Artificial Intelligence in Facial Feminization Surgery: From Automated Analysis to Patient-Centered Virtual Surgical Planning.

Facial feminization surgery is central to gender-affirming craniofacial care, combining skeletal and soft tissue procedures that align facial appearance with gender identity and improve psychosocial well-being. Because the forehead, supraorbital rims, orbits, zygoma, nose, mandible, and chin strongly shape gender perception, careful planning is essential. Virtual surgical planning enables 3-dimensional analysis, simulation, patient communication, and safe transfer of the plan to the operating room. Artificial intelligence may automate segmentation, measurement, and parts of planning, while classifiers, morphing, and predictive shape models can help individualize feminization goals, constrained by surgical safety, patient autonomy, soft-tissue uncertainty, and surgeon judgment.