Preoperative Radiology and Virtual Surgical Planning.

Area of Science:

• Plastic Surgery
• Medical Imaging
• Biomedical Engineering

Background:

• Virtual surgical planning (VSP) integrates preoperative imaging with surgical goals.
• VSP is crucial for translating planned procedures into operative actions.
• Maxillofacial computed tomography (CT) scans are foundational for VSP.

Purpose of the Study:

• To outline the application of VSP in facial feminization and masculinization surgery.
• To detail the types of surgical modifications and custom devices used in VSP for facial contouring.
• To highlight the role of VSP in creating patient-specific surgical guides and implants.

Main Methods:

• Comparison of preoperative maxillofacial CT scans with a reference skull.
• Identification of specific surgical modifications for facial feminization (e.g., forehead recontouring, gonial angle reduction) and masculinization (e.g., forehead augmentation, chin augmentation).
• Custom manufacturing of surgical guides (osteotomy, drilling, ostectomy, genioplasty) and implants (mandibular, chin).

Main Results:

• VSP enables precise planning and intraoperative execution of complex facial bone surgeries.
• Custom cutting/recontouring guides and implants are manufactured based on VSP.
• Specific guides and implants facilitate procedures like forehead modification, jaw contouring, and chin reshaping.

Conclusions:

• Virtual surgical planning is a key technology for achieving precise outcomes in facial feminization and masculinization surgeries.
• The use of custom guides and implants derived from VSP enhances the accuracy and reproducibility of surgical corrections.
• VSP facilitates patient-specific surgical solutions for aesthetic facial contouring.