This book examines facial feminization surgery (FFS), which encompasses a myriad of procedures that are performed in order to alleviate gender dysphoria among transgender and non-binary populations. Demand for FFS has risen significantly, thus warranting greater discussion and education of such procedures among the plastic surgery community. To date, there has not been a standardized text for plastic and reconstructive surgeons and trainees to refer to when performing FFS.
Chapters address key issues, such as: 1) anatomic differences between cis-masculine and cis-feminine faces; 2) operative techniques and considerations among respective procedures performed for facial feminization (i.e. forehead reduction, hairline advancement, brow lift, rhinoplasty, lip lift, genioplasty, facial fat grafting, and chondrolaryngoplasty); 3) operating room setup, anesthesia considerations, as well the post-operative protocols for hospitalization among patients undergoing FFS; 4) process of pre-operative consultation and pre-rehabilitation, among transgender and non-binary patients; 5) interdisciplinary collaboration among primary care providers, endocrinologists, and mental health providers in preparing patients for FFS; 6) the advent and role of virtual surgical planning (VSP) within FFS; 7) the challenges of promoting access, lowering cost, and enhancing delivery of FFS care; 8) patient perspectives to touch upon the nuances of navigating FFS.
Facial Feminization Surgery: Operative Techniques and Clinical Considerations is an essential resource for physicians, residents, fellows, medical students, patients, and caregivers who are interested in gender-affirming care and facial gender-affirming surgery.
Introduction.- Primary Care Considerations for Transgender and Gender
Diverse (TGD) Individuals Seeking Facial Feminization.- Navigating the
Pre-Operative Consultation.- Navigating the Pre-Operative Consultation.-
Virtual Surgical Planning in Facial Feminization Surgery.- Feminizing the
Upper Third of the Face: Forehead, Orbits, and Brows.- Approaching
Rhinoplasty for Feminization.- Performing Genioplasty for Feminization.-
Orthognathic Considerations in Facial Feminization.- Performing
Chondrolaryngoplasty for Facial Feminization.- Understanding the Soft Tissue
in Facial Feminization.- Ethnicity Considerations in Facial Feminization.-
Addressing Facial Feminization in the Non-Binary Population.- Managing
Anesthesia During Facial Feminization.- The Operating Room.- Hospital Course
and the Post-Operative Period.- Discussing Outcomes and Evidence-Based
Research in Facial Feminization Surgery.- Access to Care in Facial
Feminization.- Patient Perspectives.- Concluding Remarks.
Justine C. Lee, MD, PhD, FACS is a Professor of Surgery, the Bernard G. Sarnat Endowed Chair in Craniofacial Biology, and Associate Chief of the Division of Plastic and Reconstructive Surgery at the University of California Los Angeles (UCLA). Clinically, Dr. Lee is a craniofacial plastic and reconstructive surgeon who developed the facial feminization surgery program at UCLA. Her work on refining facial feminization surgery via precision with virtual surgical planning as well as studying outcomes following facial gender-affirming surgery has led to numerous invited lectures at plastic surgery departments nationally and internationally, the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the United States Professional Association for Transgender Health, the Japan Society of Plastic and Reconstructive Surgeons, the Korean Society of Plastic and Reconstructive Surgery, the Argentina Society of Plastic, Aesthetic, and Reconstructive Surgery, as well as multiple journal publications.
Sumun Khetpal, MD is a resident physician in plastic and reconstructive surgery at the University of California Los Angeles (UCLA). During her residency training, Dr. Khetpal has multiple publications within craniofacial surgery, facial feminization surgery, rhinoplasty, and healthcare innovation in journals including Plastic and Reconstructive Surgery and the Aesthetic Surgery Journal.. She has been invited to present her research findings at various national and international meetings including the American Society of Plastic Surgeons, The Aesthetic Society, International Society of Craniofacial Surgery, and International Meeting of Rhinoplasty Societies. She is a graduate of the Yale University School of Medicine, the Life Sciences and Management (LSM) Program at the University of Pennsylvania and the Wharton School, and Phillips Exeter Academy.
