Facial Feminization Surgery: Guidelines for Patient Evaluation and Operative Techniques

Abstract

Facial feminization surgery (FFS) is one of many gender affirming surgeries that can reduce gender dysphoria and rate of mis-gendering. A multidisciplinary team with experience caring for transgender patients is valuable for generating high quality outcomes and patient satisfaction. In particular, specific technical pearls can assist in improving outcomes of this procedure. This article provides a review of patient and procedure selection for a range of FFS procedures including chondrolaryngoplasty, hairline advancement, forehead reduction and recontouring, orbital opening and brow lift, rhinoplasty, lip lift or augmentation, malar augmentation, and mandibular recontouring and genioplasty. The authors share technical insights and pre- and postoperative management recommendations gained from experiences at 2 institutions performing high volume FFS.