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Effect of Facial Feminization Surgery (FFS) on Eyelid Anatomic Features
Hanna N Luong1, Alice S Liu2, Basel A Sharaf3
1Department of Ophthalmology, Mayo Clinic Alix School of Medicine, Scottsdale, Arizona.
Facial Plastic Surgery : FPS
|April 27, 2024
Summary
Facial feminization surgery (FFS) utilizes brow lifts and eyelid surgeries to enhance gender congruence. Brow lifts were common in FFS, and combined with eyelid surgery, effectively feminized features.
Area of Science:
- Plastic Surgery
- Gender Affirming Care
- Ophthalmology
Background:
- Facial feminization surgery (FFS) is critical for alleviating gender dysphoria.
- Periocular features significantly influence perceived gender, yet brow and eyelid surgeries are underutilized in FFS.
Purpose of the Study:
- To determine the utilization rates of brow and eyelid surgeries during FFS.
- To characterize pre- and postoperative periocular features in patients undergoing FFS.
Main Methods:
- Retrospective review of FFS patients diagnosed with gender dysphoria from 2019-2022.
- Analysis of 38 surgical cases from 34 patients, examining eyelid and brow surgical procedures and periocular measurements.
Main Results:
- Brow lifts were performed in 79% of cases, and eyelid surgeries in 35%.
- Patients undergoing both brow lift and eyelid surgery were older, had more negative canthal tilt, and smaller margin-reflex distance 1.
- Brow lift increased tarsal platform show and lash-to-brow distance; upper blepharoplasty increased tarsal platform show.
Conclusions:
- High rates of brow lift are observed in FFS, with appropriate patient selection for eyelid surgery.
- Brow lift and upper blepharoplasty effectively feminize anatomical features based on cisgender standards.
- Further research is needed on the impact of periocular features on gender perception in transgender individuals.
