Facial corrections in male to female transsexuals: a preliminary report on 16 patients

The need for facial corrective surgery to facilitate passing as a member of the other sex occurs in a relatively low percentage of male-to-female transsexuals. The aim of this study was to explore criteria and techniques for facial corrections in male-to-female transsexuals because little is known on objective measures for meaningful facial alterations in the female direction. In the period 1992 to 1994, 16 male-to-female transsexual patients were eligible for bony facial corrections. Several techniques were used to feminize the masculine appearance: mandibular angle reduction, genioplasty, bimaxillary osteotomy, and zygoma onlay and zygoma sandwich osteotomies. Subjectively good results were obtained. Improvement in quality of life was not objectively assessed. Facial corrective surgery seems to be promising in selected cases of male-to-female transsexualism. Further research is recommended on quantification of the differences in male and female faces for optimal indications and design of this type of surgery. The psychosocial aspects of the facial surgery and long-term stability of the surgical result also need to be further investigated