背景:面部女性化手术(FFS)是一种新兴的做法,属于性别确认手术的更广泛范围。有多种方法可以使脸部女性化,然而,很少发表的文章详细描述了每个组件过程的技术。考虑到所采用的干预措施的多样性,本手稿的目的是突出高级作者使用的FFS技术,并创建相应的媒体画廊。
方法:对2017年6月至2022年8月期间所有诊断为性别烦躁不安的患者进行了回顾。根据机构审查委员会(IRB)批准的研究方案,从电子病历中回顾性收集数据。收集和分析的数据包括人口统计,操作文件,术后随访。术中和术后收集多媒体材料。
结果:共有231例患者接受了262次手术,共1224次FFS手术。平均随访时间为7.7±11个月。在262次行动中,24例(9.2%)患者出现轻微并发症,包括3例(1.1%)伤口裂开,13例(5.0%)合并血肿,14例(5.3%)术后感染需要抗生素治疗。其中,3(1.1%)需要返回手术室以冲洗或去除颌骨植入物。
结论:尽管在基本手术原则上达成了共识,以实现面部结构的充分女性化,这样做的具体技术根据个人实践而有所不同。随着技术的分歧,他们的风险状况和结果也是如此;技术必须,因此,与患者的介入目标保持一致。这里提供的材料是许多可以支持受训者和初级外科医生建立性别确认实践的材料之一。
BACKGROUND: Facial feminization surgery (FFS) is an emerging practice that falls under the broader umbrella of gender-affirming surgery. Various approaches exist to feminize the face, yet few published articles describe in detail the techniques of each component procedure. Considering the diversity of interventions employed, the objective of this manuscript is to highlight FFS techniques utilized by the senior author and create a corresponding media gallery.
METHODS: All patients with the diagnosis of gender dysphoria that were referred to the senior author for FFS consultation between June 2017 and August 2022 were reviewed. Data were retrospectively collected from electronic medical records according to the institutional review board (IRB)-approved study protocol. Data collected and analyzed included demographics, operative documentation, and postoperative follow-up. Multimedia material was collected intraoperatively and postoperatively.
RESULTS: A total of 231 patients underwent 262 operations with a total of 1224 FFS procedures. The average follow-up time was 7.7 ± 11 months. Out of the 262 operations, 24 (9.2%) patients experienced minor complications, including 3 (1.1%) with wound dehiscence, 13 (5.0%) with hematomas, and 14 (5.3%) with postoperative infection requiring antibiotics. Of those, 3 (1.1%) required a return to the operating room for washout or removal of malar implants.
CONCLUSIONS: Although there is a consensus on the fundamental surgical principles to achieve adequate feminization of the facial architecture, the specific techniques to do so differ according to individual practices. As techniques diverge, so do their risk profiles and outcomes; techniques must, thus, align with patients\' interventional goals. The material presented here is one of many that can support trainees and junior surgeons as they build a gender-affirming practice.