Feminizing Rhinoplasty in Transfeminine Patients: Complications and Outcomes in 102 Patients.

[BACKGROUND] Transfeminine patients have anatomically male noses, although most surgeons perform rhinoplasties on female noses.

[OBJECTIVES] This study reports on the outcomes of feminizing rhinoplasty in 102 transfeminine patients and the reasons for revision.

[METHODS] A retrospective review of patient characteristics was performed for 102 transfeminine patients who received feminizing rhinoplasty from January 2021 to February 2024. Multivariate regression was used to assess the relationship between the need for revision and patient characteristics.

[RESULTS] Three patients (2.9%) experienced postoperative complications. One had postoperative hemorrhage requiring an ER visit and nasal packing, 1 had scar contracture at the alar base (after alar base resection), and 1 had chondritis requiring medrol and NSAIDs. Seventeen patients (16.7%) received revision surgery, citing 22 total reasons. Dorsal hump reduction (N=8, 36.4%) and tip revision (N=8, 36.4%) were the most common reasons, followed by a wide dorsum (N=3, 13.6%). Fourteen patients had a prior rhinoplasty or septoplasty, of which 14.3% (N=2) had revisions. Twenty-three percent of Caucasians (N=9), 50% of Asians (N=2), 22% of multiracial patients (N=6), and no African American and unspecified ethnicity patients underwent revision. Dorsal hump reduction was the most common revision reason for Caucasian and Asian patients, whereas multiracial patients equally cited dorsal hump reduction and poor tip rotation. No patient characteristics were significantly associated with revision.

[CONCLUSION] Revision surgery was not significantly associated with any patient characteristics. Patients most sought revision for dorsal hump reduction and tip revision. Surgeons and patients should discuss desired outcomes to minimize revision incidence.