Cirurgia de feminização facial em pacientes transfemininas: Técnicas, resultados e complicações

Abstract

Facial feminization surgery (FFS) aims to align facial features with gender identity in transgender women, promoting social recognition and reducing gender dysphoria. This study systematically reviewed the available evidence on FFS techniques, outcomes, and complications. A comprehensive search was conducted in PubMed and Scopus, without date restrictions, including clinical trials, cohort, case-control, and case series studies (≥5 patients). Two reviewers independently performed screening and qualitative analysis. From 801 records, 40 studies met the inclusion criteria. The fronto- orbital region was the most frequently addressed (n=15), followed by the mandible (n=6) and nose (n=5). Objective results confirmed significant anatomical changes, such as a mean increase of 8.2° in the nasofrontal angle and a 7.7 mm reduction in mandibular width. Subjectively, up to 95% of patients reported improvements in self- esteem, femininity perception, and quality of life. The overall complication rate was 10.1%, most commonly transient paresthesia following mandibular procedures. In conclusion, FFS demonstrates consistent and safe outcomes, consolidating its role as an effective tool for gender affirmation. Nevertheless, challenges remain regarding methodological heterogeneity, higher risk in specific anatomical regions, and inequality of access, underscoring the need for multicenter, standardized, and long-term studies.