Systematic Review of Complication Rates of Gender-affirming Breast Augmentation and Its Closest Analogue: Tuberous Breast Augmentation.

Background: Gender-affirming breast augmentation (GABA) with implants is most commonly compared with cosmetic breast augmentation. A better comparator is tuberous breast augmentation (TBA). Anatomically, both feature relative medial pole deficiency, constricted breast footprints, and parenchymal herniation through the areola.

Gender-affirming DIEP Flap Breast Augmentation.

Implant-based techniques have been the mainstay of gender-affirming breast augmentation (GABA). Here we describe a novel autologous technique for GABA. We provide a single-patient case report of gender-affirming deep inferior epigastric artery perforator (DIEP) flap breast augmentation.

Social and Systemic Barriers to Transition-Related Surgical Procedures for Transgender Americans.

Transgender and gender-diverse (TGD) individuals in the United States face disproportionate barriers to health care access. This study compared characteristics of individuals who have and have not undergone gender-affirming surgery with the goal of identifying social and systemic barriers to transition-related surgery. Data were extracted from the 2015 United States Transgender Survey, a cross-sectional nonprobability sample of nearly 28,000 TGD adults.

Chondrolaryngoplasty with Endoscopic Direct Visualization of the Vocal Cords: Demonstration of Technique.

Chondrolaryngoplasty is a surgical procedure that reduces a prominent thyroid cartilage. Demand for chondrolaryngoplasty has significantly increased over recent years in transgender women and nonbinary individuals and has been shown to alleviate gender dysphoria and improve quality of life. When performing chondrolaryngoplasty, surgeons must carefully balance the desire for maximal cartilage reduction with the potential for damage to surrounding structures (ie, the vocal cords) that may result because of overaggressive or imprecise resection.

Laryngochondroplasty: A Systematic Review of Safety, Satisfaction, and Surgical Techniques.

Background: Since first performed in 1975, two main surgical techniques for laryngochondroplasty have evolved: anatomical localization and direct endoscopic visualization. The aim of this study was to evaluate which method is safest and had the highest patient-reported satisfaction rates, and to determine whether these outcomes have changed over time.

Methods: A systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to find and analyze all medical publications related to laryngochondroplasty.

Telemedicine for Gender-Affirming Medical and Surgical Care: A Systematic Review and Call-to-Action.

Telemedicine has facilitated the delivery of affordable and accessible health care. However, little has been discussed about its use in gender-affirming care (GAC). Telemedicine has the potential to overcome many barriers encountered by transgender individuals such as limited geographic access to care and financial constraints, which have both been exacerbated by the COVID-19 pandemic.

Gender Affirming Surgery: A Comprehensive, Systematic Review of All Peer-reviewed Literature and Methods of Assessing Patient-centered Outcomes (Part 2: Genital Reconstruction).

Objective: To perform the first systematic review of all available GAS publications across all procedures to assess outcomes reported in the literature and the methods used for outcome assessment.

Summary Of Background Data: Assessment of GAS results is complex and multidimensional, involving not only complication rates but also anatomic (eg, vaginal depth), functional (eg, urinary), and psychosocial outcomes. A fully comprehensive aggregation of all prior research would offer an essential cornerstone for continued progress.

Strategic Planning and Essential Steps for Establishing a Uterine Transplant and Rehabilitation Program: From Idea to Reality.

UTx is performed to address absolute uterine infertility in the presence of uterine agenesis, a nonfunctional uterus, or after a prior hysterectomy. After the initial success of UTx resulting in a livebirth (2014) in Sweden, there are over 70 reported UTx surgeries resulting in more than 40 livebirths worldwide. Currently, UTx has been performed in over 10 countries.

Trends of Medicare Reimbursement Rates for Common Plastic Surgery Procedures.

Background: Knowledge of Medicare reimbursement is essential for plastic surgeons providing care to Medicare beneficiaries. The authors sought to evaluate changes in Medicare reimbursement for common plastic surgery procedures from 2010 to 2020.

Methods: The authors assessed the Physician Fee Schedule of the Centers for Medicare and Medicaid Services website.

Vaginal Canal Reconstruction in Penile Inversion Vaginoplasty with Flaps, Peritoneum, or Skin Grafts: Where Is the Evidence?

Background: To optimize neovaginal dimensions, several modifications of the traditional penile inversion vaginoplasty are described. Options for neovaginal lining include skin grafts, scrotal flaps, urethral flaps, and peritoneum. Implications of these techniques on outcomes remain limited.

Gender Affirming Surgery: A Comprehensive, Systematic Review of All Peer-reviewed Literature and Methods of Assessing Patient-centered Outcomes (Part 1: Breast/Chest, Face, and Voice).

Objective: To perform the first systematic review of all available gender-affirming surgery (GAS) publications across all procedures to assess both outcomes reported in the literature and the methods used for outcome assessment.

Summary Of Background Data: Rapidly increasing clinical volumes of gender-affirming surgeries have stimulated a growing need for high-quality clinical research. Although some procedures have been performed for decades, each individual procedure has limited data, necessitating synthesis of the entire literature to understand current knowledge and guide future research.

The Affordable Care Act and Its Impact on Plastic and Gender-Affirmation Surgery.

The Affordable Care Act's provisions have affected and will continue to affect plastic surgeons and their patients, and an understanding of its influence on the current American health care system is essential. The law's impact on pediatric plastic surgery, craniofacial surgery, and breast reconstruction is well documented. In addition, gender-affirmation surgery has seen exponential growth, largely because of expanded insurance coverage through the protections afforded to transgender individuals by the Affordable Care Act.

Anatomical Basis and Surgical Techniques Employed in Facial Feminization and Masculinization.

Increasingly, facial feminization and masculinization techniques are being employed in the treatment of gender dysphoria. For the facial surgeon, knowledge of the anatomical differences between masculine and feminine facial skeletal structures is of utmost importance. Combining this knowledge with the various surgical and non-techniques that may be employed in order to achieve each patient's goals will allow the facial surgeon to greatly impact the lives of persons of transgender and gender diverse experience.

Training Surgeons in Gender Confirmation Surgery.

Gender confirmation surgery can be an important component in helping individuals alleviate gender dysphoria. Increased advocacy, awareness, and acceptance of these medically necessary procedures have resulted in a greater demand for such procedures, exceeding the number of qualified surgeons able to perform them. It is recognized that formal training guidelines and fellowship programs are needed so as to assure that surgeons performing these procedures are adequately experienced.

Gender Confirmation Surgery: Moving Forward.

Facial surgery can help facilitate an individual's social transition and alleviate gender dysphoria. As such, surgical requests for feminizing and masculinizing procedures continue to increase. Surgical management requires knowledge of anatomy and anatomic differences as well as an understanding of social challenges faced by transgender and gender diverse individuals.

Cheek Augmentation Techniques.

The restoration of a youthful appearance to the midface can enhance its femininity. In this article, we discuss several strategies and techniques, both surgical and nonsurgical, for augmentation of the lateral and centro-lateral midface.