Kalavacherla Sandhya, Kalavacherla Sruthi, Cordero Justin, Becker Miriam, Straus Sabrina, Sheahan Lucy, Gosman Amanda
School of Medicine, University of California San Diego, La Jolla, California.
Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts.
Eplasty. 2024 May 7;24:e26. eCollection 2024.
Although facial feminizing rhinoplasty can reduce gender dysphoria, there is limited evidence on approaches to maximize transgender patient satisfaction. In a retrospective cohort of transfeminine patients who underwent feminizing rhinoplasty, we compare pre- and postoperative nasal metrics and postoperative satisfaction.
Records were retrospectively reviewed to identify transfeminine patients who had feminizing rhinoplasty and cisgender females who had aesthetic rhinoplasty at least 8 weeks post-rhinoplasty. Transgender patients were contacted to rate their aesthetic and functional rhinoplasty satisfaction. Patients with 75% or greater of the total survey score were "very satisfied," those between 50% and 75% were "satisfied," and those below 50% were "less satisfied." The Vectra 3D imaging software was utilized to measure each patient's pre- and post-rhinoplasty dorsal lengths; tip projection ratios; and nasolabial, nasofrontal, and nasofacial angles. Relative percent changes for each patient between pre- and post-rhinoplasty measurements were compared between transgender and cisgender females using descriptive statistics.
Twenty-five transgender patients met the inclusion criteria; 19 answered the survey with 12 very satisfied, 7 satisfied, and 0 less satisfied patients. The median age of surveyed patients was 35, and 42.1% identified as Hispanic. Between very satisfied and satisfied patients, median relative percent changes in dorsal length (-1.2% vs 5.7%, = .043), tip projection ratio (2.4% vs 8.1%, = .038), and nasolabial angle (-2.5% vs 9.7%, = .026) significantly differed; median relative changes in nasofrontal angles (4.2% vs -0.6%, = .071) and nasofacial angles (-0.7% vs -3.6%, = .703) were insignificantly different. Satisfied transgender patients and cisgender patients (n = 5) had significant differences in median relative changes in dorsal length (5.7% vs 0.7%, = .047), tip projection ratio (8.1% vs -3.5%, = .033), and nasolabial angles (9.7% vs -5.4%, = .042). Very satisfied transgender and cisgender females had no significant differences in relative metric changes.
Very satisfied transgender patients had decreases in dorsal length, smaller increases in tip projection ratio, and decreases in the nasolabial angle compared with satisfied patients. These data can help focus feminizing rhinoplasty approaches to maximize satisfaction. Further, very satisfied transgender patients had similar changes as cisgender females, reaffirming the utility of applying cisgender female rhinoplasty considerations to feminizing rhinoplasty.
尽管面部女性化隆鼻术可减轻性别焦虑，但关于如何最大程度提高跨性别患者满意度的方法，证据有限。在一组接受女性化隆鼻术的跨性别女性患者的回顾性队列研究中，我们比较了术前和术后的鼻部指标以及术后满意度。
回顾性查阅病历，以确定接受女性化隆鼻术的跨性别女性患者以及在隆鼻术后至少8周接受美学隆鼻术的顺性别女性患者。联系跨性别患者对其美学和功能性隆鼻满意度进行评分。总调查得分达到或超过75%的患者为“非常满意”，得分在50%至75%之间的患者为“满意”，得分低于50%的患者为“不太满意”。使用Vectra 3D成像软件测量每位患者隆鼻术前和术后的鼻背长度、鼻尖突出比例以及鼻唇角、鼻额角和鼻面角。使用描述性统计方法比较跨性别女性和顺性别女性患者术前和术后测量值之间的相对百分比变化。
25名跨性别患者符合纳入标准；19名患者回复了调查，其中12名非常满意，7名满意，0名不太满意。接受调查患者的中位年龄为35岁，42.1%的患者为西班牙裔。在非常满意和满意的患者之间，鼻背长度的中位相对百分比变化（-1.2%对5.7%，P = 0.043）、鼻尖突出比例（2.4%对8.1%，P = 0.038）和鼻唇角（-2.5%对9.7%，P = 0.026）存在显著差异；鼻额角（4.2%对-0.6%，P = 0.071）和鼻面角（-0.7%对-3.6%，P = 0.703）的中位相对变化无显著差异。满意的跨性别患者和顺性别患者（n = 5）在鼻背长度的中位相对变化（5.7%对0.7%，P = 0.047）、鼻尖突出比例（8.1%对-3.5%，P = 0.033）和鼻唇角（9.7%对-5.4%，P = 0.042）方面存在显著差异。非常满意的跨性别女性和顺性别女性在相对指标变化方面无显著差异。
与满意的患者相比，非常满意的跨性别患者鼻背长度减小，鼻尖突出比例增加幅度较小，鼻唇角减小。这些数据有助于聚焦女性化隆鼻术方法以最大程度提高满意度。此外，非常满意的跨性别患者与顺性别女性有相似的变化，再次证明将顺性别女性隆鼻术的考虑因素应用于女性化隆鼻术的实用性。
