Abstract Background  An increasing number of nonbinary patients are receiving gender-affirming procedures due to improved access to care. However, the preferred treatments for nonbinary patients are underdescribed. The purpose of this study was to investigate the goals and treatments of nonbinary patients. Methods  A retrospective study of patients who self-identified as nonbinary from our institutional Gender Health Program was conducted. Patient demographics, clinical characteristics, surgical goals, and operative variables were analyzed. Results  Of the 375 patients with gender dysphoria, 67 (18%) were nonbinary. Over half of the nonbinary patients were assigned male at birth ( n  = 57, 85%) and nearly half preferred the gender pronoun they/them/theirs ( n  = 33, 49%). A total of 44 patients (66%) received hormone therapy for an average of 2.5 ± 3.6 years, primarily estrogen ( n  = 39). Most patients ( n  = 46, 69%) received or are interested in gender-affirming surgery, of which, almost half were previously on hormone therapy ( n  = 32, 48%). The most common surgeries completed or desired were facial feminization surgery ( n  = 15, 22%), vaginoplasty ( n  = 15, 22%), mastectomy ( n  = 11, 16%), and orchiectomy ( n  = 9, 13%). Nonbinary patients who were assigned male at birth (NB-AMAB) were more often treated with hormones compared to nonbinary patients assigned female at birth (NB-AFAB) (72% vs. 30%, p  = 0.010). Conversely, patients who were AFAB were more likely to complete or desire surgical intervention than those who were AMAB (100% vs. 63.0%, p  < 0.021). Conclusion  Majority of nonbinary patients were assigned male at birth. NB-AFAB patients all underwent surgical treatment, whereas NB-AMAB patients were predominantly treated with hormone therapy.

Gender Affirming Surgery in Nonbinary Patients: A Single Institutional Experience

BACKGROUND: Dermatologists have the opportunity to provide medically necessary procedures, including laser hair removal, to transgender patients for gender affirmation. Further research is required to better assess the unique dermatologic needs of this population. OBJECTIVE: To examine the prevalence of dermatologic procedures among transgender people in the context of gender-affirming treatment. METHODS: This cross-sectional study examined survey responses from 696 transgender persons enrolled in the Study of Transition, Outcomes, and Gender cohort. Prevalence of self-reported dermatologic procedures was examined and compared across participant subgroups. RESULTS: Electrolysis was the most commonly reported procedure (32.9%). Transfeminine patients were more likely to use dermatologic procedures compared with transmasculine patients. Only 19 participants (2.8%) reported the use of dermal filler injections. CONCLUSION: Differences in utilization of dermatologic procedures were noted in transgender populations. Motivations, barriers, and optimal timing for gender-affirming dermatologic procedures among transgender persons should be examined in future studies.

Survey of Dermatologic Procedures in Transgender Adults.

Beards and facial hair are part of males. It may be a sign of masculinity and attraction. Topical therapy for beard enhancement may be desired by some men to improve beard growth and density. A review of all reports on topical treatment options for beard enhancement is presented here. Reports on topical treatment for beard enhancement were searched using The United States National Library of Medicine PubMed, exploring all titles containing beard, facial hair or mustache as of July 22 2020. A total of 445 articles resulted from the search after reviewing the publications for potential relation to beard enhancement. Three studies match the aim of the review regarding topical therapy for beard enhancement in men. Two of which were double-blind clinical trials and one was a case report. Topical 3 % minoxidil, as studied by Ingprasert et al., showed a significant increase in hair count, photographic scoring and patient self-assessment. Saeedi et al. studied the use of 2.5 % testosterone gel for men with thalassemia major with an increase in terminal hair. Vestita et al. published a case report demonstrating unexpected improvement of beard density for a patient using tretinoin 0.05 % cream. Only limited evidence could be presented on topical treatments for beard enhancement. Topical minoxidil is an off-label treatment to enhance the beard. Other topical options such as testosterone, tretinoin, bimatoprost could constitute potential treatment options. Further studies needed to recommend the best topical options for men who desire to enhance their beards.

/pdf/review-of-topical-therapies-for-beard-enhancement-41bf54vezu.pdf

Review of Topical Therapies for Beard Enhancement

Hair transplantation is a safe and effective treatment option in patients with male and female pattern hair loss. Alopecia leads to a lack of self-confidence and social withdrawal in young patients when compared to their peers with good hair density. Patient selection, counseling, and planning the procedure have equal importance as that of the hair transplantation surgery itself. Follicular unit transplantation (FUT) and follicular unit extraction (FUE) are the two commonly used techniques of hair restoration. In FUT, a strip of tissue is excised from the occipital donor area resulting in a linear scar. Whereas in FUE, the scarring can be avoided as small individual follicular units are harvested and transplanted in the recipient area. FUE is emerging as a most opted hair restoration procedure in patients with patterned hair loss. This review elaborates on the procedure of FUE in brief and gives a detailed step-by-step guide for performing the procedure.

Hair transplantation: A brief review

Objective: To introduce the surgical procedures and experiences in restoration of lower facial esthetics for a male and a female patients who suffered from burn injuries. The difference of surgical methods which varied from sexes were discussed. Materials and Methods: The clinical data of the patients was collected and retrospectively analyzed. The cervical contracture was repaired by pre-expanded free scapular flaps with sufficient pliable tissue for large defects. Moreover, for the male patient, prefabricated double pedicle scalp flap was applied to rebuild the beard region. The patients were followed up for 2 years. Surgical procedures and outcomes were detailed in the article. Results: All the flaps were survived well. The facial hair-bearing area of the man was recovered with natural appearance. The reconstructed mental cervical angels and mandibular margins were clear. The neck extension mobility was improved. The 2 patients were satisfied with the outcomes of the treatments. Conclusion: The treatments of facial and neck scar varied from sexes and different requirements. For male patient, the combination of scalp and scapular flaps was a feasible method to achieve natural beard and cervical appearance. For female patient, bilateral expanded scapular flaps could meet the demands of large tissue supply and a relative hidden donor site. 

Restoration of Lower Facial and Neck Esthetics by Application of Pre-Expanded Bipedicle Scalp and Free Scapular Flaps

What’s New in Facial Hair Transplantation?: Effective Techniques for Beard and Eyebrow Transplantation

Beard Hair Transplantation.

Hair restoration has long been thought of as restoring hair predominantly in the scalp in men and women who have lost hair for various reasons. Advances in hair restoration techniques have made it possible to transplant hair in non-scalp areas of the face where patients may have never had hair. Refinements in techniques have allowed for the restoration of beard hair and eyebrow hair with very natural appearing results. Pick up any of the latest fashion magazines and you see female models with thick, full eyebrows, or men sporting full beards. In part, due to these fashion and culture trends, along with advancements in techniques that we have developed, our practice has seen a large increase in the demand for beard and eyebrow restoration. This article describes the pre-operative evaluation, operative technique and post-operative care developed from the experience of over 1,000 procedures in facial hair restoration.

https://www.longdom.org/open-access/facial-hair-restoration-effective-techniques-for-beard-and-eyebrow-restoration-2167-0951-1000140.pdf

Facial Hair Restoration: Effective Techniques for Beard and Eyebrow Restoration

Pick up any recent magazine and you will see it filled with models with thick, full eyebrows. Gone are the pencil thin-eyebrows popularized in the past. The latest vogue is for full, thick eyebrows. Many patients with naturally thin eyebrows or thinning eyebrows due to over-plucking/ aging are now being seen in our clinicdesiring to have fuller eyebrows. Cultural trends and refinements in hair transplantation techniques, as well as the results we are achieving, have resulted in a huge increase in the number of patients seen for eyebrow transplantation. This article describes the clinical evaluation and candidacy for eyebrow transplantation, the Surgical Techniques, The Post-Operative Care, And the Management of Complications.

/pdf/refining-techniques-in-eyebrow-transplantation-8dzbvre2xf.pdf

Refining Techniques in Eyebrow Transplantation

Hair Transplantation Techniques for the Transgender Patient.

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