surgical-approach-to-full-soft-tissue-face-allograft-procurement-for

Surgical Approach to Full Soft Tissue Face Allograft Procurement for Vascularized Composite Allotransplantation

Full facial vascularized composite allotransplantation (VCA) offers a reconstructive option for patients with severe facial disfigurement who cannot be ...

New York University Langone Health

 Facial feminization surgery (FFS) is critical to gender-affirming surgery, consisting of craniomaxillofacial procedures to align facial features with a patient's gender identity. Central to FFS is genioplasty, which reshapes or repositions the chin; however, limited research exists on genioplasty in FFS. This review and cohort analysis aim to evaluate current practices and outcomes for individuals undergoing FFS with genioplasty.  A systematic review included transfeminine individuals undergoing FFS with genioplasty. A retrospective study reviewed FFS cases with genioplasty between 2017 and 2024. Data collected included demographics, imaging, virtual surgical planning (VSP), complications, and patient-reported outcomes (PROs).  The review included 12 studies with 1417 patients, with 34.2% undergoing genioplasty. The mean age was 37.3 years, and 60.1% were White. Preoperative imaging and VSP were used in 66.7% of studies, 3D-printed cutting guides in 37.5%, and 3D reconstruction in 75.0%. Reduction genioplasty was the most common technique. All PROs indicated high satisfaction, with a 2.67% revision rate. Complications were low (0.55%), with infections being most frequent (0.48%). In the institutional cohort, 351 patients underwent FFS, with 64.4% undergoing genioplasty, significantly higher than in the review ( < 0.001). Sliding genioplasty was preferred without preoperative imaging or VSP. Postoperative dissatisfaction was 3.54%, with 0.88% requiring revision ( = 0.063). Complication rates (1.77%) were similar to those of the review ( = 0.065).  Genioplasty is important in FFS, with low complication and revision rates and high patient satisfaction. However, gaps remain in validated PROs and technique-specific outcomes. While preoperative imaging and VSP show benefits, comparable outcomes are achievable without them.

A Comprehensive Analysis of Genioplasty in Facial Feminization Surgery: A Systematic Review and Institutional Cohort Study.

Despite the growing demand for hyaluronic acid (HA) lip fillers, there is a paucity of robust, quantitative data across high-powered studies. This systematic review and meta-analysis aims to assess the efficacy and safety of HA lip fillers as reported by randomized controlled trials (RCTs). A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, utilizing PubMed, Embase, and Cochrane, and eligible studies included RCTs with human subjects utilizing HA filler for lip augmentation. Meta-analysis evaluated rates of improvement in lip fullness, aesthetic appearance, patient satisfaction, and adverse events. A comprehensive review initially identified 2,038 articles. Following screening by title and abstract, full-text review, and risk of bias assessment with the Cochrane risk-of-bias tool for randomized trials (RoB 2), sixteen articles were included in the study. Meta-analysis demonstrated that 60% (95% CI: 44-76%) had improvement in lip fullness, 82% (95% CI: 67-92%) had improvement in aesthetic appearance, 68% (95% CI: 58-78%) reported satisfaction, 50% (95% CI: 27-73%) had adverse events, and 1.5% (95% CI: 1.9-4.0%) had serious adverse events requiring treatment, needing follow-up, or lasting beyond 30 days. The most common adverse events were swelling (78%), firmness (48%), bruising (34%), and tenderness (33%). Across studies with the highest level of evidence, HA filler efficacy and patient satisfaction is moderate to high. Severe adverse reactions are rare, but adverse events are common.

Article	Year
A Comprehensive Analysis of Genioplasty in Facial Feminization Surgery: A Systematic Review and Institutional Cohort Study. Journal of clinical medicine\| PubMed ID: 39797264	2024
Efficacy and Safety of Hyaluronic Acid Lip Fillers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Aesthetic surgery journal\| PubMed ID: 41186199	2025

Hailey P. Wyatt

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