Quantitative Analysis of Morphometric Changes in Feminization Rhinoplasty Utilizing a Standardized Forehead-Rhinoplasty Technique

Vikram G Mookerjee,Kevin G Hu,Jacqueline Ihnat,Neil Parikh,Michael Alperovich,David P Alper,Heloise M De Baun,Mariana N Almeida

doi:10.1093/asjof/ojad095

Vikram G Mookerjee, Kevin G Hu + Show 6 more

Open Access

https://doi.org/10.1093/asjof/ojad095

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Abstract

Abstract Background Rhinoplasty is one of the most commonly performed facial gender-affirming surgeries (FGASs) for transgender females, but well-established morphometric parameters describing feminizing nasal changes do not exist. Objectives Describe the author's technique for feminization rhinoplasty, analyze the changes in 3-dimensional nasal anthropomorphic parameters, and describe patient-reported outcomes. Methods Three-dimensional photogrammetric evaluation was performed both preoperatively and postoperatively in transgender female patients who underwent FGAS. Measurements assessed included the nasofrontal angle, nasolabial angle, dorsal height, mid-dorsal width, alar width, nasal tip width, and tip projection. Patients were surveyed preoperatively and postoperatively using the FACE-Q Nose module. Paired t-tests were utilized to assess changes in postoperative measurements and FACE-Q Nose satisfaction scores. Results Twenty patients underwent FGAS during the study period. The average time between surgery and postoperative 3-dimensional images was 13.6 ± 6.8 months. The nasofrontal angle increased by 8.2° (148.0 ± 7.4° to 156.1 ± 6.7°, P &lt; .001) and tip projection increased by 0.017 (0.58 ± 0.03 to 0.60 ± 0.04, P &lt; .01). Dorsal height, mid-dorsal width, and tip width all decreased significantly (P &lt; .05). There were significant improvements in patients’ “Satisfaction with Nose,” “Satisfaction with Facial Appearance Overall,” “Psychological Function,” and “Social Function” on FACE-Q. One revision rhinoplasty was performed, and no documented surgical complications were reported. Conclusions There were statistically significant changes in the nasofrontal angle, tip projection, dorsal height, mid-dorsal width, and tip width in patients receiving feminization rhinoplasty. These data may help surgeons with preoperative planning and intraoperative decision making. Level of Evidence: 4

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