3D
Stereophotogrammetry Analysis and Psychosocial Outcomes of Injectable Fillers in Gender‐Affirming Facial Contouring: A Prospective Analysis
Bruna S. F. Bravo, Ana Luísa Leopoldino de Souza, Victoria Kong, Leonard Knoedler, Michael Alfertshofer, Robert Gaudin, Deise Caldas Kühlman, Juliana Martins Leal, Marina Ramos Baeta Neves, Leonardo Gonçalves Bravo, Regina Casz Schechtman, Sueli Carneiro ABSTRACT
Background
Gender‐affirming facial procedures alleviate dysphoria, yet prospective data on nonsurgical interventions remain scarce. Objective data on anatomical and psychosocial outcomes following injectable fillers in transgender populations are poorly defined.
Aims
To quantitatively evaluate soft‐tissue changes and psychosocial outcomes following gender‐affirming facial contouring with hyaluronic acid (HA) fillers.
Patients/Methods
In this prospective, single‐center study, 50 transgender patients (25 trans women and 25 trans men) underwent individualized HA filler treatments. Three‐dimensional (3D) stereophotogrammetry was performed using a VECTRA (Canfield Scientific, Parsippany, NJ, USA) to assess facial soft‐tissue changes at baseline and 30 days post‐treatment. Linear distances were measured on 3D facial images using the VECTRA Analysis Module software with integrated digital caliper tools. Psychosocial outcomes were measured using validated Likert‐type measures of satisfaction and gender identification, including the Global Aesthetic Improvement Scale (GAIS).
Results
Mean injected volume was 9.8 ± 3.5 mL and was well tolerated, with no serious adverse events. Satisfaction and gender identification scores improved significantly (Δ + 1.53 and + 1.71, respectively; both p < 0.001). The 3D analysis demonstrated significant, directionally gender‐congruent changes. Trans women showed increases in bizygomatic width (+ 3.75 mm) and labial height (+ 1.77 mm), along with a reduction in perceived chin width (−12.94 mm). Trans men exhibited increases in bigonial width (+ 5.04 mm) and chin width (+ 4.53 mm) (all p < 0.001). Despite millimeter‐scale changes, these modifications were associated with substantial psychosocial improvement.
Conclusions
This prospective study demonstrated measurable, gender‐congruent changes in facial morphology following injectable HA filler treatment, accompanied by improvements in patient‐reported satisfaction and gender identification. Despite similar injected volumes, anatomical effects differed between groups, reflecting strategic three‐dimensional redistribution of soft tissue rather than volume alone. These findings support nonsurgical facial contouring as an effective approach for gender affirmation.