Facial feminization surgery: Key CT findings for preoperative planning and postoperative evaluation

Andrew L. Callen, Ryan K. Badiee, Andrew Phelps, Valeria Potigailo, Eric Wang, Solomon Lee, Jason Talbott, Christine Glastonbury, Jason H. Pomerantz, Jared Narvid

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Facial feminization surgery is an increasingly performed component of gender affirmation surgery for transgender women. Preoperative facial CT is performed to plan the adjustment of the patient’s masculine characteristics to feminine and to plan operative navigation around specific readily identifiable anatomic structures. In the upper face, surgery is performed to reduce the prominence of the brow and increase the nasofrontal angle; the radiology report should indicate the frontal sinus and supraorbital foramen anatomy. In the midface, rhinoplasty is performed to increase the nasofrontal and nasolabial angles; the radiology report should indicate the presence of a dorsal hump and septal deviation or spurring. In the lower face, the prominence of the chin and squareness of the jaw are adjusted via genioplasty and mandible contouring, respectively; the radiology report should describe the location and potential anatomic variations of the inferior alveolar nerve and mental foramina as well as the presence of dental abnormalities that directly inform the surgical approach. CT may also be performed if there is clinical suspicion for postoperative complications such as hardware fracture or osteotomy through the supraorbital or mental foramen. Familiarity with these findings will facilitate improved communication between radiologists and surgeons, thereby contributing to the care of transgender women.

Original languageEnglish (US)
Pages (from-to)709-717
Number of pages9
JournalAmerican Journal of Roentgenology
Issue number3
StatePublished - Sep 2021


  • CT
  • Facial feminization surgery
  • Gender dysphoria
  • Surgical planning
  • Transgender

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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