Transsexualism is a gender
identity disorder in which there is a strong desire to live and be accepted as
a member of the opposite sex.
In male-to-female transsexuals with strong
masculine facial features, facial feminization surgery is performed as part of
the gender reassignment. A strong association between femininity and
attractiveness has been attributed to the upper third of the face and the
interplay of the glabellar prominence of the forehead. Studies have shown that
a certain lower jaw shape is characteristic of males with special attention to
the strong square mandibular angle and chin and also suggest that the
attractive female jaw is smaller with a more round shape mandibular angles and
a pointy chin.
Other studies have shown that feminization of the forehead
through cranioplasty have the most significant impact in determining the gender
of a patient. Facial feminization surgeries are procedures aimed to change the
features of the male face to that of a female face. These include contouring of
the forehead, brow lift, mandible angle reduction, genioplasty, rhinoplasty and
a variety of soft tissue adjustments.
In our maxillofacial surgery department
at the Sheba Medical Center we perform forehead reshaping combining with brow
lift and at the same surgery, mandibular and chin reshaping to match the
remodeled upper third of the face. The forehead reshaping is done by
cranioplasty with additional reduction of the glabella area by burring of the
frontal bone. After reducing the frontal bossing around the superior orbital
rims we manage the soft tissue to achieve the brow lift. The mandibular
reshaping, is performed by intraoral approach and include contouring of the
angles by osteotomy for a more round shape (rather than the manly square shape
angles), as well as reshaping of the bone in the chin area in order to make it
more pointy, by removing the lateral parts of the chin and in some cases
performing also genioplasty reduction by AP osteotomy.
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