Patients undergoing male-to-female gender reassignment have more feminine facial profiles as a result of nasal surgery, according to a report in Archives of Facial Plastic Surgey (JAMA/Archives), September/October issue.

The authors write “Transsexualism is a recognized medical condition, with an estimated incidence of one in 37,000, in which the affected individuals strongly believe themselves to have been born into the body of the wrong sex. Increasing acceptance of this condition as a medical disorder has led to the development of a number of medical and surgical approaches aimed at aligning the patient’s physical appearance with his or her perceived sex.”

S. A. Reza Noureai, M.B.B.Chir., Charing Cross Hospital, London, England, and team looked at 12 male-to-female gender reassignment patients who had had surgery on the nose (rhinoplasty) during the period 1998-2004. This type of surgery reduces the dimensions of the nose as well as altering nasal angles to correspond with those of women more closely. Two independent observers looked at the patients’ facial profile before and after their rhinoplasty, as well as measuring specific facial angles. Each patient’s nasal function had been tested before, and then after surgery. Participants were also asked to rate, out of five, their satisfaction with the operation one year after it was performed.

The authors write “The surgical procedure resulted in a more feminine nasal profile in all patients. One patient was subjectively unhappy with the results of surgery and underwent revision surgery, and the remaining patients were very satisfied with the results of surgical treatment, both in the early postoperative period and at the one-year follow-up visit. Five patients stated at the one-year visit that their nasal procedure had had one of the greatest impacts on their overall perception of themselves as female.” None of the patients had any difficulty with nasal valve functioning.

The authors concluded that rhinoplasty is effective in achieving feminine facial profiles undergoing male-to-female gender reassignment. “This requires reducing the overall nasal size and changing nasal angles to those more reminiscent of the female form. Because of the extensive resections often required to modify the nasal form, it is important to pay particular attention to preserving function, which may require concomitant nasal valve reconstruction.”

Arch Facial Plast Surg. 2007;9(5):318-320
http://archfaci.ama-assn.org

Written by: Christian Nordqvist