Belgium-based maxillofacial surgeon Dr Bart van de Ven specialises in facial feminisation surgeries. He has done close to 2,000 such surgeries, and has had a couple of Indian patients, too. Excerpts from an interview:
From a surgical perspective, what are the prominent differences between Indian faces and that of people from other races?
My approach to facial feminising surgery is based on the skin type. In people with coloured skin, very few incisions in visible areas have to be made. This is because the skin heals in a different way and the risk of leaving behind bigger and uglier scars is higher. Hence, procedures such as lip lift or hairline lowering have to be avoided, if possible. If these are unavoidable and hypertrophic scars appear, we treat them by injecting corticosteroids into the scars, which greatly help to make them heal beautifully.
What is the facial feature that is most desirable among Indian trans patients?
Racial differences between white and Indian people are not that big. In fact, masculine facial features of people from India tend to be a bit softer than in most white people. This makes it easier for me to feminise these faces. There is a big difference, however, not only in the colour, but also in the healing tendency of the skin. There are a few major procedures that are deemed important for most patients, no matter where they are from. These include the reduction of the brow bone, together with forehead recontouring and a brow lift, the reduction/recontouring of the jaw and chin, and rhinoplasty.
Given the geographical limitations, how do you work with your trans patients before the surgery?
The geographical limitations don't form an obstacle. I give advice on procedures based on high-quality pictures we receive from the patient and [send] computer simulations of the result such procedures would have [to the patient]. Subsequently, we have a Skype consultation to discuss everything.
What has been your most challenging surgical experience till date?
The most challenging obviously are patients with very masculine faces. I have treated many of them. In all, I have performed over 2,000 facial feminisation surgeries.