Publication | Open Access
Abstract: Prospective Quality of Life Outcomes after Facial Feminization Surgery
11
Citations
0
References
2017
Year
Quality Of LifeSurgeryOrthopaedic SurgeryGender IdentityCosmetic SurgeryGender StudiesAesthetic SurgeryGender Affirming SurgeryTransgender PeopleHealth SciencesTransgender MedicineFacial Feminization SurgerySexual Well-beingProspective QualityAesthetic Facial SurgeryOutcomes ResearchFacial AnalysisTransgender VoiceMedicineTransgender StudyPlastic SurgeryWomen's Health
INTRODUCTION: Recent estimates suggest there are at least 25 million transgender people worldwide. Up to 0.9% of the US population is thought to express some form of gender dysphoria. Medical and surgical gender-confirmation has been proven to have a substantial impact on transgender patients’ physiologic and psychosocial outcomes along with improved quality of life. Yet, little is known about the quality of life outcomes after facial feminization surgery (FFS). The purpose of this study was to examine the quality of life outcomes after FFS. METHODS: A multi-center prospective cohort study was implemented and enrolled patients over the age of 18 from two institutions who were planning to undergo FFS. Subjects were asked to complete a previously validated instrument for assessment of quality of life outcomes after FFS and have clinical photographs at pre-determined intervals: pre-operatively, 1 week to 1 month post-operatively, and greater than 6 months post-operatively. An FFS outcome score was calculated at each interval with a range from 0 – 100, and photos were analyzed through facial analysis. Patient demographic data was obtained. Non-parametric unpaired Mann-Whitney test was used for statistical analysis. RESULTS: Fifteen patients have been enrolled with an average age was 34.5 years and less than a third of patients had a smoking history. All subjects had begun medical transition with hormone therapy while 50% had previous gender-confirming surgery and 15.4% had previous FFS. Most patients had begun their transition over one year ago. The mean pre-operative FFS outcome score was 48.3 ± 15.4 which improved to 86.9 ± 13.2 at < 1 month post-operatively (p=0.0002 vs pre-op) then 89.8 ± 8.7 at > 6 months post-operatively (p=0.0004 vs pre-op; p=0.66 vs 1 month). Subjects reported being very satisfied (mean = 3.7 ± 0.5) with the outcomes of their FFS on a four-point Likert scale (0=least satisfied, 4=most satisfied) at > 6 months post-operatively. Facial analysis showed substantial changes in facial properties. CONCLUSION: FFS has a significant positive impact on transgender patient quality of life with minimal complications. More patients are continually being enrolled in this study, but these preliminary results and previous research points to the medical necessity of FFS for transgender patients.