INTRODUCTION: Facial Feminization Surgery (FFS) is a group of procedures aimed at creating a feminine appearance in general, and especially in patients who are in the process of gender reassignment. The purpose of this study is to examine the level of feminine appearance obtain, the optimization of the process in this highly demanding group of patients, side effects and complications.
MATERIALS AND METHODS: We examined a consecutive series of patients who were operated between 2003 - 2015. We reviewed the patient`s charts, examine carefully the before and after photographic records, the time to full recovery, the satisfaction rate measured by a questionnaire and the complications rate.
RESULTS: 105 patients at ages ranging from 18 to 65 with a mean age of 29 underwent a total of 151 major FFS procedures. Of them 54 transgender males, 24 males who desired a softer appearance of the forehead; and 27 females seeking a more feminine look. All patients underwent supraorbital bossing reduction, in 58 patients the frontal sinus was significantly exposed anteriorly, its size reduced and reconstructed with Methyl-Metacrylate; for 26 of them, the procedure included also anterior hair line advancement. 41 patients had lower jaw reduction. One hundred sixty one minor FFS procedures were performed including 18 cheek implants, 80 rhinoplasties, 31 Bichat removals, and 45 upper lip shortening. All patients reported significant softening appearance or feminization post op. Sixty five patients had multiple procedures at one operation and 50% had one touch up procedure at least within 6 months post op; of those who had single procedure only 6 had a need for corrective surgery. None had acute sinusitis, meningitis, airway obstruction, permanent facial nerve palsy or major mental nerve damage. Cheek implant infection appeared in four patient which was followed by removal of the implants. Scar widening/hair loss on scalp was the biggest side effect in supraorbital reduction and noticed in 10% of patients at different degrees. The best approach in this case was hair transplant.
CONCLUSION: Aesthetic craniofacial surgical procedures for FFS are effective and safe and can significantly feminized or soften patient appearance. Single procedure approach is much easier to control and recommended for those who like to implement these methods.
The author has no disclosure or financial support