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Facial Masculinization Surgery and its Role in the Treatment of Gender Dysphoria

Sayegh, Farah BA*; Ludwig, David C. DDS, MD; Ascha, Mona MD; Vyas, Krishna MD, PhD§; Shakir, Afaaf MD||; Kwong, Jeffrey W. BS; Swanson, Marco MD; Evans, Morgan W. MD, FRCSC#; Gatherwright, James MD**; Morrison, Shane D. MD, MS#

doi: 10.1097/SCS.0000000000005101
Original Articles

Background: Interest in facial masculinization surgery is expected to increase as gender-affirming surgery becomes more widely accepted and available. The purpose of this study is to summarize the current literature describing operative techniques in facial masculinization surgery and provide an algorithmic approach to treating this patient population.

Methods: PubMed, EMBASE, and Medline databases were queried for literature on operative techniques and outcomes of facial masculinization surgery in transgender and cisgender patients, published through July 2018. Data on patient demographics, follow-up, operative techniques, complications, and outcomes were collected.

Results: Fifteen of the 24 identified studies met inclusion criteria. Two studies discussed the outcomes of 7 subjects (6 trans-male and 1 cis-male) who underwent facial masculinization procedures. No objective outcomes were reported in either study; however, subjects were generally satisfied and there were no complications. The remaining studies reviewed operative techniques utilized in the cisgender population.

Conclusion: A summary of considerations for each facial anatomic subunit and respective operative techniques for facial masculinization is presented. Current facial masculinization procedures in cisgender patients may be considered in the transgender patient population with favorable outcomes. However, further research is needed on techniques and objective outcome measures of facial masculinization procedures in the transgender population.

*Tulane University School of Medicine, New Orleans, LA

Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA

Division of Plastic Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH

§Department of Plastic Surgery, Mayo Clinic, Rochester, MN

||Division of Plastic Surgery, Department of Surgery, University of Chicago Medicine, Chicago, IL

Stanford University School of Medicine, Stanford, CA

#Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA

**Division of Plastic Surgery, Metrohealth Medical Center, Cleveland, OH.

Address correspondence and reprint requests to Shane D. Morrison, MD, MS, 325 9th Ave., Mailstop #359796, Seattle, WA 98104; E-mail:

Received 13 August, 2018

Accepted 1 September, 2018

The authors report no conflicts of interest:

FS, DCL, and MA contributed equally to this work.

© 2019 by Mutaz B. Habal, MD.