Facial Feminization: Perioperative Care and Surgical Approaches | Journal CME Article-Journal CME Article: Facial Feminization: Perioperative Care and Surgical Approaches v2 of 3

Video Transcription

This is an educational video on facial feminization surgery with intraoperative technique highlighting jawline reshaping. Preoperative virtual planning is performed  based on each patient's 3D CT scan.  Mandibular angle reduction involves completely excising the red prominent bone.  The lower facial width is thus reduced as demonstrated by toggling.  Jawline reshaping may also involve complete inferior border resection as demonstrated.  Titanium allows for cutting above the guide while polyamide allows for cutting below.  Geneoplasty narrowing is done by removing a central wedge of bone.  A reciprocating rasp can trim off edges as demonstrated.  The jawline then will appear tapered.  Geneoplasty cutting guides are occlusal based.  Custom plates may be used with screw depths.  Geneoplasty opening gingiva buccal sulcus incision is made.  Soft tissue deglobing is done with an elevator.  Occlusal cutting guide is placed and fixated. Central wedge osteotomy is done with a reciprocating saw.  Transverse osteotomy is performed.  Removal of cutting guide is followed by osteotomy completion.  Central wedge excision is done with bovie.  Additional transverse wedge removal helps shorten the chin. Reciprocating rasp is used for trimming edges.  Next, plate fixation is performed to the native mandible.  Hook retraction aids in centralization of the geneoplasty segments.  Fixation provides both narrowing and advancing of the segments.  A bone wedge fills a gap.  Mentalis fixation is first done to the plate.  A second layered closure helps prevent witch's chin deformity.  Geneoplasty closure is performed with running lock in chromic suture.  Mandibular angle reduction is modeled with our cutting guide.  Opening incision is performed followed by subperiosteal dissection. Acetaric stripping is done with a bovie and J stripper.  Cutting guide is placed.  Screw fixation is done.  VRO oscillating saw is used.  Cutting guide is removed. Bony angle is removed.  Contouring with a pineapple bur and reciprocating rasp is performed.  After irrigation, final closure is performed.  Facial feminization techniques like jawline reshaping demonstrated in this educational video are helpful to provide a more beautiful feminine appearance for the transgender woman.

Video Summary

The video covers facial feminization surgery, focusing on jawline reshaping. Using preoperative virtual planning based on 3D CT scans, the surgery involves mandibular angle reduction and jawline reshaping via bone excision and contouring. Techniques include inferior border resection and genoplasty narrowing by removing a bone wedge. Custom plates and screw fixations aid in maintaining the new structure. Occlusal cutting guides assist in the process, and several steps ensure precise cutting and trimming. The video discusses how these procedures help achieve a feminine appearance, which is particularly significant for transgender women seeking facial feminization.

Keywords

facial feminization

jawline reshaping

mandibular angle reduction

genoplasty narrowing

transgender women