Facial masculinization surgery
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Facial masculinization surgery(FMS) is a set ofplastic surgeryprocedures that can transform the patient'sfaceto exhibit typical masculinemorphology.Cisgendermen may elect to undergo these procedures, and in the context oftransgenderpeople, FMS is a type of facial gender confirmation surgery (FGCS), which also includesfacial feminization surgery(FFS) fortransgender women.[1]
FMS can include various bony procedures such aschin augmentation,cheek augmentation,as well as augmentation of theforehead,jaw,andAdam's apple.In FMS, most procedures involve "having structures added to give more angles to the face."[2]
History[edit]
Trans men have requested FMS procedures since the 20th century.[3]FMS is currently less common than FFS.[4]Urologist Miriam Hadj-Moussa notes that "transgender men rarely undergo facial masculinization surgery sincetestosteronetherapy leads to growth offacial hairand makes it easier for them to present. "[5]
In 2011,Douglas Ousterhoutoutlined the available FMS procedures, drawing on the work ofPaul Tessier.[6]In 2015 Shane Morrison published an overview of all gender affirming surgeries for trans men, including FMS.[7]In 2017, Ousterhout's successorJordan Deschamps-Bralypublished acase reporton the first female-to-male facial confirmation surgery that included masculinization of the Adam's apple.[8]
According to theWorld Professional Association for Transgender Health(WPATH), for manytransgendermen, FMS is consideredmedically necessaryto treatgender dysphoria.[9][10]Following the WPATH recommendations, several literature reviews and summaries of the state of the art were published in 2017 and 2018.[11][12][13][14]
Surgical procedures[edit]
The surgical procedures most frequently performed during FMS often includefacial implantsand include the following, as outlined in the literature.[6][15][16]
Forehead augmentation[edit]
The purpose of forehead augmentation is to create a less rounded forehead with a more prominentsupraorbital ridgetypical of cisgender men. It can be done with a customized implant, acalvarialbone graft,fat grafting,or materials such asbone cementthat are molded into shape before they harden.Injectable fillersmay also be used as an outpatient procedure.[6][16][17]
Jaw augmentation[edit]
Orthognathic surgerywas first performed for functional reasons in the late 19th century, with cosmetic procedures being improved and refined throughout the 20th century.[18]In facial masculinization surgery, the goal is to create a more robust and square jaw with a sharpermandibular angle.This can be achieved throughhydroxyapatite(bone mineral) grafts, which promote new bone growth, or through customized implants.[16]
Chin augmentation[edit]
To change the appearance of the jaw,chin augmentationmay also be performed. This can consist of chin implants or anosteotomyto make the chin tip appear wider and more prominent.[16]
Adam's apple augmentation[edit]
This newer procedure uses an implant made fromcartilagetaken from the patient'srib cageto augment the tip of thethyroid cartilageknown as the "Adam's apple." It was first performed in 2017.[8]
See also[edit]
References[edit]
- ^Deschamps-Braly, JC (2018). "Facial Gender Confirmation Surgery".Clinics in Plastic Surgery.45(3): 323–331.doi:10.1016/j.cps.2018.03.005.PMID29908620.S2CID49266967.
- ^Yarbrough E (2018).Transgender Mental Health.American Psychiatric Association Publishing.ISBN9781615371136
- ^Ng EM (1999). Sexuality in the New Millennium: Proceedings of the 14th World Congress of Sexology, Hong Kong SAR, China, August 23–27, 1999. CompositoriISBN9788877942296
- ^Colebunders B, D'Arpa S, Weijers S, Lumen N, Hoebeke P, Monstrey S (2016). Female-to-Male Gender Reassignment Surgery. In Ettner R, Monstrey S, Coleman E, Eds.Principles of Transgender Medicine and Surgery.RoutledgeISBN9781317514602
- ^Hadj-Moussa, M; Agarwal, S; Ohl, DA; Kuzon, WM (2019). "Masculinizing Genital Gender Confirmation Surgery".Sexual Medicine Reviews.7(1): 141–155.doi:10.1016/j.sxmr.2018.06.004.PMID30122339.S2CID52041826.
- ^abcOusterhout, DK (2011). "Dr. Paul Tessier and Facial Skeletal Masculinization".Annals of Plastic Surgery.67(6): S10–S15.doi:10.1097/SAP.0b013e31821835cb.PMID22123544.S2CID2985782.
- ^Morrison, SD; Perez, MG; Nedelman, M; Crane, CN (2015). "Current State of Female-to-Male Gender Confirming Surgery".Current Sexual Health Reports.7(1): 38–48.doi:10.1007/s11930-014-0038-2.S2CID73246160.
- ^abDeschamps-Braly, JC; Sacher, CL; Fick, J; Ousterhout, DK (2017). "First Female-to-Male Facial Confirmation Surgery with Description of a New Procedure for Masculinization of the Thyroid Cartilage (Adam's Apple)".Plastic and Reconstructive Surgery.139(4): 883e–887e.doi:10.1097/PRS.0000000000003185.PMID28350659.S2CID25766890.
- ^World Professional Association for Transgender Health(2016).Position Statement on Medical Necessity of Treatment, Sex Reassignment, and Insurance Coverage in the U.S.A.Page accessed September 8, 2018
- ^World Professional Association for Transgender Health.Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, Version 7.Archived2015-08-14 at theWayback Machinepg. 58 (2012).
- ^Berli, JU; Capitán, L; Simon, D; Bluebond-Langner, R; Plemons, E; Morrison, SD (2017). "Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care".International Journal of Transgenderism.18(3): 264–270.doi:10.1080/15532739.2017.1302862.S2CID151530474.
- ^Capitán, L; Simon, D; Berli, JU; Bailón, C; Bellinga, RJ; Santamaría, JG; Tenório, T; Sánchez-García, A; Capitán-Cañadas, F (2017). "Facial Gender Confirmation Surgery: A New Nomenclature".Plastic and Reconstructive Surgery.140(5): 766e–767e.doi:10.1097/PRS.0000000000003798.PMID28753146.
- ^Morrison, SD; Chen, ML; Crane, CN (2017). "An overview of female-to-male gender-confirming surgery".Nature Reviews Urology.14(8): 486–500.doi:10.1038/nrurol.2017.64.PMID28508877.S2CID20532197.
- ^Massenburg, BB; Morrison, SD; Rashidi, V; Miller, C; Grant, DW; Crowe, CS; Velasquez, N; Shinn, JR; Kuperstock, JE; Galaiya, DJ; Chaiet, SR; Bhrany, AD (2018). "Educational Exposure to Transgender Patient Care in Otolaryngology Training".Journal of Craniofacial Surgery.29(5): 1252–1257.doi:10.1097/SCS.0000000000004609.PMID29771846.S2CID21696185.
- ^Schechter LS, Safa B, Eds. (2018). Gender Confirmation Surgery.Clinics in Plastic Surgery.Volume 45, Issue 3, Pages 295-446 (July 2018).ISBN9780323610742
- ^abcdHarris, Jason; Premaratne, Ishani D.; Spector, Jason A. (2021-10-01)."Facial Masculinization from Procedures to Payment: A Review".LGBT Health.8(7): 444–453.doi:10.1089/lgbt.2020.0128.ISSN2325-8292.PMID34403627.S2CID237197450.
- ^Park, DK; Song, I; Lee, JH; You, YJ (2013)."Forehead Augmentation with a Methyl Methacrylate Onlay Implant Using an Injection-Molding Technique".Archives of Plastic Surgery.40(5): 597–602.doi:10.5999/aps.2013.40.5.597.PMC3785596.PMID24086816.
- ^Puricelli, E (2007)."A new technique for mandibular osteotomy".Head & Face Medicine.3(1): 15.doi:10.1186/1746-160X-3-15.PMC1845144.PMID17355642.