TY - JOUR
T1 - Frontal Bone Cranioplasty for Facial Feminization in Gender-Affirming Surgery
T2 - Can Fewer Screws Fixate Bone and Avoid Nonunion?
AU - Lee, Andrew
AU - Piraquive, Jacquelyn
AU - Spiegel, Jeffrey H.
N1 - Publisher Copyright:
© 2022 American Academy of Facial Plastic and Reconstructive Surgery, Inc.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Background: Facial feminization surgery can include forehead feminizing cranioplasty (FFC). The reshaped bones are fixated together with titanium plates and screws. Objective: To define the authors' preferred plating patterns and measure complications of bony nonunion when less hardware is applied. Methods: A 7-year retrospective review of patients who underwent FFC was conducted. Data collection included cranioplasty technique, fixation patterns, and complications. Traditional fixation (≥2 screws on each side of the osteotomy) was compared with conservative fixation (<2 screws). Results: A total of 483 patients were identified with a median of 241 days of follow-up (interquartile range: 8-528 days). Most patients (77.8%) had frontal bone fixation with microplates and screws. The most common combination was placement of two plates with four screws in total, comprising two screws on each plate, with one screw on each side of the fracture line (305/483, 63.1%). No signs or symptoms of bone flap mobility were noted on examination. Conclusion: Conservative fixation of the anterior table does not appear to increase signs of nonunion in forehead reshaping gender-affirming surgery.
AB - Background: Facial feminization surgery can include forehead feminizing cranioplasty (FFC). The reshaped bones are fixated together with titanium plates and screws. Objective: To define the authors' preferred plating patterns and measure complications of bony nonunion when less hardware is applied. Methods: A 7-year retrospective review of patients who underwent FFC was conducted. Data collection included cranioplasty technique, fixation patterns, and complications. Traditional fixation (≥2 screws on each side of the osteotomy) was compared with conservative fixation (<2 screws). Results: A total of 483 patients were identified with a median of 241 days of follow-up (interquartile range: 8-528 days). Most patients (77.8%) had frontal bone fixation with microplates and screws. The most common combination was placement of two plates with four screws in total, comprising two screws on each plate, with one screw on each side of the fracture line (305/483, 63.1%). No signs or symptoms of bone flap mobility were noted on examination. Conclusion: Conservative fixation of the anterior table does not appear to increase signs of nonunion in forehead reshaping gender-affirming surgery.
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U2 - 10.1089/fpsam.2022.0018
DO - 10.1089/fpsam.2022.0018
M3 - Article
C2 - 36169481
AN - SCOPUS:85139375718
SN - 2689-3614
VL - 24
JO - Facial Plastic Surgery and Aesthetic Medicine
JF - Facial Plastic Surgery and Aesthetic Medicine
ER -