one year after surgery. Thirty-six patients were included in the study. A statistically significant difference (p < 0.005) was observed between pre and postoperative scores. The repositioning of the malar fat pads increased the malar volume, providing a more oval overall shape of the face, which is typically feminine. No major complications were observed. Despite our encouraging results, new studies with a larger sample of patients are needed to support the benefits of the deep plane facelift as part of FFS to elevate this technique from an ancillary to a routine procedure for patients undergoing gender affirmation surgery.
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Affiliation(s)
- Simone La Padula
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131 Napoli, Italy.
| | - Edoardo Coiante
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Nicola Beneduce
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Roma, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Roma, Italy
| | - Luca D'Andrea
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Giorgio Lo Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", Via Pansini, 5, 80131 Naples, Italy
| | - Rosita Pensato
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Lucas Ungerer
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Barbara Hersant
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Jean Paul Meningaud
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
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Massenburg BB, Ettinger RE, Morrison SD. Gender-Affirming Surgery of the Mandible: Lower Jaw Feminization and Masculinization. Facial Plast Surg Clin North Am 2023; 31:381-392. [PMID: 37348981 DOI: 10.1016/j.fsc.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
For patients with gender dysphoria, gender-affirming surgery of the face has been shown to vastly improve quality of life. The mandible is one area of the face that has distinct feminine and masculine presentations. This article will review gender-affirming surgery of the lower jaw, both for feminization and masculinization. Techniques for bony contouring and soft tissue manipulation will be discussed.
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Affiliation(s)
- Benjamin B Massenburg
- Division of Plastic Surgery, Department of Surgery, University of Washington; Division of Craniofacial and Plastic Surgery, Department of Surgery, Seattle Children's Hospital
| | - Russell E Ettinger
- Division of Plastic Surgery, Department of Surgery, University of Washington; Division of Craniofacial and Plastic Surgery, Department of Surgery, Seattle Children's Hospital
| | - Shane D Morrison
- Division of Plastic Surgery, Department of Surgery, University of Washington; Division of Craniofacial and Plastic Surgery, Department of Surgery, Seattle Children's Hospital.
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Managing the Soft-Tissue Envelope in Facial Feminization Surgery: Filling and Tightening Surgical Approaches. Plast Reconstr Surg 2023; 151:537e-538e. [PMID: 36730101 DOI: 10.1097/prs.0000000000009953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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