Complications and quality of life in facial gender affirmation surgery: systematic review

Abstract

Introduction: Facial gender affirmation surgery (FGAS) is an essential procedure in the transition process for transgender individuals. This systematic review aims to describe the complications and quality of life of patients undergoing facial gender affirmation surgery. Methods: A systematic review was conducted across multiple databases, including PUBMED, Embase, SCOPUS, Virtual Health Library (BVS), and Cochrane, until December 2024. Studies examining postoperative complications and quality of life following FGAS were included. Articles quality was evaluated by using the Newcastle-Ottawa Scale. Results: Fifteen studies involving various FGAS procedures met inclusion criteria. Complications were rare, with rates varying by proce dure type and patient factors. Common minor complications included wound infections, hematomas, and transient nerve hypoesthesia. Complications, such as pulmonary embolism, were infrequent. Quality of life outcomes consistently improved across studies, with validated tools like FACE-Q and SF-36 showing increases in satisfaction and reductions in psychological distress postoperatively. Conclusion: FGAS is a safe intervention for improving the mental health and quality of life of transgender individuals. While complication rates are low, comprehensive surgical planning and postoperative care are crucial for optimizing outcomes. Future research should focus on standardizing quality of life assessment measures and evaluating long-term results to enhance patient care further.