Safety of Facial Feminization Surgery at an Ambulatory Surgery Center

Facial feminization surgery (FFS) encompasses a broad range of procedures that aim to provide gender affirmation for male-to-female transgender individuals. Historically, these surgeries have been performed in tertiary care centers and have required overnight stay in the hospital. We reviewed our experience performing FFS at an ambulatory surgery center.

Patients undergoing FFS at an ambulatory surgery center between July 2018 and January 2022 were included in this retrospective study. Postoperative transfer to hospital and emergency department visits were the primary outcome measures. Procedures performed and case duration were also recorded.

A total of 304 FFS cases were performed at an ambulatory surgery facility between July 2018 and January 2022. The average number of procedures performed per case was 3.5, and the average case duration was 3 hours and 13 minutes (with a range of 20 minutes to 8.5 hours). A total of 3 cases (0.99%) resulted in unplanned transfer to higher level of care. Complication rate was not related to the number of procedures, patient age, or procedure duration. None of these transfers resulted in long-term consequences for the patients.

In our cohort of FFS performed at an ambulatory surgery center, complication rate was found to be lower than the rate previously described in similar series performed at tertiary care facilities. In spite of its complexity, FFS can be performed in an outpatient setting safely and effectively.

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