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Considerations for Maximizing Perioral Aesthetics in Gender-Affirming Surgery.

Torin Thielhelm¹, Katherine Liu¹, Maria Mavrommatis¹

¹Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.

Facial Plastic Surgery : FPS

|May 12, 2025

Summary

Facial gender-affirming surgery (FGAS) refines perioral aesthetics, focusing on lips, chin, and submentum. Techniques vary for feminization and masculinization, requiring individualized approaches for optimal outcomes.

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Area of Science:

Plastic Surgery
Facial Aesthetics
Gender-Affirming Surgery

Background:

Perioral aesthetics significantly impact facial appearance and gender perception.
Facial gender-affirming surgery (FGAS) aims to align facial features with gender identity.
Understanding distinct perioral characteristics is crucial for FGAS.

Purpose of the Study:

To review the philosophy, techniques, and evidence for perioral aesthetics in FGAS.
To detail specific considerations for the lips, chin, and submentum in FGAS.
To highlight differences in perioral features between masculine and feminine appearances.

Main Methods:

Review of surgical techniques for lip feminization (e.g., subnasal lip lift, injectables).
Discussion of chin contouring methods (e.g., T-genioplasty, virtual surgical planning).
Exploration of submental area refinement (liposuction, platysmaplasty) and mandibular augmentation for masculinization.

Main Results:

Masculine features: higher lip, greater labial volume, wider mouth, prominent chin, angular submentum.
Feminine features: increased incisor show, softer/tapered chin.
Surgical techniques can effectively alter perioral features for desired aesthetic outcomes.

Conclusions:

Tailored perioral aesthetic modifications are essential for successful FGAS.
Individualized technique selection based on comprehensive anatomical understanding is vital.
Attention to lips, chin, and submentum contributes to achieving desired facial masculinization and feminization.