{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T02:14:19Z","timestamp":1758075259970,"version":"3.44.0"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Perioral aesthetics are a critical component of facial gender-affirming surgery (FGAS). The goal of this paper is to review the philosophy, techniques, and evidence supporting perioral aesthetics in FGAS with specific attention to the lips, chin, and submentum.<\/jats:p><jats:p>Masculine appearance is typically associated with greater upper lip height, labial volume, and mouth width, whereas female appearance exhibits increased upper incisor show with a softer, tapered chin shape. The masculine chin is wider and taller with greater anterior projection, whereas the feminine chin is typically more narrowed. The contour of the submentum is impacted by skeletal and soft tissue differences, with males displaying a more angular profile.<\/jats:p><jats:p>Techniques for lip feminization include the subnasal lip lift and various injectables for altering lip contour. For chin contouring, several genioplasty techniques exist, including the T-genioplasty. These procedures may utilize virtual surgical planning. Submental liposuction and platysmaplasty can refine the submental area to highlight underlying osseous structures. Augmentation of the mandible, typically using implants, can be utilized for masculinization of the perioral region.<\/jats:p><jats:p>Careful attention to the lips, chin, and submentum can help achieve desired outcomes in both facial feminization and masculinization. A comprehensive understanding of perioral anatomy and an individualized technique selection are vital for achieving optimal FGAS outcomes.<\/jats:p>","DOI":"10.1055\/a-2605-7963","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T19:59:26Z","timestamp":1747079966000},"page":"595-601","source":"Crossref","is-referenced-by-count":0,"title":["Considerations for Maximizing Perioral Aesthetics in Gender-Affirming Surgery"],"prefix":"10.1055","volume":"41","author":[{"given":"Torin","family":"Thielhelm","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Mavrommatis","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua D.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jcms.2009.03.013","article-title":"Proportions in the upper lip-lower lip-chin area of the lower face as determined by photogrammetric method","volume":"38","author":"S Anic-Milosevic","year":"2010","journal-title":"J Craniomaxillofac Surg"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.fsc.2019.01.004","article-title":"Lip lift","volume":"27","author":"A A Salibian","year":"2019","journal-title":"Facial Plast Surg Clin North Am"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.jpra.2024.07.002","article-title":"Lip feminization: a review","volume":"41","author":"A Nassar","year":"2024","journal-title":"JPRAS Open"},{"issue":"07","key":"ref4","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.bjps.2015.03.013","article-title":"The attractive lip: a photomorphometric analysis","volume":"68","author":"V Penna","year":"2015","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1097\/PRS.0b013e31829accb6","article-title":"Analysis and classification of the upper lip aesthetic unit","volume":"132","author":"P Raphael","year":"2013","journal-title":"Plast Reconstr Surg"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1097\/MOO.0b013e3283079cc0","article-title":"Update on perioral cosmetic enhancement","volume":"16","author":"A C Suryadevara","year":"2008","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1055\/a-2446-0311","article-title":"Perioral rejuvenation: lip lifts, corner of mouth lifts, and vermillion advancements","volume":"41","author":"S W Perkins","year":"2025","journal-title":"Facial Plast Surg"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1068\/p220131","article-title":"Sex discrimination: how do we tell the difference between male and female faces?","volume":"22","author":"V Bruce","year":"1993","journal-title":"Perception"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.3390\/medicina59122070","article-title":"Facial feminization surgery: anatomical differences, preoperative planning, techniques, and ethical considerations","volume":"59","author":"S L Barnett","year":"2023","journal-title":"Medicina (Kaunas)"},{"issue":"22","key":"ref10","doi-asserted-by":"crossref","first-page":"4667","DOI":"10.1007\/s00266-024-04245-1","article-title":"Advancements in face and neck contouring: integrating radiofrequency-assisted liposuction with FaceTite and buccal fat pad excision for facial slimming","volume":"48","author":"M Tettamanzi","year":"2024","journal-title":"Aesthetic Plast Surg"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/DSS.0000000000001648","article-title":"Personal (self) perceptions of submental fat among adults in the United States","volume":"45","author":"L Baumann","year":"2019","journal-title":"Dermatol Surg"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1097\/SCS.0000000000005391","article-title":"Approach to feminization surgery and facial masculinization surgery: aesthetic goals and principles of management","volume":"30","author":"J C Deschamps-Braly","year":"2019","journal-title":"J Craniofac Surg"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1055\/a-2559-7309","article-title":"Selecting the right technique for the treatment of submental adiposity","author":"E A Jones","year":"2025","journal-title":"Facial Plast Surg"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1055\/s-0040-1716440","article-title":"Facial feminization surgery: a review of 220 consecutive patients","volume":"53","author":"P S Telang","year":"2020","journal-title":"Indian J Plast Surg"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"765e","DOI":"10.1097\/PRS.0000000000002580","article-title":"Full facial feminization surgery: patient satisfaction assessment based on 180 procedures involving 33 consecutive patients","volume":"138","author":"L Pavlidis","year":"2016","journal-title":"Plast Reconstr Surg"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1097\/PRS.0000000000004254","article-title":"Patient-reported outcome measures used in gender confirmation surgery: a systematic review","volume":"141","author":"M Andr\u00e9asson","year":"2018","journal-title":"Plast Reconstr Surg"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"NP123","DOI":"10.1093\/asj\/sjy253","article-title":"Nonsurgical management of facial masculinization and feminization","volume":"39","author":"M Ascha","year":"2019","journal-title":"Aesthet Surg J"},{"issue":"10","key":"ref18","doi-asserted-by":"crossref","first-page":"3173","DOI":"10.1111\/jocd.14320","article-title":"Male lip filler-aesthetic enhancement is not just limited to females: a case report","volume":"20","author":"A Goel","year":"2021","journal-title":"J Cosmet Dermatol"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1097\/PRS.0b013e3181af023a","article-title":"Influence of the recipient site on the outcomes of fat grafting in facial reconstructive surgery","volume":"124","author":"A Mojallal","year":"2009","journal-title":"Plast Reconstr Surg"},{"issue":"11","key":"ref20","doi-asserted-by":"crossref","first-page":"2843","DOI":"10.1007\/s40618-024-02373-8","article-title":"Efficacy of topical minoxidil in enhancing beard growth in a group of transgender assigned female at birth individuals on gender affirming hormone therapy","volume":"47","author":"L Marinelli","year":"2024","journal-title":"J Endocrinol Invest"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"NP42","DOI":"10.1093\/asj\/sjaa430","article-title":"Facial hair transplantation for transgender patients: a literature review and guidelines for practice","volume":"41","author":"V Patel","year":"2021","journal-title":"Aesthet Surg J"},{"issue":"05","key":"ref22","doi-asserted-by":"crossref","first-page":"877e","DOI":"10.1097\/PRS.0b013e3182a4c4fc","article-title":"Importance of the chin in lower facial contour: narrowing genioplasty to achieve a feminine and slim lower face","volume":"132","author":"K Hwang","year":"2013","journal-title":"Plast Reconstr Surg"},{"issue":"09","key":"ref23","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/S0030-4220(57)80041-3","article-title":"The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. II. Operating methods for microgenia and distoclusion","volume":"10","author":"R Trauner","year":"1957","journal-title":"Oral Surg Oral Med Oral Pathol"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"139","DOI":"10.3390\/medicina60010139","article-title":"Esthetic surgery of the chin in cis- and transgender patients-application of T-genioplasty vs. single-piece segment lateralization","volume":"60","author":"R Pokrowiecki","year":"2024","journal-title":"Medicina (Kaunas)"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1001\/archfacial.qoa00045.8","article-title":"Sliding genioplasty for correction of chin abnormalities","volume":"3","author":"E W Chang","year":"2001","journal-title":"Arch Facial Plast Surg"},{"issue":"07","key":"ref26","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.bjps.2022.02.073","article-title":"Applications of three-dimensional surgical planning in facial feminization surgery: a systematic review","volume":"75","author":"J M Escand\u00f3n","year":"2022","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"07","key":"ref27","doi-asserted-by":"crossref","first-page":"614","DOI":"10.21037\/atm-20-6369","article-title":"Point of care virtual surgical planning and 3D printing in facial gender confirmation surgery: a narrative review","volume":"9","author":"D Kuruoglu","year":"2021","journal-title":"Ann Transl Med"},{"issue":"11","key":"ref28","doi-asserted-by":"crossref","first-page":"NP1368","DOI":"10.1093\/asj\/sjab032","article-title":"Three-dimensional custom-made surgical guides in facial feminization surgery: prospective study on safety and accuracy","volume":"41","author":"P Tawa","year":"2021","journal-title":"Aesthet Surg J"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"e2618","DOI":"10.1097\/GOX.0000000000002618","article-title":"Simplifying facial feminization surgery using virtual modeling on the female skull","volume":"8","author":"H Hoang","year":"2020","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"05","key":"ref30","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1097\/PRS.0000000000006166","article-title":"Osseous transformation with facial feminization surgery: improved anatomical accuracy with virtual planning","volume":"144","author":"R Gray","year":"2019","journal-title":"Plast Reconstr Surg"},{"issue":"04","key":"ref31","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.cps.2018.06.006","article-title":"Gender reassignment: feminization and masculinization of the neck","volume":"45","author":"C J Salgado","year":"2018","journal-title":"Clin Plast Surg"},{"issue":"01","key":"ref32","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.cps.2023.07.005","article-title":"Ultrasound-assisted lipoplasty","volume":"51","author":"L M Wo","year":"2024","journal-title":"Clin Plast Surg"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/SAP.0000000000004163","article-title":"Current trends in deep plane neck lifting: a systematic review","volume":"94","author":"S R Chinta","year":"2025","journal-title":"Ann Plast Surg"},{"issue":"03","key":"ref34","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1300\/J082v51n03_04","article-title":"Attempted suicide among transgender persons: the influence of gender-based discrimination and victimization","volume":"51","author":"K Clements-Nolle","year":"2006","journal-title":"J Homosex"},{"issue":"05","key":"ref35","doi-asserted-by":"crossref","first-page":"766e","DOI":"10.1097\/PRS.0000000000003798","article-title":"Facial gender confirmation surgery: a new nomenclature","volume":"140","author":"L Capit\u00e1n","year":"2017","journal-title":"Plast Reconstr Surg"},{"issue":"07","key":"ref36","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1007\/s11136-010-9668-7","article-title":"Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery","volume":"19","author":"T A Ainsworth","year":"2010","journal-title":"Qual Life Res"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1089\/fpsam.2021.0301","article-title":"Sex differences in adult facial three-dimensional morphology: application to gender-affirming facial surgery","volume":"24","author":"J J Bannister","year":"2022","journal-title":"Facial Plast Surg Aesthet Med"},{"issue":"12","key":"ref38","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1097\/DSS.0000000000001850","article-title":"a double-blind, placebo-controlled, phase 3b study of ATX-101 for reduction of mild or extreme submental fat","volume":"45","author":"R G Glogau","year":"2019","journal-title":"Dermatol Surg"},{"issue":"04","key":"ref39","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/j.jaad.2016.04.028","article-title":"ATX-101 for reduction of submental fat: a phase III randomized controlled trial","volume":"75","author":"S Humphrey","year":"2016","journal-title":"J Am Acad Dermatol"}],"container-title":["Facial Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2605-7963.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T23:08:47Z","timestamp":1758064127000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2605-7963"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,12]]},"references-count":39,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2025,9,16]]},"published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2605-7963","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0736-6825","1098-8793"],"issn-type":[{"type":"print","value":"0736-6825"},{"type":"electronic","value":"1098-8793"}],"subject":[],"published-other":{"date-parts":[[2025,5,12]]},"published":{"date-parts":[[2025,5,12]]}}}