Background: Male-to-female transgender (MTF) patients have anatomically male noses, while most surgeons perform rhinoplasties on traditional female noses. This study reports on the outcomes of feminizing rhinoplasty in 82 MTF patients and the most common reasons for revision. Methods: A retrospective review of patient characteristics including demographics and medical history was performed for 82 MTF patients who received feminizing rhinoplasty from January 2022 to February 2024. Multivariate regression was used to assess the relationship between the need for revision rhinoplasty and the above patient characteristics. Results: The analysis included 82 MTF patients with a mean age of 31±8.4 years. Two patients (2.4%) experienced postoperative complications. 1 had postoperative hemorrhagerequiring an ER visit and nasal packing and 1 had a visible scar contracture at the alar base (after alar base resection). Thirteen patients (15.9%) received revision surgery with a mean of 352±252 days between surgeries, of which 19 total reasons were provided. Eleven patients had a prior rhinoplasty or septoplasty, of which 18.2% (N=2) had revisions.Dorsal hump reduction (N=7, 36.8%) and tip revision (N=7, 36.8%) were the most common reasons, followed by a wide dorsum (N=3, 15.8%). In terms of ethnicity, 19% of Caucasians (N=6), 50% of Asians (N=2), 22% of multiracial patients (N=5) and no African American and unspecified ethnicity patients underwent revision. Dorsal hump reduction was cited as the most common revision reason for Caucasian and Asian patients, while multiracial patients equally cited dorsal hump reduction and poor tip rotation. The need for revision rhinoplasty was only significant with Asian ethnicity (p = 0.0436). Conclusion: Revision surgery was significantly associated with Asian ethnicity. Patients most commonly sought revision for dorsal hump reduction and tip revision. Surgeons performing rhinoplasties on MTF patients should consider thorough patient discussion of desired outcomes to reduce incidence of revision surgery.
