Considerations in Feminization Rhinoplasty

Spiegel, Jeffrey H.

doi:10.1055/s-0040-1702146

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…The key to successful surgical planning for these transgender patients is to obtain an in-depth insight into the individual anatomy towards fulfilling the patient's goals for transformation. The majority of the existing studies for FFS focus on the modification of certain parts of the face (2,4,(16)(17)(18)(19)(20). The modification of the whole facial skeleton contour traits consists of mandibular angle osteotomy, genioplasty, and malarplasty reduction in Chinese transsexuals is rarely reported.…”

Section: Discussionmentioning

confidence: 99%

Necessity of facial contouring in feminization surgery for Chinese transgender females

Liu¹,

Xu²,

Yu³

et al. 2021

Ann Transl Med

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Background: An increasing number of transgender females are suffering from a critical gender dysphoria, which often presents as depression and self-destructive behavior. Facial feminization surgery (FFS) is an effective method to alleviate symptoms of gender dysphoria, which could be more important than genital reassignment surgery for Chinese. Facial contour surgery is perceived as an ordinary FFS for the Chinese women to improve their facial appearance. The zygoma and jaw are key areas for feminizing the facial contour. This study mainly emphasized the necessity of FFS and discussed the importance of facial contour surgery of Chinese individuals.Methods: The differences of facial contour before and after FFS in terms of skeletal and soft tissue were analyzed. The pre-and postoperative images were evaluated for feminization. The results of the full suite of measurements were compared to reveal the effective change of FFS. Furthermore, a surgery satisfaction survey was conducted among these patients after recovery.Results: All the patients expressed their satisfaction with the reduction in the intergonial width as well as the middle face prominence. All the facial contour ratios changed significantly after surgery in both hard tissue and soft tissue.Conclusions: Facial contour surgery is crucial to changing one's facial appearance and sex impression, which significantly alleviates gender dysphoria.

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Section: Discussionmentioning

confidence: 99%

Necessity of facial contouring in feminization surgery for Chinese transgender females

Liu¹,

Xu²,

Yu³

et al. 2021

Ann Transl Med

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“…14 In some circumstances, deprojection may be necessary to accommodate the change in nasal length via division of the lower lateral crura, lateral crural overlay, or combination of the above. 10,12,15 Our analysis did not reveal any significant necessity for destructive maneuvers with the exception of a conservative cephalic trim in patients with boxy and bulbous tips.…”

Section: Discussionmentioning

confidence: 50%

“…Nonetheless, care should be made to prevent alar notching deformity. 10,12 Facial congruence. Congruence with adjacent facial features is a necessary consideration whether performing rhinoplasty as a standalone procedure or in the context of multiple facial feminization procedures.…”

Section: Technical Considerationsmentioning

confidence: 99%

Feminizing Rhinoplasty: A Systematic and Institutional Review of Operative Techniques and Clinical Outcomes

Khetpal

Dejam

Baker

et al. 2023

FACE

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Background: Facial gender-affirming surgery encompasses a myriad of procedures ranging from skeletal to soft tissue maneuvers depending on the manifestation of dysphoria in individual patients. In this work, we reviewed techniques for feminizing rhinoplasty in a single center and performed a systematic review of the literature. Methods: A systematic literature review was performed in order to survey articles that discussed techniques and clinical considerations when performing rhinoplasty among transgender females and non-binary patients. In addition, a retrospective review of such patients undergoing rhinoplasty by the senior author. Variables collected included demographic factors, operative details, and post-operative events. Results: Initial review yielded 56 articles. Standardized application of inclusion and exclusion criteria resulted in a total of 12 studies. Priorities of feminizing rhinoplasty entail reduction of dorsal hump, as well as tip refinement and deprojection. Sixty-five patients were included for analysis. The majority of patients underwent rhinoplasty through an open approach (83%). For the dorsum, 89% received dorsal reduction and 80% underwent percutaneous osteotomies. For tip work, 37 (56.9%) received a septal caudal extension graft, while a minority of patients required columellar strut (25%) or tip graft (8%). For functional restoration, septoplasty (71%) and spreader flaps/grafts (58%) were utilized to correct internal valve collapse, while alar rim (8%) and alar crural strut (3%) grafts were performed to address external valve collapse. Complications included septal deviation, hypertrophic scar, and contour irregularity. Two patients required revision (3%). Conclusion: The core tenets of the operation lie in the reduction of the nose, tip deprojection and rotation, as well as the creation of harmony with other facial structures. Our multi-pronged analysis presents an updated review of these principles, as well as a longitudinal outlook on outcomes associated with feminizing rhinoplasty.

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“…34 Intraoperatively, the skin may require careful defatting or even excision in some locations, such as the columella, if overly thick skin is still a concern. 43 The lower third also should be included in the full facial analysis when evaluating a patient for facial feminization rhinoplasty. The lower twothirds of a feminine face resemble an inverted triangle, with round prominent cheeks at the base and a smaller bigonial width and narrower chin at the apex.…”

Section: Special Considerations In Facial Feminization Rhinoplastymentioning

confidence: 99%

“…34 Intraoperatively, the skin may require careful defatting or even excision in some locations, such as the columella, if overly thick skin is still a concern. 43…”

Section: Special Considerations In Facial Feminization Rhinoplastymentioning

confidence: 99%

“Gender Considerations in Rhinoplasty”

Rodriguez

Savetsky

Cohen

et al. 2023

Plastic &Amp; Reconstructive Surgery

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The "10-7-5" approach provides a systematic and detailed approach to nasofacial analysis that is required during every rhinoplasty consultation and preoperative planning session. 6,7 Distinguishing features of the White cisgender male nose are elaborated and contrasted to its feminine counterpart (Table 1). FRONTAL VIEW Facial ProportionsThe upper horizontal third (brow to hairline) lacks consistency in relation to the other SPECIAL TOPIC Summary: Precise nasofacial analysis ahead of rhinoplasty is imperative. Features common to the White masculine nose are reviewed in a stepwise fashion and contrasted with those of the White feminine nose. A solid understanding of the cisgender male, masculine nose enables the plastic surgeon to determine the changes required for a successful facial feminizing rhinoplasty as a part of facial gender confirmation surgery.

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Considerations in Feminization Rhinoplasty

Cited by 9 publications

References 5 publications

Necessity of facial contouring in feminization surgery for Chinese transgender females

Necessity of facial contouring in feminization surgery for Chinese transgender females

Feminizing Rhinoplasty: A Systematic and Institutional Review of Operative Techniques and Clinical Outcomes

“Gender Considerations in Rhinoplasty”

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