American Association of Plastic Surgeons

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Enhanced Efficiency And Comprehensive Approach In Facial Feminization Surgery: A Comparative Analysis With National Averages
Alay R. Shah, MD, Alexis K. Gursky, BS, Sachin R. Chinta, BS, Hailey P. Wyatt, MD, Eduardo D. Rodriguez, MD DDS.
NYU Langone Health, New York City, NY, USA.

PURPOSE: Facial feminization surgery (FFS) is a multi-procedural intervention designed to achieve facial features consistent with feminine aesthetics. This study evaluates the operative time and number of procedures performed during FFS at our institution, comparing these metrics with national averages from the NSQIP database.
METHODS: Data on operative times and the number of procedures per FFS event were collected during a retrospective analysis of patients who underwent FFS at our institution between 2017-2024. Similarly, operatives and number of FFS procedures were collected from the NSQIP database for patients with the ICD-10 diagnosis for gender dysphoria and CPT codes for any FFS procedure. Statistical analysis was performed using independent samples t-test and chi-square for independence.
RESULTS: The average operative time at our institution is 207.19 minutes, compared to the national average of 302.97 minutes (p < 0.001). Additionally, we perform an average of 5.01 procedures per surgical event, significantly higher than the national average of 3.29 procedures (p < 0.001).
CONCLUSION: Our institution's approach to facial feminization surgery significantly reduces operative time and allows for more procedures to be performed in a single session, enhancing both patient safety and surgical outcomes. Shorter surgeries decrease anesthesia exposure and associated risks, while the ability to perform more procedures in one operative event reduces the need for multiple surgeries, improving patient satisfaction. This optimized approach not only lowers healthcare costs but also serves as a potential model for other institutions.
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