Effect of Duration of Feminizing Hormone Therapy on Facial Fat Volumes.

IF 3.2 2区 医学 Q1 SURGERY Plastic and reconstructive surgery Pub Date : 2024-11-01 Epub Date: 2023-11-14 DOI:10.1097/PRS.0000000000011200
Shahrzad Moghadam, Yvonne Roca, Jonnby S LaGuardia, Kelly X Huang, Madeline G Chin, Meiwand Bedar, Sarah K Fadich, Justine C Lee
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Abstract

Background: Gender-affirming feminizing hormone therapy induces body fat redistribution. However, the amount and timing of facial fat changes in response to feminizing hormone therapy are unknown, despite being relevant to counseling and surgical planning for facial gender-affirming surgery. The authors assessed the influence of feminizing hormone therapy duration on malar and temporal fat volume.

Methods: Malar and temporal fat volumes were compared using computed tomography in transfeminine patients (age, 20 to 29 years; body mass index, 18.5 to 24.9) treated with feminizing hormone therapy for less than 2 years versus 2 years or longer. Patients with previous surgical or nonsurgical facial soft-tissue interventions were excluded. Multivariable linear regressions evaluated the contribution of hormone therapy duration to malar and temporal fat volumes.

Results: A total of 45 patients were included, 30 (66.7%) treated with feminizing hormone therapy for 2 years or longer and 15 (33.3%) treated for less than 2 years (median [interquartile range], 44.5 [33.5 to 65.6] versus 15.0 [11.0 to 18.0] months; P < 0.001). Patients treated with hormone therapy for 2 years or longer demonstrated a 1.6-fold greater malar fat volume (5.5 [4.2 to 6.3] versus 3.4 [2.3 to 4.2] cm 3 ; P < 0.001) and 1.4-fold greater temporal fat volume (2.8 [2.4 to 3.6] cm 3 versus 2.0 [1.7 to 2.4] cm 3 ; P = 0.01) compared with those treated for less than 2 years. When accounting for other contributory variables, such as body mass index, skull size, and total soft-tissue depth, in multivariable linear regression models, hormone therapy duration of 2 years or longer independently predicted higher malar (β = 0.51, P < 0.001) and temporal (β = 0.32, P = 0.02) fat volumes.

Conclusion: Feminizing hormone therapy increases malar and temporal fat volumes by approximately 2 cm 3 and 0.8 cm 3 for each area, respectively, after 2 years of treatment.

Clinical question/level of evidence: Therapeutic, III.

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女性化激素疗法持续时间对面部脂肪量的影响
背景:确认性别的女性化激素疗法会诱导身体脂肪重新分布。然而,尽管面部脂肪的数量和时间变化与面部性别确认手术的咨询和手术计划有关,但人们对女性化激素疗法引起的面部脂肪变化的数量和时间却一无所知。作者评估了女性化激素治疗持续时间对耳廓和颞部脂肪体积的影响:使用计算机断层扫描比较了接受女性化激素治疗少于 2 年和 2 年或更长时间的转女性患者(年龄在 20 至 29 岁之间;体重指数在 18.5 至 24.9 之间)的耳廓和颞部脂肪体积。曾接受过面部软组织手术或非手术治疗的患者除外。多变量线性回归评估了激素治疗时间对颧部和颞部脂肪体积的影响:共纳入了 45 名患者,其中 30 人(66.7%)接受了 2 年或更长时间的女性化激素治疗,15 人(33.3%)接受了不到 2 年的治疗(中位数[四分位间范围],44.5 [33.5 至 65.6] 个月对 15.0 [11.0 至 18.0] 个月;P < 0.001)。与接受激素治疗不足 2 年的患者相比,接受激素治疗 2 年或以上的患者颊脂肪体积增加了 1.6 倍(5.5 [4.2 至 6.3] 厘米 3 对 3.4 [2.3 至 4.2] 厘米 3;P < 0.001),颞脂肪体积增加了 1.4 倍(2.8 [2.4 至 3.6] 厘米 3 对 2.0 [1.7 至 2.4] 厘米 3;P = 0.01)。在多变量线性回归模型中,如果考虑到体重指数、头骨大小和软组织总深度等其他相关变量,激素治疗持续时间为 2 年或更长可独立预测较高的颞部脂肪体积(β = 0.51,P < 0.001)和颞部脂肪体积(β = 0.32,P = 0.02):结论:女性化激素疗法在治疗 2 年后,颊部和颞部脂肪体积分别增加约 2 cm 3 和 0.8 cm 3:临床问题/证据级别:治疗,III。
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来源期刊
CiteScore
5.00
自引率
13.90%
发文量
1436
审稿时长
1.5 months
期刊介绍: For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis. Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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