Approach to Feminization Surgery and Facial Masculinization Surgery: Aesthetic Goals and Principles of Management

Abstract The 1960s and 1970s were an important time for craniofacial surgery because of the work of Paul Tessier and Hugo Obwegeser, both mentored by Sir Harold Gillies, along with many other important monumental minds. During this era, the birth of craniofacial surgery occurred and represented a new discrete specialty within plastic surgery. In the 1980s distraction of the facial skeleton became an indispensable tool in the arsenal of the craniofacial surgeon, based on initial cases in Italy, and rigorous research by McCarthy, Grayson, and others. In more recent times, from 2000 onward, craniofacial surgery has benefitted from the advent and refinement of techniques using computer-aided planning for procedures, spring distraction, as well as the widespread use of fat grafting as part of facial reconstruction. In the last decade, innovations based on the fusion of microsurgical procedures with craniofacial procedures for face allotransplantation and improvements in safety regarding separation of craniopagus infants have been observed. The author thinks it is worth mentioning and conferring praise upon the anesthesia colleagues for improvements in anesthesia