Virtual Surgical Planning for Facial Masculinization Surgery

Facial masculinization surgery is a set of procedures for transmasculine patients, including mandible angle, chin, and tracheal augmentation. This study assesses outcomes and complications in 6 transmasculine patients who have undergone facial masculinization with poly (ether-ether ketone) (PEEK) implants following virtual surgical planning. Six patients were scanned preoperatively and personalized implants were created for each patient depending on their anatomy. Projection for the chin was calculated such that the most anterior portion of the chin postimplant is in line with the most anterior portion of the nasal spine. Projection for the mandibular angles was designed such that the width of each mandibular angle postimplant is 1 to 2 mm less than the width of the respective zygoma to give a tapered, but still prominent jawline. Patient characteristics such as demographic information and medical history were analyzed, in addition to intraoperative and postoperative complications and outcomes. A total of 12 procedures were performed, with the multiprocedures occurring in a single operation for each patient. All 6 patients had mandible augmentation, while 3 patients had chin augmentation and 3 had Adam's apple enhancement. All procedures utilized VSP for chin and mandibular angle implants. One patient, who did not take the prescribed postoperative antibiotics, developed a chin abscess that was treated with drainage and antibiotics. All patients were very satisfied with their results and no patients requested revisionary surgery. VSP for facial masculinization surgery allows gender affirming surgeons to tailor implants depending on specific patient anatomy, which increases patient satisfaction by giving patients ideal masculine proportions.