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Facial feminization surgery results in high patient satisfaction

Patient satisfaction was high following full facial feminization surgery, according to recently published study results.

Researchers retrospectively analyzed the medical charts of 33 patients aged between 19 and 40 years who were referred for male-to-female facial feminization surgery between January 2003 and December 2013 at a private clinical practice in Parma, Italy.  The patients had received at least 1 year of pharmacological therapy with 100 mg of cyproterone acetate per day and had met specific criteria for facial feminization surgery, including requirements on physical fitness and psychological preparation.

Patient-administered questionnaires were used to subjectively analyze surgical outcomes, while serial photographs were used for objective analysis.

Sixteen patients (48.4%) had previously undergone breast augmentation, while six (18.1%) had undergone surgery of the genitalia.

Facial feminization surgery was completed in 6 months for all patients except for six who then underwent orthognathic surgery because of orthodontic therapy.

There were 180 operations conducted, including hard and soft facial tissue reshaping in all patients. Revision rhinoplasty was performed on 28 patients (84.9%), while five patients had primary rhinoplasty.

Mandible reshaping at both the angle and symphysis were performed on all patient to achieve “a harmonic feminine profile of the lower third of the face,” the researchers wrote.

Twenty-six patients had Adam’s apple reduction. Structural fat grafting for lip and zygomatic enhancement and to further support orthognathic surgery was performed in all patients.

Postoperative facial edema had spontaneous resolution approximately 2 months after each surgical step.

All patients answered positively to a nine-question survey, suggesting “an improved quality of life with regard to physical, mental and social functioning after facial feminization therapy,” according to the researchers.

There was a loss of masculine features in both frontal ant profile views, with two independent surgeons rating aesthetic results as “very much improved” in 29 patients (87.8%) and “significantly improved” in four patients.

“We report a surgical sequence for facial feminization that starts from the medial and inferior thirds of the face and then proceeds to the superior third to guarantee proper relationships between each facial segment,” the researchers concluded. “A 6-month period was sufficient to complete all procedures, allowing recovery of each surgical subunit before we proceeded to the remaining subunits.

“The result was a high degree of patient satisfaction because facial feminization surgery was approached as a unified process.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.