Gender-Affirming Facial Surgery: Experiences and Outcomes at an Academic Center.

Gender-affirming facial surgery (GFS) is becoming more widely available for transgender individuals, but data on surgical approaches and outcomes remain limited. Retrospective analysis of surgical outcomes among consecutive GFS cases performed at a tertiary care academic center between March 2016 and August 2020. Seventy-seven patients underwent 109 surgeries, including 478 individual procedures. The median age was 42 years. Ninety-five percent of patients had public health insurance. Two-stage GFS was often used in older patients ( = 0.001), with the first stage involving bone and cartilaginous alterations, and the second stage involving soft tissue procedures. Mean hospital stay after first-stage GFS was 1.2 days, with 70% discharged on postoperative day 1. Mean follow-up was 11.3 months. Among 66 patients with at least 1 month of follow-up, all complications were minor and included surgical site infection (5%), dehiscence (3.0%), seroma (3%), and medical complications (6%). Thirty-day hospital readmission rate was 1.5%. There are unique surgical approaches for GFS, which demonstrate low complication and readmission rates. Understanding these approaches and outcomes may help guide preoperative patient consultations and clinical decision making.