The evolution of facial feminisation surgery
09 July 2024 (Last updated: 9 Jul 2024 14:44)
Dr Luis Capitán, has pioneered facial feminisation surgery since 2007, but it is only in recent years that he feels that society and the medical world have begun to recognise the specialism as a part of maxillofacial surgery. He is co-founder and co-director of Facialteam, which provides premium and comprehensive facial feminization services for the transgender community.
At the BAOMS Annual Scientific Meeting, Luis outlined the evolution of the field since the early 1930s when Lili Elbe — the Danish Girl — was one of the first people to undergo sex reassignment surgery. The first transgender health guidelines were published in 1967 and version eight of these saw the light of day in 2022, in which there is a turning point for facial feminisation surgery, which is recognised as a necessary medical treatment for the transitioning transgender patient.
Echoing the theme “the patients' voice”, Luis' presentation focused on how he and colleagues ensure positive outcomes for the patients they work with. He told us that this is the part of his work he enjoys the most: “Facial feminisation surgery can be a turning point in someone’s personal and social life. The techniques are complex but over time and with practice they become easy. What I never tire of is seeing the positive response from patients.”
Like the field, Luis’s own practice has evolved. When he started out, x-rays and photographs were used in planning facial surgery but today three dimensional scans and videos of patients moving their faces has vastly helped to improve results. He says: “The face is a dynamic structure and technology now allows us to pay attention to far more of the detail as we plan surgeries. Using three dimensional scans and videos we can better predict how facial movements and gestures will appear after surgery and ensure more positive outcomes for our patients.”
Preparation for surgery involves far more than scanning and planning. His team at FacialTeam in Marbella, Spain, is multidisciplinary, with doctors, psychologists, physiotherapists and nurses all working closely with every patient to ensure a positive experience. Each procedure is personalised to a patient’s unique facial features and with their goals in mind and the process is complex.
The team at Facialteam have helped over 2,000 patients in 15 years and now performs operations on around 350 patients each year with an average of 3.2 operations per patient. Many travel from around the world for facial feminisation. Luis and colleagues are developing a virtual facial feminisation surgery portal to recreate potential outcomes ahead of procedures to show patients how they could look with lowered testosterone influence in their face. This provides an idea of the results that could be achieved and allows patients to see a realistic picture in motion in advance.
Luis concludes: “After so many years of practising facial feminisation surgery without being present at medical conferences I am pleased that we are starting to get recognised. We have learned a lot since we started out 16 years ago and would like to share that knowledge with other professionals in order to achieve the very best outcomes for patients whose lives can be transformed by this surgery.”
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