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Quantification Of Morphometric Parameters Following Facial Feminization Surgery
Paula Flores Perez, BA, Albert Rancu, BS, Melanie Vassallo, BS, MS, Thayer Murkherjee, MD, Katelyn Lewis, MD, Michael Alperovich, MD, MSc.
Yale University School of Medicine, New Haven, CT, USA.
PURPOSEFacial feminization surgery (FFS) aims to soften masculine features through procedures like frontal sinus setback, genioplasty, and gonial angle reduction. Despite increased demand, there is limited research quantifying resultant bony changes. This study expands on established segmentation methods to assess craniofacial changes in a larger cohort.
METHODSPre- and post-operative CT scans of patients who underwent frontal sinus setback, genioplasty, or mandibular contouring were analyzed using Mimics software, following our previously described methods for forehead, chin, and gonial angle segmentation. Measurements included volume and surface area for forehead, chin, and gonial angle regions, along with frontonasal and bossing angles for the forehead, sagittal and vertical projection for the chin, and the intergonial: interzygomatic distance ratio.
RESULTSIn a 68 patient cohort (mean age 34 ± 10 years), significant reductions were noted in forehead, chin, and gonial angle volume and surface area, as well as in frontonasal and bossing angles. Correlations were found between preoperative measurements and postoperative changes in chin volume, surface area, and vertical projection as well as intergonial:interzygomatic ratio (p < 0.005), indicating larger initial values predicted greater reductions.
CONCLUSIONSFFS alleviates gender dysphoria and improves transgender individuals’ quality of life. Our results demonstrate that FFS significantly softens facial features by reducing forehead, chin, and gonial prominence, emphasizing the value of gender-affirming surgeries in aligning external appearance with gender identity. Future studies linking bony changes with patient-reported outcomes could further refine preoperative planning, enhancing patient satisfaction and surgical outcomes.
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