Atypical Orthognathic Surgical Protocol for Facial Feminisation as an Adjunct to Gender Affirmation Therapy: a Case...

Gender Affirmation Surgery/Therapy (GAS/GAT) constitutes an array of surgical and hormonal therapy performed on patients presenting with a diagnosis of 'Gender Dysphoria'. Facial Feminisation Surgery is a part of the overall gender reassignment process. It is a broad term used to describe the surgical alteration, generally performed on a male-to-female transsexual individual, in which, a masculine facial appearance is changed to a more feminine form. An 18-year-old transgender male undergoing GAT reported to our centre in Mumbai, India with a complaint of masculine face with forwardly placed teeth in the upper arch and thick-set backwardly placed lower jaw and lip. Patient was taken up for ortho-surgical management to establish a feminine facial form and a stable functional occlusion. Mandibular advancement using the bilateral sagittal split ramus osteotomy, which is an uncommon protocol in GAT cases was found to be a viable option in the successful management of such a clinical scenario.