Radiologists play key role in transgender patients’ facial feminization surgery

CT imaging plays a pivotal part in transgender patients’ facial feminization surgery and radiologists should familiarize themselves with the procedure, experts urged on Thursday.

The U.S. trans population has grown in recent years, according to survey data, as has the utilization of hormone therapy and sex reassignment surgeries. Computed tomography is useful for planning prior to these procedures, providing greater anatomic detail and improved 3D characterization of the face when compared to radiography.

“Communication between radiologists and surgeons is key in ensuring the success of the surgery and the overall care of transgender patients,” Andrew Callen, MD, an assistant professor with the University of Colorado’s Department of Radiology and former clinical fellow at the University of California, San Francisco, said in a Feb. 4 UCSF news update.

Callen and a team of UCSF physicians recently detailed some of their clinical guidance in the American Journal of Roentgenology. They homed in on the bone-related aspects of this surgery, detailing identifiable CT imaging features and their relation to surgical planning. The analysis presents a framework for analyzing the important craniofacial structures and the anatomic variants that affect a surgeon's approach.

Along with preoperative planning, the manuscript also explores evaluating patients afterward for possible complications from facial feminization surgery. Callen et al. offer up a checklist and reporting template for radiologists in these scenarios.

“This article adds to the growing body of literature on FFS and highlights the crucial role radiologists play in the workup and evaluation of patients undergoing FFS,” Karen Buch, MD, with the Department of Radiology at Massachusetts General, wrote in a corresponding editorial. “With gender affirmation surgeries becoming more prevalent, it is important for radiologists to be familiar with gender diverse imaging and gender-affirming surgical procedures.”

Up next, the authors may explore the use of MRI in pre-operative planning related to the soft tissue of the face, along with facial masculinization surgery and considerations for the radiologist, the news update noted.

You can read the entire study in AJR here.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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