Morrison Shane D, Vyas Krishna S, Motakef Saba, Gast Katherine M, Chung Michael T, Rashidi Vania, Satterwhite Thomas, Kuzon William, Cederna Paul S
Seattle, Wash.; Lexington, Ky.; Loma Linda and San Francisco, Calif.; Ann Arbor, Mich.; and Durham, N.C.
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Washington School of Medicine; the Division of Plastic Surgery, Department of Surgery, University of Kentucky College of Medicine; the Department of Plastic Surgery, Loma Linda University; the Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Michigan Health System; the Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University School of Medicine; and Brownstein and Crane Surgical Services.
Plast Reconstr Surg. 2016 Jun;137(6):1759-1770. doi: 10.1097/PRS.0000000000002171.
Facial feminization surgery encompasses a broad range of craniomaxillofacial surgical procedures designed to change masculine facial features into feminine features. The surgical principles of facial feminization surgery can be applied to male-to-female transsexuals and anyone desiring feminization of the face. Although the prevalence of these procedures is difficult to quantify, because of the rising prevalence of transgenderism (approximately one in 14,000 men) along with improved insurance coverage for gender-confirming surgery, surgeons versed in techniques, outcomes, and challenges of facial feminization surgery are needed. This review is designed to critically appraise the current facial feminization surgery literature.
A comprehensive literature search of the Medline, PubMed, and EMBASE databases was conducted for studies published through October of 2014 with multiple search terms related to facial feminization. Data on techniques, outcomes, complications, and patient satisfaction were collected.
Fifteen articles were selected and reviewed from the 24 identified, all of which were either retrospective or case series/reports. Articles covered a variety of facial feminization procedures. A total of 1121 patients underwent facial feminization surgery, with seven complications reported, although many articles did not explicitly comment on complications. Satisfaction was high, although most studies did not use validated or quantified approaches to address satisfaction.
Facial feminization surgery appears to be safe and satisfactory for patients. Further studies are required to better compare different techniques to more robustly establish best practices. Prospective studies and patient-reported outcomes are needed to establish quality-of-life outcomes for patients. However, based on these studies, it appears that facial feminization surgery is highly efficacious and beneficial to patients.
面部女性化手术涵盖了广泛的颅颌面外科手术程序，旨在将男性面部特征转变为女性特征。面部女性化手术的外科原则可应用于男变女的变性者以及任何想要面部女性化的人。尽管这些手术的患病率难以量化，但由于跨性别现象的患病率上升（约为每14000名男性中有1人），以及性别确认手术的保险覆盖范围有所改善，因此需要精通面部女性化手术技术、结果和挑战的外科医生。本综述旨在对当前面部女性化手术的文献进行批判性评估。
对Medline、PubMed和EMBASE数据库进行了全面的文献检索，以查找截至2014年10月发表的与面部女性化相关的多项检索词的研究。收集了有关技术、结果、并发症和患者满意度的数据。
从24篇已识别的文章中筛选出15篇进行综述，所有文章均为回顾性研究或病例系列/报告。文章涵盖了各种面部女性化手术。共有1121例患者接受了面部女性化手术，报告了7例并发症，不过许多文章并未明确提及并发症。患者满意度较高，尽管大多数研究并未采用经过验证或量化的方法来评估满意度。
面部女性化手术对患者而言似乎是安全且令人满意的。需要进一步开展研究，以更好地比较不同技术，从而更有力地确立最佳实践方法。需要进行前瞻性研究和患者报告的结果，以确定患者的生活质量结果。然而，基于这些研究，面部女性化手术似乎对患者具有高度有效性和益处。
