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An update in facial gender confirming surgery

Juszczak, Hailey M.a; Fridirici, Zacharyb; Knott, P. Danielb; Park, Andrea M.b; Seth, Rahulb

Current Opinion in Otolaryngology & Head and Neck Surgery: August 2019 - Volume 27 - Issue 4 - p 243–252
doi: 10.1097/MOO.0000000000000549
FACIAL PLASTIC SURGERY: Edited by Travis T. Tollefson

Purpose of review To summarize current surgical and nonsurgical approaches to facial gender confirming surgery (FGCS) and highlight standards of care and areas of future research.

Recent findings Gender nonconforming individuals may encounter considerable internal coping and external social stressors that may contribute to gender-associated dysphoria. FGCS provides patients the ability to align facial appearance with gender identity, using recently described advances in surgical and nonsurgical techniques. The majority of FGCS is performed on transwomen (individuals identifying as female), yielding the more common term of facial feminization surgery (FFS). Although no set protocols or standards are in place, certain procedures are commonly performed to alter sex-determining characteristics of the face, and further research may help define guidelines. As many training programs have minimal exposure to FGCS, promotion of transgender health awareness is paramount for diverse and inclusive surgical training.

Summary Although demand for FGCS is increasing, there remains a need for improving surgical approaches, developing evidence-based care guidelines, and implementing education and awareness in training programs.

aSchool of Medicine

bDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA

Correspondence to Rahul Seth, MD, University of California San Francisco, 2233 Post Street, 3rd Floor, San Francisco, CA 94115, USA. Tel: +1 415 885 7494; fax: +1 415 885 7785; e-mail:

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