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Assessment of Malar Feminization: A Prospective Comparative Pilot Study.

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Summary

Facial feminization surgery using malar implants or lipofilling effectively enhances the midface in individuals assigned male at birth (AMAB). Both techniques yield high patient satisfaction, with neither proving superior in this comparative study.

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Area of Science:

  • Plastic Surgery
  • Facial Feminization Surgery
  • Aesthetic Surgery

Background:

  • Malar region augmentation is essential for facial feminization in individuals assigned male at birth (AMAB).
  • Current options include malar implants and lipofilling, with no established consensus on the superior technique.
  • This study is the first to compare malar implants and lipofilling for midface feminization in AMAB patients.

Purpose of the Study:

  • To compare the effectiveness of malar implants versus lipofilling for midface feminization in AMAB patients.
  • To evaluate patient satisfaction levels following each surgical technique.
  • To assess the efficacy of both methods for achieving feminization of the cheeks.

Main Methods:

  • A prospective, bicentric study involving 40 AMAB patients undergoing midface feminization.
  • Patients were treated with either malar implants or fat grafting (lipofilling).
  • Efficacy and satisfaction were assessed using validated scales (Face-Q, SWLS, SHS, FNL-ONAS) preoperatively and one year post-surgery.

Main Results:

  • Both malar implants and lipofilling demonstrated significant improvements in patient scores (p<0.05) from pre- to post-surgery.
  • High levels of patient satisfaction and treatment efficacy were observed, irrespective of the chosen method.
  • No statistically significant difference in patient satisfaction was found between the malar implant and lipofilling groups.

Conclusions:

  • Malar enhancement via implants or lipofilling is an effective strategy for malar feminization in AMAB individuals.
  • Treatment should be personalized based on patient expectations and clinical evaluation.
  • Further research with longer follow-up and larger cohorts is warranted to definitively determine technique superiority.