Assessment of Malar Feminization: A Prospective Comparative Pilot Study

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.