Abstract
BACKGROUND: Specialized medical care for transgender patients during the transition process can substantially improve mental and physical health for this population, due to the multitude of changes they may experience in both areas. Minimally invasive aesthetic procedures (MIPs) on the face can promote the anatomical changes and skin quality improvements necessary for gender affirmation, increasing gender congruence and, consequently, improving patients' quality of life. Given that gender-affirming hormone therapy (GAHT) impacts skin quality, MIPs may offer valuable complementary benefits during the transition process. OBJECTIVE: Here we describe a novel treatment plan to improve skin quality in transgender patients who are or are not undergoing GAHT. METHOD: The combination of incobotulinumtoxinA (Xeomin; Merz Pharmaceuticals GmbH, Frankfurt, Germany), calcium hydroxylapatite-carboxymethylcellulose (Radiesse; Merz North America Inc., Franksville, WI, USA), and Cohesive Polydensified Matrix hyaluronic acid with glycerol (CMP-HA20G, Belotero Revive; Anteis S.A., Plan-les-Ouates, Switzerland, a company of the Merz Aesthetics group) should be administered in a single session to improve skin quality. Photographs were taken at baseline and follow-up to assist with 3-dimensional reconstructions for evaluation of skin quality according to the four emergent perceptual categories (EPCs) defining skin quality. OUTCOMES: EPC monitoring may help to guide MIP treatments, support future evaluation of treatment efficiency, and assist in delivering personalized gender-affirming care. CONCLUSION: This new treatment plan for skin quality improvement offers gender-affirming care to the transgender community, based on clinical expertise.