面部女性化手术由各种颅颌面外科手术组成,越来越受到男性对女性变性人患者和寻求面部女性化的人的追捧。面部女性化手术在缓解性别焦虑方面可以发挥突出作用。考虑到近年来执行的性别确认程序有所增加,广泛的技术知识基础,结果,面部女性化手术的挑战应该由提供这些程序的外科医生来确定。我们的评论旨在批判性地评估当前文献,并为性别确认外科实践的未来进展提供信息。此外,我们详细介绍了一个具有代表性的案例,以说明资深作者对完全面部女性化的方法。
PubMed的全面文献检索,EMBASE,和Cochrane数据库是针对截至2020年6月发布的研究进行的,使用以下搜索词进行的:“面部”或“面部”或“颅面”和“女性化”或“女性化手术”或“性别重新分配”或“性别确认手术”或“性别确认手术”。“程序数据,结果,患者年龄,随访时间,并发症,并收集患者满意度。数据按面部三分法分类,然后按面部特征进一步分层。
我们的搜索产生了388篇文章。30篇文章符合我们的纳入标准,其中,审查中包括23篇文章。我们提取了3554名年龄在18至73岁之间的患者的主要数据,这些患者总共接受了8506次手术。大多数程序都针对上面部三分之一(发际线,前额,和眉毛),占全部手术的49.1%。按面部特征进一步分类显示,最常见的特征是额头(占手术的34.6%),其次是鼻子(12.8%)和下巴(12.2%)。在使用定量措施来衡量患者报告结果的研究中,满意度很高。
面部女性化手术似乎是安全的,无论是在单一阶段还是分阶段进行。面部女性化程序后,患者报告满意度高,性别一致性更好。需要进一步的研究来建立最佳的手术实践,并在平均随访时间之外评估患者的满意度,并确定寻找辅助程序的频率。
Facial feminization surgery is composed of a variety of craniomaxillofacial surgical procedures that are increasingly sought after by male-to-female transgender patients and by those seeking feminization of the face. Facial feminization surgery can play a prominent role in alleviating gender dysphoria. In consideration of an observed increase in gender-affirming procedures performed in recent years, a broad knowledge base in the techniques, outcomes, and challenges of facial feminization surgery should be established by surgeons offering these procedures. Our review was designed to critically appraise the current literature and inform future advancements in gender-affirming surgical practice. In addition, we detail a representative
case to illustrate the senior author\'s approach to full facial feminization.
A comprehensive literature search of the PubMed, EMBASE, and Cochrane databases was conducted for studies published through June 2020 using following the search terms: \"Face\" OR \"facial\" OR \"craniofacial\" AND \"Feminization\" OR \"Feminization Surgery\" OR \"Gender Reassignment\" OR \"Gender Affirming Surgery\" OR \"Gender Confirmation Surgery.\" Data on procedures, outcomes, patient age, follow-up time, complications, and patient satisfaction were collected. The data were categorized by facial thirds and then further stratified by facial feature.
Our search yielded 388 articles. Thirty articles fit our inclusion criteria, and of these, 23 articles were included in the review. We extracted primary data pertaining to 3554 patients with an age range of 18 to 73 who underwent 8506 total procedures. Most of the procedures addressed the upper facial third (hairline, forehead, and brow), comprising 49.1% of total procedures performed. Further categorization by facial feature revealed that the most commonly addressed feature was the forehead (34.6% of procedures), followed by the nose (12.8%) and the chin (12.2%). In studies that used quantitative measures to gauge patient-reported outcomes, satisfaction was high.
Facial feminization surgery seems to be safe, whether it is conducted in a single stage or as a staged procedure. Patients report high satisfaction and better gender congruency after facial feminization procedures. Further research is needed to establish best surgical practice and gauge patient satisfaction beyond the length of average follow-up and determine the frequency with which adjunctive procedures are sought out.