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Background <p>Gender-affirming facial surgery (GAFS) can be performed as a full, single-staged procedure (F-GAFS) or in multiple, partial stages (P-GAFS). P-GAFS addresses either the upper, middle, or lower facial thirds, while F-GAFS includes procedures performed on multiple facial regions during a single anesthetic event. This study assesses the safety profile of GAFS, comparing surgical complications between F-GAFS and P-GAFS.</p> Methods <p>Data from the NSQIP databases spanning 2012–2022 were analyzed. Surgical complications included return to the operating room, hospital readmission, urinary tract infection, surgical site infection, and wound dehiscence. T-tests and chi-square tests were used to assess the relationship between complications and patient and surgical characteristics.</p> Results <p>A total of 552 patients underwent GAFS, with 193 (35.0%) undergoing P-GAFS and 359 (65.0%) undergoing F-GAFS. The prevalence of GAFS increased by 1725% over the ten-year study period. Nineteen patients (3.4%) had surgical complications. Fifteen patients had surgical site infections, three had bleeding requiring transfusion, and one had a pulmonary embolism. There were complications in 2.1% of P-GAFS patients (n = 4) and 4.2% of F-GAFS patients (n = 15). No statistically significant difference in complication rates was observed between F-GAFS and P-GAFS. Undergoing genioplasty was associated with increased complication risk (<i>p</i> = 0.02).</p> Conclusions <p>Our findings underscore the increasing popularity of GAFS while also highlighting the safety of both F-GAFS and P-GAFS for transgender and gender-diverse patients. These results support informed decision-making to optimize aesthetic goals and mitigate complications. Insurers should guarantee coverage for both approaches, providing surgeons and patients the most flexibility in choosing a surgical strategy. </p> Level of Evidence IV <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors &#xa0;<a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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A Comparative Analysis of Full and Partial Gender-Affirming Facial Surgeries Surgical Complications and Trends: Insights from a NSQIP Study

  • 期刊论文

  • 发表日期：

    2025年5月9日

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  • Amitai S. Miller,
  • Peter Willenborg,
  • Clay B. Beagles,
  • Kavitha Ranganathan,
  • Elie P. Ramly,
  • Devin Coon,
  • Branko Bojovic,
  • Ryan P. Cauley,
  • Martin R. Buta,
  • Oren Ganor

摘要

Background

Gender-affirming facial surgery (GAFS) can be performed as a full, single-staged procedure (F-GAFS) or in multiple, partial stages (P-GAFS). P-GAFS addresses either the upper, middle, or lower facial thirds, while F-GAFS includes procedures performed on multiple facial regions during a single anesthetic event. This study assesses the safety profile of GAFS, comparing surgical complications between F-GAFS and P-GAFS.

Methods

Data from the NSQIP databases spanning 2012–2022 were analyzed. Surgical complications included return to the operating room, hospital readmission, urinary tract infection, surgical site infection, and wound dehiscence. T-tests and chi-square tests were used to assess the relationship between complications and patient and surgical characteristics.

Results

A total of 552 patients underwent GAFS, with 193 (35.0%) undergoing P-GAFS and 359 (65.0%) undergoing F-GAFS. The prevalence of GAFS increased by 1725% over the ten-year study period. Nineteen patients (3.4%) had surgical complications. Fifteen patients had surgical site infections, three had bleeding requiring transfusion, and one had a pulmonary embolism. There were complications in 2.1% of P-GAFS patients (n = 4) and 4.2% of F-GAFS patients (n = 15). No statistically significant difference in complication rates was observed between F-GAFS and P-GAFS. Undergoing genioplasty was associated with increased complication risk (p = 0.02).

Conclusions

Our findings underscore the increasing popularity of GAFS while also highlighting the safety of both F-GAFS and P-GAFS for transgender and gender-diverse patients. These results support informed decision-making to optimize aesthetic goals and mitigate complications. Insurers should guarantee coverage for both approaches, providing surgeons and patients the most flexibility in choosing a surgical strategy.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266.