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WPATH GEI Day 2 8) Surgery - Facial (Angel Penedo Vazquez) - Coggle…
WPATH GEI Day 2
8) Surgery - Facial
(Angel Penedo Vazquez)
Planning
Virtual FFS (photo vs video? different angles, facial expressions)
By artists who know anatomy and surgery
NO AI
Realistic expectations
Listen to the individual
3D CT scan
3D surgical guides
3D cutting guides
Multidisciplinary - Optimal results
(Lower regret & revertion)
Mental health
Surgical results
Impact on their lives
Stop hormones? Use heparin?
Stop smoking 3 months before (and after)
SOC 7 / 8
Medically necessary vs depending on clinical situations
Now including facial feminization, chest masculization…
Face & gender identification
Lower third
Jaw & chin
Triple intraoral approach
Cutting guides: 3D printed
Piezosurgery
Upper third
Forehead reduction (and hair transplant)
Titanium meshes (not close to supraorbital nerves)
Reshaping and opening of orbits (effects of testosterone)
Frontal sinus (different characteristics vs different meshes)
Anterior wall thickness
Volume
Projection
5 types of hairline
(Different donor areas)
Frontal branch of facial nerve
(Reinnervation needs 2 years)
(Can compare with various facial surgeries)
1.8%
Incision
Posterior
(Follicles at the posterior are better)
(Easier hiding with long hair)
Anterior
(Very low rate of hair loss there)
Hairline :cry: obvious scars
(Revision: With hair transplant (80% transplanted)
Soft tissue
One-year postop satisfaction
(One year to regain facial expression)
Total/partial/little satisfaction
Regret
Medical (complications, unmet expectations)?
Decisional (choice of surgeries)?
Societal/discrimination?
Gender-related?
Complications
Sinus not closed
6-12 months
Infection
Resorption (aesthestics)
Tracheal shave
(thyroid cartilage)
(and open vocal cord surgery)
Rhinoplasty
Prospective Quality-of-Life Outcomes after Facial Feminization Surgery: An International Multicenter Study
Cranium: Membranous bone
Usually not affected by bone density