The expert consensus, based on literature review and aggregated experience spanning thousands of FGCS patients, explicitly states that FGCS procedures are medically necessary. For these reasons, the first International Facial Gender Symposium (IFGS) was held in 2019, bringing together a multidisciplinary group including surgeons, psychologists, and researchers focused on the area of facial gender surgery. However, this has not obviated the need for more surgeons competent in performing FGCS or the need for expert consensus-even the current version of the WPATH standards of care (SOC7) does not explicitly deem FGCS as medically necessary. Access to care and medical necessityĪs access to healthcare has increased for this population and patients are receiving treatment earlier, the need for FGCS has decreased secondary to the earlier use of hormone therapy ( 13). Although there has only been one international, prospective, international, multicenter, cohort study on FFS demonstrating improved quality of life, the daily impact of the results of these procedures are unequivocally positive ( 5- 12). For many transgender patients the face is a source of significant dysphoria and addressing this can increase the patient’s quality of life and unify his/her physical features and self-image ( 4). Since these procedures have become more prevalent, there have been questions regarding the medical necessity of FGCS and the psychosocial outcomes these procedures generate. As much has changed since the advent of FGCS, we seek to provide a concise review of FGCS in the modern context with special consideration to the medical necessity of FGCS, use of virtual surgical planning (VSP), and updated technical considerations. In recent years, as transgender men have also sought facial harmonizing procedures, it became increasingly apparent that a more encompassing term was needed.
NOSE CONTOUR SURGERY SERIES
FFS was originally described as a series of procedures in order to feminize a transgender man’s face which arose out of a need for validation of the transwomen in carrying out their new social role as a woman. Douglas Ousterhout in San Francisco in the mid 1980s ( 1, 2). What is now known as FGCS had its initial moniker as facial feminization surgery (FFS) and was a field pioneered by Dr. Introduction History of facial gender confirmation surgery (FGCS) Keywords: Facial feminization gender affirmation surgery frontal sinus setback Finally, postoperative care and complications considered. We then discuss the history of the frontal sinus setback and offer our algorithmic approach to recontouring the forehead with detailed description of the operative steps and decision making.
Use of VSP allows the surgeon to provide reproducible and accurate results. Virtual surgical planning (VSP), a tool broadly used in surgical fields, has a special role in FGCS and we offer advice in using VSP when addressing the frontal sinus.
Hairline modifying therapies including pharmacotherapy and hair transplantation are explained. Key differences in the forehead and the hairline of cis men and women are discussed which inform pharmacologic and surgical interventions.
This narrative review focuses on the upper third of the face. This field in plastic and reconstructive surgery has quickly gained more attention in the past decade due to the pioneering work of groups around the world along with increased social acceptance and medical care of the transgender community.
Originally described in San Francisco in the 1980s, FGCS has evolved to encompass all elements of the craniofacial skeleton and facial soft tissue. Policy of Dealing with Allegations of Research MisconductĪbstract: Facial gender confirmation surgery (FGCS) is a series of procedures which seek to harmonize a patient’s face with his/her self-image and gender identity.Policy of Screening for Plagiarism Process.
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