Chapter 1: Facial Feminization Surgery: A Global Approach

The document from 2017 provides an overview of facial feminization surgery (FFS), detailing the procedures and techniques used to modify masculine facial features to be more feminine, in alignment with a patient's gender identity. It explains that FFS involves structural bone modification, such as osteotomies and burring, and the adjustment of soft tissues, focusing on areas like the frontonasal-orbital complex, nose, jaw, and chin. These areas are significantly affected by testosterone during puberty and do not respond to hormone therapy. The document also touches on secondary aspects like hairline, facial hair, skin texture, and fat distribution, which can be treated with hormone therapy. It emphasizes the importance of thorough evaluation, diagnosis, and the use of imaging tests for accurate surgical planning. Techniques discussed include fat transfer, rhinoplasty, lip lifts, and bone sculpture methods, with a focus on avoiding visible scars and ensuring precision and safety. The reduction of the thyroid cartilage is also mentioned. Postoperative management is highlighted as crucial for quick recovery and satisfactory results. The document concludes with the recommendation for a multidisciplinary approach and the sharing of experiences to further establish FFS as a recognized medical discipline.