FACE-Q satisfaction following upper third facial gender-affirming surgery using custom bone-section guides

Area of Science:

• Plastic Surgery
• Gender Affirming Care
• Patient Reported Outcomes

Background:

• Patient satisfaction after facial gender-affirming surgery (FGAS) lacks validated assessment tools.
• No specific postoperative satisfaction questionnaires exist for transgender patients undergoing facial surgery.
• 3D planning and bone cutting guides have shown promise in fronto-orbital feminization surgery.

Purpose of the Study:

• To evaluate postoperative patient satisfaction with the upper face after fronto-orbital surgery in trans women using the validated FACE-Q questionnaire.
• To identify predictive factors influencing satisfaction following fronto-orbital FGAS.
• To assess the efficacy of custom-made bone cutting guides in improving patient outcomes.

Main Methods:

• A cohort of 42 trans women undergoing frontoplasty with frontal sinus impaction osteotomies using custom bone cutting guides was studied.
• 3D preoperative CT planning was utilized for all patients.
• Patient-reported outcomes were assessed preoperatively and at 1-year postoperative using FACE-Q scales for the upper face and general items.

Main Results:

• Significant improvements were observed at 1 year in overall facial appearance (33.6 to 70.1), forehead/eyebrow appearance (38.3 to 80.1), and reduced appearance-related psychological distress (58.1 to 24.6).
• Significant improvement was also noted for forehead wrinkles (54.1 to 82.6).
• No specific factors predictive of postoperative satisfaction were identified for the frontal FGAS procedures.

Conclusions:

• The FACE-Q questionnaire is a validated tool for assessing patient satisfaction after fronto-orbital FGAS in trans women.
• Custom-made bone cutting guides combined with 3D planning lead to significant improvements in patient satisfaction and appearance.
• Further research is needed to identify predictive factors for satisfaction in FGAS.