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Dang, Brian N.,Hu, Allison C.,Bertrand, Anthony A.,Chan, Candace H.,Jain, Nirbhay S.,Pfaff, Miles J.,Lee, James C.,Lee, Justine C. Korean Society of Plastic and Reconstructive Surge 2021 Archives of Plastic Surgery Vol.48 No.5
Facial feminization surgery (FFS) incorporates aesthetic and craniofacial surgical principles and techniques to feminize masculine facial features and facilitate gender transitioning. A detailed understanding of the defining male and female facial characteristics is essential for success. In this first part of a two-part series, we discuss key aspects of the general preoperative consultation that should be considered when evaluating the prospective facial feminization patient. Assessment of the forehead, orbits, hairline, eyebrows, eyes, and nose and the associated procedures, including scalp advancement, supraorbital rim reduction, setback of the anterior table of the frontal sinus, rhinoplasty, and soft tissue modifications of the upper and midface are discussed. In the second part of this series, bony manipulation of the midface, mandible, and chin, as well as soft tissue modification of the nasolabial complex and chondrolaryngoplasty are discussed. Finally, a review of the literature on patient-reported outcomes in this population following FFS is provided.
Brian N. Dang,Allison C. Hu,Anthony A. Bertrand,Candace H. Chan,Nirbhay S. Jain,Miles J. Pfaff,James C. Lee,Justine C. Lee 대한성형외과학회 2022 Archives of Plastic Surgery Vol.49 No.1
Facial feminization surgery (FFS) refers to a set of procedures aimed at altering the features of a masculine face to achieve a more feminine appearance. In the second part of this two-part series, assessment and operations involving the midface, mandible, and chin, as well as soft tissue modification of the nasolabial complex and chondrolaryngoplasty, are discussed. Finally, we provide a review of the literature on patient-reported outcomes in this population following FFS and suggest a path forward to optimize care for FFS patients.
Alexander F. Haddad,John F. Burke,Praveen V. Mummaneni,Andrew K. Chan,Michael M. Safaee,John J. Knightly,Rory R. Mayer,Brenton H. Pennicooke,Anthony M. Digiorgio,Philip R. Weinstein,Aaron J. Clark,Dea 대한척추신경외과학회 2021 Neurospine Vol.18 No.2
Objective: The use of telemedicine has dramatically increased due to the coronavirus disease 2019 pandemic. Many neurosurgeons are now using telemedicine technologies for preoperative evaluations and routine outpatient visits. Our goal was to standardize the telemedicine motor neurologic examination, summarize the evidence surrounding clinical use of telehealth technologies, and discuss financial and legal considerations. Methods: We identified a 12-member panel composed of spine surgeons, fellows, and senior residents at a single institution. We created an initial telehealth strength examination protocol based on published data and developed 10 agree/disagree statements summarizing the protocol. A blinded Delphi method was utilized to build consensus for each statement, defined as >80% agreement and no significant disagreement using a 2-way binomial test (significance threshold of p<0.05). Any statement that did not meet consensus was edited and iteratively resubmitted to the panel until consensus was achieved. In the final round, the panel was unblinded and the protocol was finalized. Results: After the first round, 4/10 statements failed to meet consensus (<80% agreement, and p=0.031, p=0.031, p=0.003, and p=0.031 statistical disagreement, respectively). The disagreement pertained to grading of strength of the upper (3/10 statements) and lower extremities (1/10 statement). The amended statements clarified strength grading, achieved consensus (>80% agreement, p>0.05 disagreement), and were used to create the final telehealth strength examination protocol. Conclusion: The resulting protocol was used in our clinic to standardize the telehealth strength examination. This protocol, as well as our summary of telehealth clinical practice, should aid neurosurgical clinics in integrating telemedicine modalities into their practice.