AAFPRS024 - Multi-Procedural Facial Feminization Surgery: A Review of Outcomes and Complications
Wednesday, April 27, 2022
2:15 PM – 2:20 PM CT
Location: Landmark D
Nissim Hazkour BA; Jose Palacios BS; Weiying Lu BS; Robin Rivera FNP-BC; Nicholas Bastidas, MD
Nissim Hazkour: SUNY Downstate College of Medicine, Brooklyn, NY, USA
Jose Palacios & Weiying Lu: Donald & Barbara Zucker School of Medicine at Hofstra University/Northwell, Hempstead, NY, USA
Robin Rivera & Nicholas Bastidas: Division of Plastic and Reconstructive Surgery, Northwell Health, Great Neck, NY, USA.
Background: Facial feminization surgery (FFS) is instrumental in gender affirmation for transgender patients. Multilevel FFS crosses sterile and nonsterile planes, including the oropharynx, nose, and frontal sinus. A closer look at the prevention and management of resulting surgical and medical consequences of such complex reconstruction is necessary.
Methods: We performed a retrospective look at post-op complications for a cohort of multilevel FFS patients. Patients who underwent FFS between January 2020 and June 2021 were eligible for inclusion. Patients underwent a personalized combination of common FFS procedures to achieve feminization of the face and neck. Patient demographics, irrigation methods, instrument type, operation duration, procedure order, procedures performed, postoperative antibiotic regimen and postoperative complications were assessed.
Results: 31 patients, with mean age of 37 years (range: 19-65), underwent 259 procedures. Patients had, on average, eight procedures done within a range of 3.5-6 hours. 68% of patients experienced no postoperative complications. Six patients experienced a postoperative infection, with four of the patients requiring return for washout (13%). Implemented preventative measures for infection include: preoperative dental check, use of intraoperative antibiotic irrigation, locking sutures, and postoperative antibiotics. After preventive measures were implemented, no procedure related infections were noted.
Conclusion: Patients generally do not suffer from major complications after multilevel FFS. Factors such as age, irrigation method, dental history, and suture type may be important variables affecting outcomes after facial feminization surgery.