31 results on '"Capitán L"'
Search Results
2. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8
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Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Dhejne, C., Edmiston, E. K., Edwards Leeper, L., Ehrbar, R., Hall, B. P., Ehrensaft, D., Eisfeld, J., Feldman, J. L., Fisher, A. D., Garcia, M. M., Johnson, K., Klink, D. T., Gijs, L., Green, S. E., Hardy, T. L. D., Irwig, M. S., Jacobs, L. A., Mazur, T., Mclachlan, C., Janssen, A. C., Kreukels, B. P. C., Kuper, L. E., Kvach, E. J., Obedin Maliver, J., Malouf, M. A., Massey, R., Morrison, S. D., Mosser, S. W., Neira, P. M., Reed, T., Rider, G. N., Nygren, U., Oates, J. M., Pagkalos, G., Patton, J., Phanuphak, N., Sabir, K., Safer, J. D., Rachlin, K., Ristori, J., Robbins Cherry, S., Roberts, S. A., Steensma, T. D., Rodrigue Wallberg, K. A., Rosenthal, S. M., Scheim, A. I., Seal, L. J., Sehoole, T. J., Vala, L. N., Van Mello, N. M., Spencer, K., St. Amand, C., Strang, J. F., Taylor, G. B., Tilleman, K., Arcelus, J., Johnson, T. W., T’Sjoen, G. G., Veale, J. F., Vencill, J. a., Vincent, B., Motmans, J., Wesp, L. M., West, M. A., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Tangpricha, V., Tishelman, A. c., Meyer Bahlburg, H. F. L., Monstrey, S. J., Nahata, L., Nieder, T. O., Reisner, S. L., Allen, L. R., Richards, C., Schechter, L. S., Van Trotsenburg, M. A. A., Winter, S., Ducheny, K., Berg, D. R., Adams, N. J., Adrián, T. M., Azul, D., Bagga, H., Başar, K., Byrne, J., Capitán, L., Bathory, D. S., Belinky, J. J., Berli, J. U., Bluebond Langner, R. O., Bouman, M.B., Dalke, K. B., Bowers, M. L., Brassard, P. J., Cargill, C. J., Carswell, J. M., Chang, S. C., D’Marco, A., Chelvakumar, G., Corneil, T., De Cuypere, G., de Vries, E., Den Heijer, M., Elaut, E., Erickson Schroth, L., Devor, A. H., APH - Mental Health, APH - Quality of Care, VU University medical center, Plastic, Reconstructive and Hand Surgery, APH - Methodology, Other Research, Internal medicine, APH - Aging & Later Life, Amsterdam Gastroenterology Endocrinology Metabolism, Medical psychology, APH - Personalized Medicine, Amsterdam Reproduction & Development (AR&D), and Obstetrics and gynaecology
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CENTRAL PRECOCIOUS PUBERTY ,Health (social science) ,SOC8 ,assessment ,Psychology, Clinical ,Medicine (miscellaneous) ,Social Sciences ,population ,institutional settings ,surgery ,Endocrinologia ,Transgèneres ,QUALITY-OF-LIFE ,terminology ,Medicine and Health Sciences ,Social Sciences - Other Topics ,Psychology ,adolescents ,Public, Environmental & Occupational Health ,education ,intersex ,AFFIRMING HORMONE-THERAPY ,communication ,Health Policy ,WORLD PROFESSIONAL ASSOCIATION ,Social Sciences, Interdisciplinary ,transgender ,OVARIAN TISSUE CRYOPRESERVATION ,eunuch ,PENILE INVERSION VAGINOPLASTY ,Life Sciences & Biomedicine ,mental health ,nonbinary ,sexual health ,FACIAL FEMINIZATION SURGERY ,Gender Studies ,Transgender people ,endocrinology ,primary care ,SEX REASSIGNMENT SURGERY ,children ,reproductive health ,Science & Technology ,voice ,postoperative care ,Biomedical Social Sciences ,Social Sciences, Biomedical ,health care professional ,gender diverse ,CONGENITAL ADRENAL-HYPERPLASIA ,Standards of Care ,TO-FEMALE TRANSSEXUALS - Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person. ispartof: INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH vol:23 issue:Suppl 1 pages:S1-S258 ispartof: location:United States status: published
- Published
- 2022
3. Multicentre propensity score-matched analysis of conventional versus extended abdominoperineal excision for low rectal cancer
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Ortiz, H., Ciga, M. A., Armendariz, P., Kreisler, E., Codina-Cazador, A., Gomez-Barbadillo, J., Garcia-Granero, E., Roig, J. V., Biondo, S., Lujan, J., Fraccalvieri, D., Armendáriz, P., de Miguel, M., Espí, A., Codina, A., Ruiz, M. D., Espin, E., Palasí, R., Parajo, A., Camps, I., Piñol, M., Pellicer, E., Viciano, V., Alonso, E., Pera, M., García, T., Casal, E., Garcia, J., Rodríguez, M., Reina, Á., Roig, J., Errasti, J., Múgica, J. A., Gomez, J., Rada, R., Orelogio, M., Uribe, N., de Dios Franco, J., Arroyo, A., Sierra, J. E., Hernandez, P., Paredes, J., Martínez, G., Garcia, M., Carreño, G., Cifuentes, J., Monzón, J., Maseda, O., Huerga, D., Pavel, C., Gris, F., Segura, I., Palma, P., Díaz, J. G., Jiménez, J. L., Pérez, F., Portugal, V., Bernal, J. C., Lluis, F., Capitán, L., Cáceres, N., Martínez, J., Estévez, A., Maestre, M. V., Díaz, J. M., Reig, M., Amaya, A., Carmona, J. A., Jiménez, F. J., Ribé i Serrat, D., Prieto, I., Garcia, D., de Francisco, González T., Turienzo, A., Martinez, M., del Valle, S., Parra, P., Romero, F., Garcea, A., de la O, Rodamilans X., Pérez, A., Ais, G., de Zarate, Ortiz L., Sánchez, J., Estevan, R., Sueiras, A., Lamiquiz, A., Larzabal, A., Die, J., Solana, A., Blanco, F. J., Lage, A. M., Domínguez, J. L., Dujovne, P., Palencia, N., García, R., Adell, R., Martínez, R., Huidobro, A. M., Pastor, C., Garijo, J. Á., Carrillo, Á., del Coral de la Vega, M., and López, M.
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- 2014
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4. LA 21 e SESSION DU CONGRÈS INTERNATIONAL DES AMÉRICANISTES
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CAPITAN, L.
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- 1925
5. UN MANUSCRIT JUDICIAIRE DE 1534 NAHUATL-ESPAGNOL
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CAPITAN and Capitan, L.
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- 1923
6. Dependencia a benzodiacepinas
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Capitán, L., Selfa, M., Méndez, M., and Franco, M.D.
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- 2009
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7. Facial feminization surgery: surgical techniques and analysis of results in 200 patients
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Capitán, L., primary, Simon, D., additional, and Bailón, C., additional
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- 2013
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8. Soft-tissue complications after facial feminization bone surgery.
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Capitán L, Simon D, Coon D, Gutiérrez Santamaría J, Bellinga RJ, Bailón C, Pérez de Perceval Tara M, Tenório T, and Capitán-Cañadas F
- Abstract
The soft tissues have a considerable impact on whether the results of facial feminization surgery are favorable. Complications or suboptimal results related to the soft tissue may be due to poor choice of surgical approach, improper execution of the surgical technique, a lack of assistance when resuspending the soft tissues during closure, or deficient readaptation of the overlying soft tissue to the new bone contour. This article identifies the possible poor soft-tissue outcomes that may occur after facial feminization bone surgery, describing strategies to prevent them and treatment alternatives., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier Ltd.)
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- 2024
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9. [Advanced Surgical Techniques in Forehead Feminization and Hairline Redefinition].
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Labrot-Moreno IL, Capitán L, Simon D, and Capitán-Cañadas F
- Abstract
Facial Gender-Affirming Surgery (FGAS) has emerged as a transformative option for individuals who wish to align their external appearance with their asserted gender identity. This article delves into the surgical techniques employed in forehead feminization and hairline redefinition, highlighting the nuanced approaches used to modify specific facial characteristics to achieve the desired feminizing outcomes. Our extensive experience, encompassing over 2300 forehead feminization surgeries conducted over the past 16 years, provides a robust foundation for understanding the complexities and intricacies of these procedures. This knowledge is crucial for maxillofacial and plastic surgeons, as well as other healthcare professionals involved in comprehensive gender-affirming care, ensuring they are well-equipped to deliver optimal results for their patients., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
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- 2024
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10. Secondary Facial Gender Surgery: Causes of Poor Outcomes and Strategies for Avoidance and Correction.
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Simon D, Capitán L, Coon D, Gutiérrez-Santamaría J, Bailón C, Bellinga RJ, Pérez de Perceval Tara M, Tenório T, and Capitán-Cañadas F
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- Humans, Male, Face surgery, Forehead surgery, Facial Bones surgery, Feminization surgery, Plastic Surgery Procedures
- Abstract
Summary: Facial feminization surgery covers a broad spectrum of procedures across both hard and soft tissues. Despite the fact that this is a decidedly predictable surgery, because of the high demand for the procedures, a growing number of patients are requiring revision surgery, whether to correct unexpected results or to treat mid-term to long-term functional and aesthetic complications. This Special Topic article categorizes unsatisfactory outcomes encountered after forehead surgery, lower jaw surgery, and thyroid chondroplasty; key steps to avoid these pitfalls; and strategies for structured analysis and operative planning in revision cases., (Copyright © 2023 by the American Society of Plastic Surgeons.)
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- 2023
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11. Telepsychiatry: The future is already present.
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Gutiérrez-Rojas L, Alvarez-Mon MA, Andreu-Bernabeu Á, Capitán L, de Las Cuevas C, Gómez JC, Grande I, Hidalgo-Mazzei D, Mateos R, Moreno-Gea P, De Vicente-Muñoz T, and Ferre F
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- Humans, Reproducibility of Results, Delivery of Health Care, Psychotherapy, Psychiatry methods, Telemedicine methods
- Abstract
This review paper analyzes the state of knowledge on Telepsychiatry (TP) after the crisis caused by COVID and the resulting need to use new modalities of care. Six essential aspects of TP are addressed: patient's and mental health staff satisfaction, diagnostic reliability, effectiveness of TP interventions, cost-effectiveness in terms of opportunity cost (or efficiency), legal aspects inherent to confidentiality and privacy in particular and the attitude of professionals toward TP. Satisfaction with TP is acceptable among both patients and professionals, the latter being the most reluctant. Diagnostic reliability has been demonstrated, but requires further studies to confirm this reliability in different diagnoses and healthcare settings. The efficacy of TP treatments is not inferior to face-to-face care, as has been proven in specific psychotherapies. Finally, it should be noted that the attitude of the psychiatrist is the most decisive element that limits or facilitates the implementation of TP., (Copyright © 2022 The Author(s). Published by Elsevier España S.L.U. All rights reserved.)
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- 2023
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12. Evaluating the Effect of a Telepsychiatry Educational Program on the Awareness, Knowledge, Attitude, and Skills of Telepsychiatry Among Spanish Psychiatrists during COVID-19 Pandemic.
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de Las Cuevas C, Gutiérrez-Rojas L, Alvarez-Mon MA, Andreu-Bernabeu Á, Capitán L, Gómez JC, Grande I, Hidalgo-Mazzei D, Mateos R, Moreno-Gea P, De Vicente-Muñoz T, and Ferre F
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- Humans, Health Knowledge, Attitudes, Practice, Pandemics, Psychiatry, Telemedicine, COVID-19 epidemiology
- Abstract
Introduction: The COVID-19 pandemic has renewed the interest in telepsychiatry as a way to help psychiatrists care for their patients, but mental health providers' unfamiliarity and concerns may impede implementation of such services. This study aimed to determine the effect of an online educational intervention on awareness, knowledge, attitude, and skills (AKAS) of telepsychiatry among psychiatrists. Methods: The study used a pre-post-test design to compare AKAS of telepsychiatry among psychiatrists participating in an online course of practical telepsychiatry. The telemedicine AKAS questionnaire adapted to telepsychiatry was applied before and after the educational intervention, during the months of October to December 2020. Results: Responses from 213 participants were analyzed before the educational intervention and from 152 after it. The knowledge showed by Spanish psychiatrists before the educational intervention was good in 61% of participants, fair in 37%, and inadequate in 2%. With respect to attitudes toward telepsychiatry, 62% self-reported a high attitude, 33% moderate, and 5% low. With regard self-reported skills, 57% of the participating psychiatrists were highly skilled or experts, 22% moderately skilled, and 9% unskilled in handling telepsychiatry equipment. Despite the high baseline values, the educational intervention significantly improved psychiatrists' awareness, knowledge and attitudes toward telepsychiatry although not their skills. Conclusions: Online course of practical telepsychiatry was effective although future editions need to improve its focus on skills. This educational intervention represents an effort to promote the implementation of telepsychiatry as a health care alternative.
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- 2023
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13. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8.
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, and Arcelus J
- Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person., Competing Interests: Conflict of interests were reviewed as part of the selection process for committee members and at the end of the process before publication. No conflicts of interest were deemed significant or consequential., (© 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.)
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- 2022
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14. Facial Gender Confirmation Surgery: The Lower Jaw. Description of Surgical Techniques and Presentation of Results.
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Simon D, Capitán L, Bailón C, Bellinga RJ, Gutiérrez-Santamaría J, Tenório T, Sánchez-García A, and Capitán-Cañadas F
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- Chin surgery, Face surgery, Female, Feminization surgery, Humans, Male, Mandible surgery, Sex Reassignment Surgery
- Abstract
Background: Of the primary procedures associated with facial gender confirmation surgery, those involving the mentomandibular complex have received the least attention in the literature., Methods: The authors present their experience with 837 trans feminine patients operated on for facial gender confirmation surgery who underwent mandibular bone contouring procedures, including bone contouring, chin and mandibular body and angle ostectomies, and osteotomies to reposition the chin. The authors describe the surgical techniques and materials used, and present a customized lower border-supported cutting guide designed by their team and used with 205 patients. A femininity perception score was calculated preoperatively and 12 months postoperatively, and satisfaction with the results was measured 12 months postoperatively., Results: The postoperative follow-up ranged from 12 to 110 months. The mean femininity perception score increased from 47.86 preoperatively to 76.41 at 12 months postoperatively (p < 0.001). No emergency surgical operations were required. In no case was there any permanent damage to the mental or inferior dental nerve. The reoperation percentage because of problems detected during the postoperative period was 2.63 percent (22 patients)., Conclusions: With facial gender confirmation surgery of the jawline and chin, it is possible to modify the transverse and vertical components of the jaw; soften the gonial angles; change the format, bone volume, and position of the chin; and harmonize the entire mandibular line. The facial feminization achieved high satisfaction scores regarding the results and feminine gender appearance 12 months after surgery. The future of mandibular bone contouring techniques includes planning with virtual software and surgical support with patient-specific cutting guides., (Copyright © 2022 by the American Society of Plastic Surgeons.)
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- 2022
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15. Trauma and stressor-related disorders among health care workers during COVID-19 pandemic and the role of the gender: A prospective longitudinal survey.
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Canal-Rivero M, Armesto-Luque L, Rubio-García A, Rodriguez-Menéndez G, Garrido-Torres N, Capitán L, Luque A, Crespo-Facorro B, and Ruiz-Veguilla M
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- Female, Health Personnel psychology, Humans, Longitudinal Studies, Male, Pandemics, Prospective Studies, SARS-CoV-2, COVID-19
- Abstract
Introduction: Health-care Workers (HCW) are facing a critical situation caused by Coronavirus Disease 2019 (COVID-19) which could impact on their mental health status. In addition, HCW women have been identified as a group at high-risk of developing psychological distress, although no previous longitudinal studies have explored this issue in a sample of HCW., Aims: The main aim of the study was to observe the temporal pattern of the stress reactions among HCW as well as to explore its potential predictors of poor outcome. Moreover, we analyzed possible gender differences in stress reaction responses., Methods: One thousand for hundred and thirty-two HCW responded an online survey including sociodemographic, clinical, and psychometric tests in May 2020 while 251 HCW answered in November 2020. Bivariate and multivariate analyses as well as repeated measures analyses were used to achieve the aims of the study., Results: The proportion of HCW who fulfilled Acute Stress Disorder criteria did not change over the follow-up period, although we observed a significant improvement in stress reactions responses among HCW. Proximal factors were the most salient predictors of traumatic reactions. Repeated analyses revealed significant gender differences in acute stress reactions. In addition, women showed significantly greater improvement than men in re-experiencing the traumatic event and hyperarousal dimensions., Conclusions: Monitoring of working conditions as well as emotional reactions in HCW facing major disasters should be carried out to prevent the development of peritraumatic stress reactions. In addition, HCW women are characterized by a different pattern of progression in stress responses., (Copyright © 2022 Elsevier B.V. All rights reserved.)
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- 2022
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16. Shaping the Lower Jaw Border with Customized Cutting Guides: Development, Validation, and Application in Facial Gender-Affirming Surgery.
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Gutiérrez-Santamaría J, Simon D, Capitán L, Bailón C, Bellinga RJ, Tenório T, Sánchez-García A, and Capitán-Cañadas F
- Abstract
Importance: Three-dimensional planning software is not standardized in facial gender-affirming surgery. Objective: To develop and validate surgical planning software to create cutting guides to contour the lower jaw border. Design, Setting, and Participants: A 3-year prospective case series study done in three phases: software development, validation, and surgical guide application. Ethics committee approval was obtained to enroll the patients (Clinical Research Ethics Committee, Hospital Costa del Sol, Marbella, Spain). Main Outcomes and Measures: Validation phase: degree of agreement between the planned and obtained results, modification of cephalometric parameters, and surgical times. Application phase: surgical technique description, complications, and patient-reported outcome measures. Results: The degree of agreement between the planned and obtained results was inframillimetric (0.31 ± 0.70 mm). The guides reduced the mandible to within feminine parameters ( p < 0.05). Surgical times decreased by 10.96% with chin ostectomies ( p < 0.05) and 23.06% with lower jaw border (angle-to-angle) surgeries ( p < 0.001). In the application phase, revision surgery was required for 11 patients out of 260 (4.23%). Conclusions and Relevance: The use of cutting guides on the lower jaw border is effective, helps reach standard feminine parameters, and decreases surgical times.
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- 2022
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17. ESSM Position Statement "Sexual Wellbeing After Gender Affirming Surgery".
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Özer M, Toulabi SP, Fisher AD, T'Sjoen G, Buncamper ME, Monstrey S, Bizic MR, Djordjevic M, Falcone M, Christopher NA, Simon D, Capitán L, and Motmans J
- Abstract
Introduction: Much has been published on the surgical and functional results following Gender Affirming Surgery ('GAS') in trans individuals. Comprehensive results regarding sexual wellbeing following GAS, however, are generally lacking., Aim: To review the impact of various GAS on sexual wellbeing in treatment seeking trans individuals, and provide a comprehensive list of clinical recommendations regarding the various surgical options of GAS on behalf of the European Society for Sexual Medicine., Methods: The Medline, Cochrane Library and Embase databases were reviewed on the results of sexual wellbeing after GAS., Main Outcomes Measure: The task force established consensus statements regarding the somatic and general requirements before GAS and of GAS: orchiectomy-only, vaginoplasty, breast augmentation, vocal feminization surgery, facial feminization surgery, mastectomy, removal of the female sexual organs, metaidoioplasty, and phalloplasty. Outcomes pertaining to sexual wellbeing- sexual satisfaction, sexual relationship, sexual response, sexual activity, enacted sexual script, sexuality, sexual function, genital function, quality of sex life and sexual pleasure- are provided for each statement separately., Results: The present position paper provides clinicians with statements and recommendations for clinical practice, regarding GAS and their effects on sexual wellbeing in trans individuals. These data, are limited and may not be sufficient to make evidence-based recommendations for every surgical option. Findings regarding sexual wellbeing following GAS were mainly positive. There was no data on sexual wellbeing following orchiectomy-only, vocal feminization surgery, facial feminization surgery or the removal of the female sexual organs. The choice for GAS is dependent on patient preference, anatomy and health status, and the surgeon's skills. Trans individuals may benefit from studies focusing exclusively on the effects of GAS on sexual wellbeing., Conclusion: The available evidence suggests positive results regarding sexual wellbeing following GAS. We advise more studies that underline the evidence regarding sexual wellbeing following GAS. This position statement may aid both clinicians and patients in decision-making process regarding the choice for GAS. Özer M, Toulabi SP, Fisher AD, et al. ESSM Position Statement "Sexual Wellbeing After Gender Affirming Surgery". Sex Med 2022;10:100471., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)
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- 2022
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18. Facial Gender Surgery: Systematic Review and Evidence-Based Consensus Guidelines from the International Facial Gender Symposium.
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Coon D, Berli J, Oles N, Mundinger S, Thomas K, Meltzer T, Houssock C, Satterwhite T, Morrison S, Bailón C, Tenório T, Simon D, Capitán-Cañadas F, and Capitán L
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- Consensus, Evidence-Based Medicine methods, Female, Gender Dysphoria psychology, Humans, Male, Patient Satisfaction, Quality of Life, Sex Reassignment Procedures methods, Transgender Persons psychology, Treatment Outcome, Evidence-Based Medicine standards, Face surgery, Gender Dysphoria surgery, Practice Guidelines as Topic, Sex Reassignment Procedures standards
- Abstract
Background: Increasing societal acceptance of transgender people has led to broader availability of gender surgery and rapid growth in transition-related operations. Facial gender surgery aims to modify patients' facial features to be more congruent with their physical expression of gender, reducing gender dysphoria and improving quality of life. Growth in research and technique evolution has not kept pace with growth in clinical volume. Therefore, the first International Facial Gender Symposium was held at Johns Hopkins University in 2019, convening surgeons who perform facial gender surgery to share ideas and assess the state of clinical evidence., Methods: To review the literature on facial gender surgery, the authors developed a search strategy for seven electronic databases (PubMed, PsycINFO, Embase, CINAHL, Web of Science, Cochrane, and Gender Studies) through May of 2019, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review guidelines., Results: Based on the English language literature and clinical experience, the authors suggest guidelines for screening, management, and appropriate surgical technique for patients undergoing facial gender surgery. They highlight facial gender surgery as a medically necessary intervention and identify shortcomings in current guidelines., Conclusions: Facial gender surgery represents a complex array of craniofacial and soft-tissue procedures that require application of advanced skills and decision-making. Facial gender operations are not cosmetic, are medically necessary, and require development of new CPT codes specific to facial gender surgery. It is imperative to create educational programs and methods to define sufficient training for facial gender surgery surgeons. Research priorities include better procedural outcomes data, more quality-of-life studies, and insight into variation in both patient and procedural subgroups., (Copyright © 2021 by the American Society of Plastic Surgeons.)
- Published
- 2022
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19. Social Perception of Facial Feminization Surgery Outcomes: Does Gender Identity Alter Gaze?
- Author
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Martin SA, Morrison SD, Patel V, Capitán-Cañadas F, Sánchez-García A, Rodríguez-Conesa M, Bellinga RJ, Simon D, Capitán L, Satterwhite T, and Nazerali R
- Subjects
- Female, Feminization, Gender Identity, Humans, Male, Social Perception, Sex Reassignment Surgery, Transsexualism surgery
- Abstract
Background: The evaluation of gender-affirming facial feminization surgery (FFS) outcomes can be highly subjective, which has resulted in a limited understanding of the social perception of favorable gender and aesthetic facial appearance following FFS. Eye-tracking technology has introduced an objective measure of viewer subconscious gaze., Objectives: The aim of this study was to use eye-tracking technology to measure attention and perception of surgery-naive cisgender female and feminized transgender faces, based on viewer gender identity., Methods: Thirty-two participants (18 cisgender and 14 transgender) were enrolled and shown 5 photographs each of surgery-naive cisgender female and feminized transgender faces. Gaze was captured with a Tobii Pro X2-60 eye-tracking device (Tobii, Stockholm, Sweden) and participants rated the gender and aesthetic appearance of each face on Likert-type scales., Results: Total image gaze fixation time did not differ by participant gender identity (6.00 vs 6.04 seconds, P = 0.889); however, transgender participants spent more time evaluating the forehead/brow, buccal/mandibular regions, and chin (P < 0.001). Multivariate regression analysis showed significant associations between viewer gender identity, age, race, and education, and the time spent evaluating gender salient facial features. Feminized faces were rated as more masculine with poorer aesthetic appearance than surgery-naive cisgender female faces; however, there was no significant difference in the distribution of gender appearance ratings assigned to each photograph by cisgender and transgender participants., Conclusions: These results demonstrate that gender identity influences subconscious attention and gaze on female faces. Nevertheless, differences in gaze distribution did not correspond to subjective rated gender appearance for either surgery-naive cisgender female or feminized transgender faces, further illustrating the complexity of evaluating social perception of favorable FFS outcomes., (© 2020 The Aesthetic Society. Reprints and permission: journals.permissions@oup.com.)
- Published
- 2021
- Full Text
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20. Masking Gender: The Impact of Facial Coverings on Gender Recognition.
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Simon D, Capitán L, Martin SA, Nazerali R, Satterwhite T, Morrison SD, and Capitán-Cañadas F
- Subjects
- Female, Humans, Male, Sex Reassignment Procedures, Transgender Persons, Facial Recognition, Forehead anatomy & histology, Masks adverse effects, Sex Characteristics
- Published
- 2021
- Full Text
- View/download PDF
21. Reply: Facial Gender Confirmation Surgery: A Protocol for Diagnosis, Surgical Planning, and Postoperative Management.
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Capitán L, Santamaría JG, Simon D, Coon D, Bailón C, Bellinga RJ, Tenório T, and Capitán-Cañadas F
- Subjects
- Face surgery, Humans, Postoperative Period, Sex Reassignment Surgery, Transsexualism
- Published
- 2021
- Full Text
- View/download PDF
22. Prospective Quality-of-Life Outcomes after Facial Feminization Surgery: An International Multicenter Study.
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Morrison SD, Capitán-Cañadas F, Sánchez-García A, Ludwig DC, Massie JP, Nolan IT, Swanson M, Rodríguez-Conesa M, Friedrich JB, Cederna PS, Bellinga RJ, Simon D, Capitán L, and Satterwhite T
- Subjects
- Adult, Female, Femininity, Gender Dysphoria psychology, Humans, Male, Middle Aged, Postoperative Period, Prospective Studies, Self Concept, Transgender Persons psychology, Face surgery, Gender Dysphoria surgery, Patient Satisfaction, Quality of Life, Sex Reassignment Surgery methods
- Abstract
Background: No data exist on the prospective outcomes of facial feminization surgery. This study set out to determine the effects of facial feminization surgery on quality-of-life outcomes for gender-diverse patients., Methods: A prospective, international, multicenter, cohort study with adult gender-diverse patients with gender dysphoria was undertaken. Facial feminization outcome score was calculated preoperatively and postoperatively (1-week to 1-month and >6 months). Photogrammetric cephalometries were measured at the same time points. Self-perceived preoperative masculinity and femininity were recorded. Externally rated gender appearance (scale of 1 to 5, with 1 being most feminine) and general aesthetics (scale of 1 to 10, with 10 being very good) for 10 facial feminization surgery patients were compared with those of five cisgender controls. Univariate linear regression analyses were used to predict outcomes from facial feminization surgery., Results: Sixty-six consecutive patients were enrolled. Patients noted that their brows, jaws, and chins were the most masculine aspects of their faces (54.5 percent, 33.3 percent, and 30.3 percent, respectively). Median facial feminization outcome score increased from 47.2 preoperatively to 80.6 at 6 months or more postoperatively (p < 0.0001). Mean satisfaction was excellent (3.0 at both 1-month and ≥6-month follow-up; p = 0.46). Cephalometric values were significantly more feminine after surgery. Gender appearance was feminine to very feminine (1.83 ± 0.96) and general aesthetics were good (6.09 ± 2.01) but different from those of cisgender women controls (1.25 ± 0.49 and 7.63 ± 1.82, respectively; p < 0.001 for each)., Conclusion: Facial feminization achieved improved quality of life, feminized cephalometries, feminine gender appearance, good overall aesthetics, and high satisfaction that were present at 1 month and stable at more than 6 months., Clinical Question/level of Evidence: Therapeutic, IV.
- Published
- 2020
- Full Text
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23. Facial Gender Confirmation Surgery: A Protocol for Diagnosis, Surgical Planning, and Postoperative Management.
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Capitán L, Gutiérrez Santamaría J, Simon D, Coon D, Bailón C, Bellinga RJ, Tenório T, and Capitán-Cañadas F
- Subjects
- Female, Femininity, Gender Dysphoria diagnosis, Gender Dysphoria psychology, Humans, Male, Masculinity, Patient Care Planning standards, Patient Selection, Postoperative Care methods, Postoperative Care standards, Postoperative Period, Sex Reassignment Surgery psychology, Sex Reassignment Surgery standards, Treatment Outcome, Clinical Protocols, Face surgery, Gender Dysphoria surgery, Sex Reassignment Surgery methods, Transgender Persons psychology
- Abstract
During the past 10 years, academic publications that address facial feminization surgery have largely examined the technical aspects of the different surgical procedures involved and clinical evaluations of postoperative results. This Special Topic article focuses on aspects that are underdeveloped to date but useful with regard to taking the correct therapeutic approach to transgender patients who are candidates for facial gender confirmation surgery. The authors propose a protocolized sequence, from the clinical evaluation to the postoperative period, based on a sample size of more than 1300 trans feminine patients, offering facial gender confirmation surgery specialists standardized guidelines to handle their patients' needs in a way that is both objective and reproducible.
- Published
- 2020
- Full Text
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24. The Upper Third in Facial Gender Confirmation Surgery: Forehead and Hairline.
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Capitán L, Simon D, Bailón C, Bellinga RJ, Gutiérrez-Santamaría J, Tenório T, and Capitán-Cañadas F
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- Adolescent, Adult, Aged, Eyebrows, Face surgery, Female, Feminization surgery, Humans, Male, Middle Aged, Young Adult, Forehead surgery, Hair, Sex Reassignment Surgery
- Abstract
The upper third of the face contains 2 features that are particularly important for facial gender recognition: the frontonasoorbital region and the hairline. The supraorbital ridge, which determines the position and exposure of the eyebrows, is almost invariably more developed in the male than in the female. Surgical modification of the frontonasoorbital complex, considered a standard procedure in facial feminization, is reliable and predictable, and also delivers satisfactory results that are stable over time.A prototypical male hairline has an M-shaped pattern compared to the more rounded shape often seen in female hairlines. Feminization of the hairline requires minimizing the temples as well as rounding out the overall shape, optimizing hair density, and occasionally changing the height of the hairline.This article provides an update on our forehead reconstruction technique and our experience in the treatment of hairline redefinition.
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- 2019
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25. Facial Gender Confirmation Surgery: A New Nomenclature.
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Capitán L, Simon D, Berli JU, Bailón C, Bellinga RJ, Santamaría JG, Tenório T, Sánchez-García A, and Capitán-Cañadas F
- Published
- 2017
- Full Text
- View/download PDF
26. Reply: Role of Rhinoplasty in Transsexual Patients.
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Capitán L, Simon D, Meyer T, Alcaide A, Wells A, Bailón C, Bellinga RJ, Tenório T, and Capitán-Cañadas F
- Subjects
- Humans, Patient Satisfaction, Sexual Behavior, Rhinoplasty, Transsexualism surgery
- Published
- 2017
- Full Text
- View/download PDF
27. Technical and Clinical Considerations for Facial Feminization Surgery With Rhinoplasty and Related Procedures.
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Bellinga RJ, Capitán L, Simon D, and Tenório T
- Subjects
- Adolescent, Adult, Aged, Esthetics, Humans, Male, Middle Aged, Patient Satisfaction, Plastic Surgery Procedures methods, Treatment Outcome, Feminization, Forehead surgery, Lip surgery, Rhinoplasty methods, Transgender Persons
- Abstract
Importance: Together with the forehead reconstruction, feminization of the nose is one of the most common procedures in facial feminization surgery. Rhinoplasty surgical techniques, which provide correct support and stability in the midterm to long term, are essential for obtaining a predictable result., Objective: To report on the technical and clinical considerations of rhinoplasty and related procedures to feminize the nose, harmonize the nose in relation to the other modified structures (mainly the forehead and maxillomandibular complex), and achieve an aesthetic result beyond gender differences., Design, Setting, and Participants: Case series study of feminization rhinoplasties, in combination with lip-lift techniques, forehead reconstruction, and other procedures, were performed at a private practice between January 11, 2010, and May 29, 2015, in 200 consecutive male-to-female transgender patients. The mean (SD) medical follow-up for patients was 32 (18.84) months (range, 12-77 months). Frontonasal angles were objectively measured. Postoperative and long-term patient satisfaction were assessed., Main Outcomes and Measures: Clinical analysis and evaluation using the 5-point Nose Feminization Scale, with 1 indicating very masculine or nose is worse and 5 indicating very feminine or exceptional result., Results: In these 200 patients, the mean (SD) age was 40.2 (12.2) years (range, 18-70 years). The mean (SE) frontonasal angle changed from 133.64° (0.63°) to 149.08° (0.57°) (difference in means, -15.44; 95% CI, -17.12 to -13.76; P < .001). Most patients considered their nose to appear more feminine after the surgery, and the degree of satisfaction after the rhinoplasty was 4 (much better) of 5 points on the Nose Feminization Scale. During the evaluation of feminization rhinoplasties, special attention was given to how the nose relates to other features essential to the identification of facial gender: the forehead and maxillomandibular complex. Emphasis was placed on the midterm to long-term stability of the results by reinforcing the internal structure., Conclusions and Relevance: In this case series of feminization rhinoplasties in combination with lip-lift techniques and forehead reconstruction, frontonasal angles were changed, and patient satisfaction with outcomes was high. The main goal of rhinoplasty in facial feminization surgery is to obtain feminine nasal features and the harmonization of the nose with the rest of the face. Lip-lifts and frontonasal recontouring can complement rhinoplasties associated with facial feminization surgery., Level of Evidence: 4.
- Published
- 2017
- Full Text
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28. Ethnic Considerations for Rhinoplasty in Facial Feminization-Reply.
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Bellinga RJ, Capitán L, and Simon D
- Subjects
- Ethnicity, Face surgery, Feminization surgery, Humans, Male, Rhinoplasty
- Published
- 2017
- Full Text
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29. Facial Feminization Surgery: Simultaneous Hair Transplant during Forehead Reconstruction.
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Capitán L, Simon D, Meyer T, Alcaide A, Wells A, Bailón C, Bellinga RJ, Tenório T, and Capitán-Cañadas F
- Subjects
- Adolescent, Adult, Face surgery, Female, Humans, Male, Middle Aged, Young Adult, Forehead surgery, Hair transplantation, Sex Reassignment Surgery methods
- Abstract
Background: Reconstruction of the frontonaso-orbital complex is one of the best-described and most commonly used procedures in the field of facial feminization surgery. To a large extent, this complex determines the facial expression and plays a key role in the visual identification of facial gender. After the forehead, the hairline pattern is the second most important feature of gender identification within the upper third of the face. The combined evaluation of these two features should be a basic premise of facial feminization surgery., Methods: The authors present a new surgical sequence developed by their group in which reconstruction of the frontonaso-orbital complex and redefinition of the hairline by means of an autologous hair transplant are carried out during the same operation: forehead reconstruction and simultaneous hair transplantation., Results: Sixty-five male-to-female transgender patients treated with forehead reconstruction and simultaneous hair transplantation are presented along with the surgical technique, sequence used, and the results obtained. A classification method for hairlines in male-to-female transgender patients is proposed based on the observation of 492 patients. A modified temporoparietooccipital coronal (posterior coronal) approach is also described., Conclusion: The forehead reconstruction and simultaneous hair transplant technique makes it possible to address the entire upper third of the face in a single facial feminization operation.
- Published
- 2017
- Full Text
- View/download PDF
30. Reply: Facial Feminization Surgery: The Forehead. Surgical Techniques and Analysis of Results.
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Capitán L, Simon D, Kaye K, and Tenório T
- Subjects
- Female, Humans, Male, Forehead surgery, Patient Satisfaction
- Published
- 2015
- Full Text
- View/download PDF
31. Facial feminization surgery: the forehead. Surgical techniques and analysis of results.
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Capitán L, Simon D, Kaye K, and Tenorio T
- Subjects
- Adolescent, Adult, Female, Feminization, Humans, Male, Middle Aged, Plastic Surgery Procedures methods, Surveys and Questionnaires, Young Adult, Forehead surgery, Patient Satisfaction
- Abstract
Background: Facial feminization surgery encompasses a series of surgical techniques derived from plastic and craniomaxillofacial surgery to soften facial features that are generally perceived as being more masculine, mainly in patients diagnosed with gender dysphoria. This article describes the main surgical techniques used in feminization of the forehead complex, sequences the different steps in forehead reconstruction, evaluates results obtained using cephalometric analysis, and includes the level of patient satisfaction., Methods: Between January of 2008 and December of 2012, the authors performed a total of 172 forehead operations. The postsurgical results were analyzed using postoperative cephalometric studies that were compared with preoperative teleradiographies. The patients' level of satisfaction was also evaluated using a satisfaction questionnaire that they filled out after a 6-month postoperative period., Results: Along with an evaluation of patient satisfaction and clinical and cephalometric results where significant setback of the frontal bossing was observed, the authors present the sequencing of frontonasal-orbital reconstruction/recontouring with systematic osteotomy of the anterior wall of the frontal sinus in addition to developing a modification of the standard coronal approach., Conclusions: By treating the forehead region with the different surgical procedures described in this article, masculine facial features of the upper third can be modified with predictable and satisfactory results. Facial feminization surgery must be considered part of the process of treating patients with gender dysphoria, because the modification and elimination of masculine facial features allows these patients to adapt more easily to the workplace and social and family environments., Clinical Question/level of Evidence: Therapeutic, IV.
- Published
- 2014
- Full Text
- View/download PDF
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