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Precise Lower-Facial Feminization Surgery Using 3D-Printed Surgical Guides: Initial Clinical Experience From a Single

Wentian Xiao1, Li Lin, Wenyi Huang

  • 1Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

The Journal of Craniofacial Surgery
|September 3, 2025
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Summary

This study introduces 3D-printed guides for precise facial feminization surgery (FFS) in Chinese patients, achieving accurate results and high patient satisfaction. Digital workflows enhance safety and outcomes for lower facial feminization.

Keywords:
Digital designfacial feminization surgerygenioplastymandibular angle reductionsurgical guide

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Area of Science:

  • Plastic Surgery
  • Medical Technology
  • 3D Printing Applications

Background:

  • Facial feminization surgery (FFS) is increasingly common worldwide.
  • Limited clinical data on FFS exists for the Chinese population.
  • Precise surgical techniques are crucial for optimal FFS outcomes.

Purpose of the Study:

  • To report the initial single-center experience with 3D-printed surgical guides for lower-facial feminization in Chinese patients.
  • To evaluate the accuracy, efficacy, and patient satisfaction of this digital workflow.

Main Methods:

  • Virtual surgical planning was used to design patient-specific 3D-printed metal guides.
  • Guides ensured precise osteotomy during lower-facial feminization procedures.
  • Quantitative measurements and FACE-Q questionnaires assessed outcomes and satisfaction.

Main Results:

  • Achieved sub-2 mm accuracy for osteotomy length and chin advancement.
  • Significant reductions in lower-facial width and masseter thickness.
  • Significant increases in mandibular angle, leading to 'V-line' contours.
  • High patient satisfaction reported in appearance, quality of life, and patient experience domains.
  • No major surgical complications were observed.

Conclusions:

  • 3D-printed surgical guides and digital workflows enhance precision and safety in lower-facial feminization.
  • This technique effectively achieves desired aesthetic outcomes ('V-line' contour) and improves patient psychosocial well-being.
  • The findings support the use of advanced digital technologies in FFS for the Chinese population.