Initial Facial Feminization Surgery Experience in a Multicenter Integrated Health Care System

Area of Science:

• Plastic Surgery
• Gender Affirming Care
• Surgical Outcomes

Background:

• Facial feminization surgery (FFS) is a critical component of gender-affirming care.
• Large-scale studies detailing FFS safety and patient considerations are limited.

Purpose of the Study:

• To report the largest comprehensive cohort of FFS procedures to date.
• To evaluate the safety of multilevel FFS.
• To identify patient-specific considerations and surgical complications.

Main Methods:

• Retrospective cohort study of 121 patients undergoing FFS.
• Data collected from a multicenter integrated health care system (April 2016 - October 2018).
• Included analysis of preoperative characteristics, procedures performed, and postoperative complications.

Main Results:

• 121 patients underwent 594 FFS procedures; 90% had cranioplasty, scalp advancement, and brow lift.
• The FFS population is generally healthy with few comorbidities.
• Significant complications occurred in only 6.6% of patients.

Conclusions:

• Multilevel FFS is associated with a low rate of major complications.
• The upper face is the most commonly addressed area in FFS.
• Age and ethnicity are important considerations in FFS planning and outcomes.