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  • Presentation

Gender-Affirming Procedural Dermatology: Overview and Basic Principles

Description

The presentation highlights gender-affirming dermatological procedures, focusing on their implementation, challenges, and techniques tailored for transgender patients. It discusses the rise in gender confirmation surgeries pre-COVID and notes the predominance of female-to-male surgeries in broader statistics, contrasting this with patient demographics in Minnesota. Using a retrospective chart review, the speaker emphasizes the critical role of hormonal treatments prior to dermatological interventions, such as laser hair removal and injectables. The narrative outlines technical details regarding procedures like phalloplasty and vaginoplasty, including pre-surgical hair removal and the importance of careful patient assessments to guide treatment plans. A significant part of the talk addresses the complications and challenges of managing scarring post-surgery, the intricacies of cosmetic procedures tailored for individual patient goals, and the importance of discussing expectations with patients. The presentation also outlines specific techniques for achieving desired facial feminization or masculinization through injectables, alongside the timing of these procedures concerning upcoming surgeries. Finally, it underscores the necessity of thorough pre-care protocols, patient comfort in sensitive areas, and the ongoing need for gender-inclusive healthcare practices to address and mitigate the unique challenges faced by transgender patients.

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Conclusions

  • Gender affirming surgeries are increasing in prevalence, particularly before the COVID-19 pandemic disrupted procedures.
  • Most patients undergoing gender affirming surgeries are on hormone therapy prior to dermatological procedures.
  • Electrolysis is the most common dermatological procedure for transgender individuals, especially among trans feminine patients.
  • There are significant billing barriers for gender affirmation procedures due to lack of specific codes and coverage.
  • Patients have diverse aesthetic preferences, which necessitate personalized approaches to dermatological treatments and procedures.
  • Patients often have untreated skin conditions and are seeking aesthetic procedures post-surgery, indicating a need for comprehensive care.
  • Dermatologists play a crucial role in managing scars post-surgery, and expectant management should include scar assessment and treatment options.
  • Laser hair removal is commonly sought, but it's important to clarify that it does not guarantee permanent hair removal, especially in anatomical sites affected by surgery.
  • Injectable treatments should be timed appropriately relative to surgical interventions to avoid complications during subsequent surgeries.
  • Hairline alterations and facial hair transplants require careful patient history and understanding of gender-specific aesthetic desires.
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