Chest and facial surgery for the transgender patient

Boerum, Melody Scheefer Van; Salibian, Ara A.; Bluebond-Langner, Rachel; Agarwal, Cori A.

doi:10.21037/tau.2019.06.18

Cited by 35 publications

(50 citation statements)

References 49 publications

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“…In fact, some social scientists view FFS as enacting a far more "profound change" than genital reconstruction surgery. FFS has been reported to be either attained or desired in 45% of transgender females (15), and shown to be highly effectively in alleviating related gender dysphoria and improving quality of life (16). Yet, only an estimated 3-8% of transgender individuals have access to FFS (17).…”

Section: Discussionmentioning

confidence: 99%

Perception of femininity and attractiveness in Facial Feminization Surgery

Ching¹,

Hirschman²,

Lu³

et al. 2021

Ann Transl Med

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Background: Facial Feminization Surgery (FFS) alters bone and soft tissue to feminize facial features of transgender females. This study aims to evaluate perceptions of femininity, attractiveness, and ideal surgical outcomes in transgender females, non-transgender females and plastic surgeons. Methods:The data was extracted from a survey of transgender females (n=104), non-transgender females (n=192) (completion rate of 48.4%) and plastic surgeons who performed FFS (n=23) (survey response rate of 31.5%). Five virtually-modified forms of three facial features, the nasal tip width, supratip break, mandibular gonial angles, and the composite images of the above features of an individual, assigned male at birth, were used. Respondents were requested to select and rank images based on personal perceptions of femininity and attractiveness.Results: Transgender females chose a narrower nasal tip width as more attractive (P≤0.001), and evaluated a more acute supratip angle, and more obtuse mandibular gonial angle as both more feminine and attractive (all P≤0.023) compared to non-transgender females. Plastic surgeons chose a more obtuse mandibular gonial angle as more feminine (P=0.007) and a more ideal surgical outcome (P=0.046), compared to transgender female respondents. In the assessment of composite images, non-transgender female ranked the options with more obtuse mandibular gonial angle as more feminine (all P≤0.036) than transgender females.Conclusions: Acknowledging the difference in transgender females' perceptions of facial femininity and attractiveness from non-transgender females and plastic surgeons could assist plastic surgeons in managing expectations of surgical outcomes.

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Section: Discussionmentioning

confidence: 99%

Perception of femininity and attractiveness in Facial Feminization Surgery

Ching¹,

Hirschman²,

Lu³

et al. 2021

Ann Transl Med

View full text Add to dashboard Cite

show abstract

“…For transfeminine breast augmentation, providers must take a detailed patient history that focuses on any steps the patient has taken in the chest feminizing process. As previously mentioned, exogenous hormones should be taken for at least a year to prepare for surgical augmentation by maximizing growth of native tissues (15). Some groups advocate for stopping exogenous hormone use approximately two to four weeks prior to surgery (16).…”

Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 99%

“…40.5% of our transfeminine patients have some degree of tobacco history, highlighting the prevalence of tobacco use and the importance of screening for its use. Wound healing capabilities are maximized with smoking cessation as well (15). In patients with diabetes, HbA1c should be below 7.0% to minimize cardiovascular and infectious complications (16).…”

Section: Preoperative Guidelines Evaluation and Considerationsmentioning

confidence: 99%

“…However, this procedure is especially useful for reducing implant visibility and palpability and it offers a more natural appearing counter (16,27). Take rates for fat grafting range from 50-60%, so multiple procedures are often needed to achieve the desired outcome (15,27). Unfortunately, fat grafting is not routinely covered by insurance, and patients must pay out of pocket for this procedure.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…Short-term care involves implant massage to soften the overlying breast skin and proper brasserie fitting (16). We recommend that patients avoid heavy lifting for at least four to six weeks (15).…”

Section: Postoperative Carementioning

confidence: 99%

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Breast augmentation in the transgender patient: narrative review of current techniques and complications

et al. 2021

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Gender-affirming surgery (GAS) is often a crucial step during the journey to identity actualization for transgender patients. Surgical breast augmentation, or "top surgery", is frequently cited as the most important and sometimes only gender-affirming procedure sought by transfeminine patients. The breast augmentation process is remarkably similar in transgender and cisgender patients. However, there are unique guidelines, anatomic considerations, and contextual issues for the transgender patient population that must be taken into account by providers to achieve optimal outcomes. The aim of this review is to outline the current state of breast augmentation for transfeminine patients. We walk through our suggested pre-surgical evaluation, breast augmentation options, and post-surgical care. In the preoperative period, providers must establish a positive provider-patient relationship that allows for thorough history taking, physical examination, and goal setting. Providers must be able to select an appropriate implant, incision location, and operative plane to balance patient desires and pre-existing anatomic characteristics in transfeminine patients.Postoperatively, the provider must address acute and chronic needs to allow for continued satisfaction and safety. After reading this review, we aim for providers to be well-equipped to provide the highest quality breast augmentation care for their transfeminine patients. As research into best practices for breast augmentation in transfeminine patients continues to develop, we expect that surgical practice will continue to evolve.

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Gender‐affirming surgeries for transgender and gender diverse individuals and associated health outcomes

Rezaei,

Miller,

Miranda

et al. 2024

Behavioral Sci & The Law

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Gender‐affirming care is treatment that recognizes and affirms the gender identity of transgender and gender‐diverse (TGD) individuals. Though not all TGD people choose to surgically transition, gender‐affirming surgeries (GAS) are an important part of many TGD people's transition. GAS can include a wide array of procedures aimed at aligning an individual's physical characteristics and gender identity. This review describes the most common procedures considered to be GAS, detailing important relevant considerations for each procedure. These include transfeminine procedures (i.e., breast augmentation, penile inversion vaginoplasty, orchiectomy, tracheal shave, and facial feminization); transmasculine procedures (i.e., chest masculinization, hysterectomy, phalloplasty, and metoidioplasty); and other procedures (i.e., fertility preservation and hair removal). Patient outcomes and the legal landscape for GAS are also discussed to contextualize these procedures within largest discourses surrounding gender‐affirming care.

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Chest and facial surgery for the transgender patient

Cited by 35 publications

References 49 publications

Perception of femininity and attractiveness in Facial Feminization Surgery

Perception of femininity and attractiveness in Facial Feminization Surgery

Breast augmentation in the transgender patient: narrative review of current techniques and complications

Gender‐affirming surgeries for transgender and gender diverse individuals and associated health outcomes

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