Gender-confirming Rhinoplasty

Overview

Facial gender confirmation surgery covers several procedures, and surgeons not specializing in it more often see a request for the nose alone. This review sets out gender norms in facial appearance, the preoperative assessment involved, and how the operation is carried out, alongside a literature review.

Sections of note

• Surgeons who do not routinely treat gender dysphoric patients are more likely to see an isolated rhinoplasty consultation than a request for full facial gender confirmation surgery.
• The surgical basis of rhinoplasty is described as almost the same as for the cisgender population.
• Despite that technical overlap, care for patients seeking rhinoplasty for gender dysphoria is stated to differ vastly.
• The review comments on gender norms in facial appearance.
• It outlines considerations for the preoperative work-up.
• It covers operative execution and includes a comprehensive literature review.
• The abstract reports no patient numbers, outcomes, complication rates, or follow-up.

What it means for a patient

• The operation itself uses the same techniques used in any rhinoplasty.
• What differs is the assessment beforehand and the goals being worked toward.
• The nose is one component of facial gender presentation and may be requested on its own or as part of a wider set of procedures.
• This is a review with no measured outcomes, so it does not report satisfaction rates or complications.

Why this paper matters

Surgeons encountering these requests occasionally need guidance on the non-technical parts of the care, which is where this review concentrates. Distinguishing technique from context is its main point. It supplies no outcome data specific to this patient group.

Terms

• Gender dysphoria: Distress arising from a mismatch between gender identity and sex assigned at birth.
• Facial gender confirmation surgery: Procedures altering facial features to align with gender identity.
• Cisgender: Having a gender identity matching the sex assigned at birth.
• Preoperative work-up: The assessment carried out before surgery.
• Gender norms: Features commonly perceived as masculine or feminine.