The Nasoorbitofrontal Complex in Facial Feminization Surgery.

Area of Science:

• Plastic Surgery
• Gender-Affirming Care
• Craniofacial Surgery

Background:

• Facial feminization surgery (FFS) demand is rising, necessitating reliable techniques for upper facial enhancement.
• The nasoorbitofrontal (NOF) complex is a key area for feminization.
• Evaluating single-stage NOF complex reshaping is crucial for improving FFS outcomes.

Purpose of the Study:

• To assess the effectiveness of single-stage nasoorbitofrontal (NOF) complex reshaping in facial feminization surgery.
• To compare outcomes between orbitofrontal (OF) surgery and combined NOF surgery.
• To evaluate patient satisfaction following these procedures.

Main Methods:

• 155 transfeminine patients undergoing upper facial surgery were included.
• Outcomes were compared between patients receiving OF surgery (65) and NOF surgery (90).
• Preoperative and postoperative CT scans analyzed 2D anatomic angles; patient satisfaction was assessed using FACE-Q at 6 months.

Main Results:

• Both OF and NOF surgeries yielded significant craniometric changes (P < 0.001).
• The NOF group showed greater improvements in nasofrontal, frontal tilt, and metopion angles compared to the OF group.
• The NOF group reported higher patient satisfaction (median 4/5) than the OF group (median 3/5). No early complications were noted.

Conclusions:

• Single-stage NOF complex surgery is an effective method for upper facial gender-affirming surgery.
• This approach provides predictable results and enhances patient satisfaction.
• NOF complex reshaping is a valuable technique in feminizing the upper face.