Lipolysis is the process by which fat cells (adipose tissue) reduce in size or get eliminated to free up the energy stored in them. The energy is stored as triglycerides which then get converted to fatty acids and glycerol that your body can use directly for muscles and other organs. Visceral fat is internal and surrounds organs and subcutaneous fat sits closer to the surface between the layers of muscle and skin.

[[File:Fat cell turnover.png|800x800px]]

It's important to note that normal '''weight loss does not get rid of fat cells but only shrinks their size'''. Fat cells will naturally be removed during their lifecycle (cell turnover) at a rate of 10% per year.<ref>https://onlinelibrary.wiley.com/doi/full/10.1111/joim.13435</ref>

Weight loss will also eliminate fat from all areas of the body at once, although hormonal factors will influence how much is maintained in a gynoid or android fat pattern. This means you can not remove fat in a specific area using exercise which makes it harder to shape your body.

The only way to remove fat in a specific area is with special medical procedures developed to target fat.

==== Injection Lipolysis ====
This is a relatively cheap and quick option often used for smaller areas, a syringe is used to inject a liquid in the fat layer under skin which disrupts fat cells and allows them to be metabolized by the body. Phosphatidylcholine and deoxycholic acid are the most commonly used solutions for injection lipolysis.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128158/</ref> Aqualyx uses phosphatidylcholine and Kybella uses deoxycholic acid. Can potentially be DIYed.

==== Liposuction ====
Common yet relatively expensive procedure in which a large amount of fat is suctioned out of the body through a cannula (a hollow tube). It requires general, regional or local anesthesia and takes 1-3 hours to complete at a clinic.<ref>https://pubmed.ncbi.nlm.nih.gov/33252626/</ref>

==== Laser Lipo ====
A specific frequency of radiofrequency waves are emitted from a device targeted to fat cells which disrupts their membranes and causes triglycerides to be released and fat cells to gradually get eliminated<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140909/</ref>. This method was originally used as a way to improve the effectiveness of liposuction by applying it through a tube inside the body.<ref>https://cdn.mdedge.com/files/s3fs-public/issues/articles/vol27_i4_Laser-Assisted_Liposuction.pdf</ref> Newer methods involve using pads which can be applied to the surface of the skin and still target subcutaneous fat.

'''Low Level Laser Therapy''' is a subset of laser lipo which uses RF waves with length <650nm. This applies heat and can cause eventual cell death. However certain studies show that this form of lipo causes fat cells to slowly "leak" over time which affects metabolism and may induce overall fat reduction, thus not suitable for the strict goal of targeted fat removal.<ref>https://link.springer.com/article/10.1007/s10103-016-2021-9</ref><ref>https://onlinelibrary.wiley.com/doi/abs/10.1002/lsm.22007</ref><ref>https://erchonia.com.ru/wp-content/uploads/2018/11/BODY-CONTOURING-USING-635NM-LOW-LEVEL-LASER-THERAPY01-nestor_body-contouring-using-635nm-laser_cutaneous-medicine-and-surgery-journal_2013.pdf</ref>

==== Coolsculpting ====
This method involves using cold temperatures applied to the surface of the body above fat deposits, causing fat cells to freeze and die without damaging the skin.

==== Ultrasonic Cavitation ====
A device emits high frequency sound vibrations which are able to disrupt fat cells under skin, effectively making them burst and get metabolized by the body.

All of the above methods show moderate effectiveness for targeted fat removal and the application varies between professional clinic services and at-home devices which work at different power levels. For a comparison of methods see these studies:

https://www.cabidigitallibrary.org/doi/full/10.5555/20123238437

https://onlinelibrary.wiley.com/doi/full/10.1002/lsm.22475

https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.15929

https://it.fillmed.com/uploads/generic_file/bio-skin-gineering._a_novel_method_to_aging_treatment..pdf

Lipolysis

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File:Fat cell turnover.png

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fat_cell_turnover

Exercise and Diet

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[[Category:Body Shape]]

In general it is recommended for trans women to start with HRT with small amounts of fat so that any new fat will grow in a female pattern. Reducing fat by eating at a caloric deficit may be a necessary part of transition for some people.

Weight loss correlated significantly with decreases in the circumference of the waist and hips, and decreases in WHR in men and women. At comparable levels of weight loss, men had greater decreases in the waist, and smaller decreases in the hips than women, resulting in greater decreases in WHR. <ref>https://pubmed.ncbi.nlm.nih.gov/1595579/</ref>

You can also improve the appearance of WHR by doing exercises targeting muscles in the lower body, in particular the glutes and quads.

Guide on lifting for better proportions: https://www.setforset.com/blogs/news/how-to-get-wider-hips-and-improve-waist-to-hip-ratio

Exercise and a good diet is also a crucial component of maintaining higher IGF levels which will increase the rate at which cells grow and cycle over, giving a greater benefit from the effects of HRT.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869853/</ref>

=== Diet ===

==== Weight manipulation ====

===== Maintaining weight =====
Maintaining your weight is as simple as balancing your calorie intake with your calorie expenditure, which depends on factors such as your height, weight and level of physical activity. A rough estimate of your maintenance calories can be calculated online or very roughly by multiplying your body weight in kg by 30.

===== Losing weight =====
To lose weight, you need to keep your calorie expenditure below your calorie intake. One kilogram of adipose tissue contains approximately 7700 kcal. <ref>WISHNOFSKY, M. (1958, September). Caloric Equivalents of Gained or Lost Weight. ''The American Journal of Clinical Nutrition'', ''6''(5), 542–546. <nowiki>https://doi.org/10.1093/ajcn/6.5.542</nowiki></ref> A safe rate of weight loss is around 0.5-1kg per week, which equates to a deficit of 550-1100kcal. Exceeding this rate can lead to symptoms such as fatigue, dizziness, poor immune function and even hair loss. <ref>{{Cite web |title=Is It Bad to Lose Weight Too Quickly? |url=https://www.healthline.com/nutrition/losing-weight-too-fast}}</ref> While losing weight, it is also important to maintain a relatively high protein intake and to exercise regularly to avoid losing muscle mass along with fat tissue. <ref>Vink, R. G., Roumans, N. J. T., Arkenbosch, L. A. J., Mariman, E. C. M., & van Baak, M. A. (2016, January 27). The effect of rate of weight loss on long‐term weight regain in adults with overweight and obesity. ''Obesity'', ''24''(2), 321–327. <nowiki>https://doi.org/10.1002/oby.21346</nowiki></ref><ref>Kreitzman, S., Coxon, A., & Szaz, K. (1992, July). Glycogen storage: illusions of easy weight loss, excessive weight regain, and distortions in estimates of body composition. ''The American Journal of Clinical Nutrition'', ''56''(1), 292S-293S. <nowiki>https://doi.org/10.1093/ajcn/56.1.292s</nowiki></ref>

If long term weight loss is desired, then it so be done so slowly as studies suggest that slower steady weight loss improves long term results. <ref>Atkinson, R., Fuchs, A., Pastors, J., & Saunders, J. (1992, July). Combination of very-low-calorie diet and behavior modification in the treatment of obesity. ''The American Journal of Clinical Nutrition'', ''56''(1), 199S-202S. <nowiki>https://doi.org/10.1093/ajcn/56.1.199s</nowiki></ref><ref>Paisey, R. B., Frost, J., Harvey, P., Paisey, A., Bower, L., Paisey, R. M., Taylor, P., & I. Belka. (2002, April). Five year results of a prospective very low calorie diet or conventional weight loss programme in type 2 diabetes. ''Journal of Human Nutrition and Dietetics'', ''15''(2), 121–127. <nowiki>https://doi.org/10.1046/j.1365-277x.2002.00342.x</nowiki></ref><ref>Feig, E. H., & Lowe, M. R. (2017, August 28). Variability in Weight Change Early in Behavioral Weight Loss Treatment: Theoretical and Clinical Implications. ''Obesity'', ''25''(9), 1509–1515. <nowiki>https://doi.org/10.1002/oby.21925</nowiki></ref>

The two main ways to increase a calorie deficit are to reduce calorie intake and to exercise. While a combination of the two is the preferred way to achieve a calorie deficit, only reducing intake will work, while keeping intake high and adding large amounts of exercise is not advisable.

When trying to lose weight, it is important to monitor progress regularly, as daily weight fluctuations can usually be attributed to water weight or other factors such as bloating. If, after a period of time (e.g. a week), body weight does not decrease by the expected amount, the calorie deficit may need to be adjusted downwards in steps of 150-250 kcal until the desired rate is achieved.

===== Gaining weight =====

==== Macro nutrients ====

===== Protein =====
It's necessary to eat high amounts of protein<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3988204/</ref> to promote healthy tissue regeneration, muscle growth and high IGF, all of which are important for achieving a more feminine body shape.

Protein intake should be at least 0.8g/kg of body weight, but 1g/kg is generally recommended for minimal physical activity.<ref>Wu, G. (2016). Dietary protein intake and human health. ''Food & Function'', ''7''(3), 1251–1265. https://doi.org/10.1039/c5fo01530h</ref> For higher intensity physical activity intake should be at least 1.5g/kg and up to 2.2g/kg is recommended. <ref>Helms, E. R., Zinn, C., Rowlands, D. S., & Brown, S. R. (2014, April). A Systematic Review of Dietary Protein During Caloric Restriction in Resistance Trained Lean Athletes: A Case for Higher Intakes. ''International Journal of Sport Nutrition and Exercise Metabolism'', ''24''(2), 127–138. https://doi.org/10.1123/ijsnem.2013-0054</ref><ref>Morton, R. W., Murphy, K. T., McKellar, S. R., Schoenfeld, B. J., Henselmans, M., Helms, E., Aragon, A. A., Devries, M. C., Banfield, L., Krieger, J. W., & Phillips, S. M. (2017, July 11). A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. ''British Journal of Sports Medicine'', ''52''(6), 376–384. https://doi.org/10.1136/bjsports-2017-097608</ref><ref>Ribeiro, A. S., Nunes, J. P., & Schoenfeld, B. J. (2019, April 26). Should Competitive Bodybuilders Ingest More Protein than Current Evidence-Based Recommendations? ''Sports Medicine'', ''49''(10), 1481–1485. https://doi.org/10.1007/s40279-019-01111-y</ref><ref>Stokes, T., Hector, A., Morton, R., McGlory, C., & Phillips, S. (2018, February 7). Recent Perspectives Regarding the Role of Dietary Protein for the Promotion of Muscle Hypertrophy with Resistance Exercise Training. ''Nutrients'', ''10''(2), 180. https://doi.org/10.3390/nu10020180</ref><ref>Morton, R. W., Murphy, K. T., McKellar, S. R., Schoenfeld, B. J., Henselmans, M., Helms, E., Aragon, A. A., Devries, M. C., Banfield, L., Krieger, J. W., & Phillips, S. M. (2017, July 11). A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. ''British Journal of Sports Medicine'', ''52''(6), 376–384. https://doi.org/10.1136/bjsports-2017-097608</ref><ref>Bandegan, A., Courtney-Martin, G., Rafii, M., Pencharz, P. B., & Lemon, P. W. (2017, February 8). Indicator Amino Acid–Derived Estimate of Dietary Protein Requirement for Male Bodybuilders on a Nontraining Day Is Several-Fold Greater than the Current Recommended Dietary Allowance. ''The Journal of Nutrition'', ''147''(5), 850–857. https://doi.org/10.3945/jn.116.236331</ref>

Increasing protein intake can also contribute to fat loss, even when there is a calorie surplus <ref>Antonio, J., Ellerbroek, A., Silver, T., Orris, S., Scheiner, M., Gonzalez, A., & Peacock, C. A. (2015, October 20). A high protein diet (3.4 g/kg/d) combined with a heavy resistance training program improves body composition in healthy trained men and women – a follow-up investigation. ''Journal of the International Society of Sports Nutrition'', ''12''(1). https://doi.org/10.1186/s12970-015-0100-0</ref><ref>Antonio, J., Ellerbroek, A., Silver, T., Vargas, L., Tamayo, A., Buehn, R., & Peacock, C. A. (2016). A High Protein Diet Has No Harmful Effects: A One-Year Crossover Study in Resistance-Trained Males. ''Journal of Nutrition and Metabolism'', ''2016'', 1–5. https://doi.org/10.1155/2016/9104792</ref><ref>Antonio, J., Peacock, C. A., Ellerbroek, A., Fromhoff, B., & Silver, T. (2014, August 15). The effects of consuming a high protein diet (4.4 g/kg/d) on body composition in resistance-trained individuals. ''Journal of the International Society of Sports Nutrition'', ''11''(1). https://doi.org/10.1186/1550-2783-11-19</ref>, due to the thermic effect of protein, which means that proteins contribute 15-30% less to the effective calories for the body's metabolism compared to fats. <ref>Pesta, D. H., & Samuel, V. T. (2014). A high-protein diet for reducing body fat: mechanisms and possible caveats. ''Nutrition & Metabolism'', ''11''(1), 53. https://doi.org/10.1186/1743-7075-11-53</ref>

Protein consumption should be optimally distributed throughout the day, ideally over up to four meals, to optimise utilisation for anabolic processes such as muscle building <ref>Schoenfeld, B. J., & Aragon, A. A. (2018, January 5). How much protein can the body use in a single meal for muscle-building? Implications for daily protein distribution. ''Journal of the International Society of Sports Nutrition'', ''15''(1). https://doi.org/10.1186/s12970-018-0215-1</ref>. Any excess protein will be used as energy in the metabolism and therefore cannot contribute to tissue growth.

===== Carbohydrates =====

===== Fat =====
<references />

Weight Loss Guide

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A good weight loss strategy should include dietary, behavioral and psychological changes to your daily life and habits.

The amount of fat you store is determined by the amount of food you ingest and your metabolism (the way your body uses the energy in the food). The energy in food can be measured in calories and the amount required to perform basic life-sustaining functions is considered your base metabolic rate (BMR).

https://onlinelibrary.wiley.com/doi/full/10.1111/joim.13435

Metabolic rate is affected by a variety of genetic and environmental factors. It can be increased with exercise such as cardio and resistance training.

Catabolic State

Calorie Deficit

Insulin Sensitivity

Exercises

Weight Loss Guide

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https://onlinelibrary.wiley.com/doi/full/10.1111/joim.13435

Main Page

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= estrogen.fyi =
'''''"the transfeminine encyclopedia"'''''

This site serves to provide an open source of knowledge, guides, and resources on transition and self-care for transfeminine individuals.

{{Infobox}}
<div class='infobox'>
<table class="wikitable">
<tr><th><h3>Categories</h3></th></tr>

<tr><td><categorytree mode="pages">Skin Care</categorytree></td></tr>
<tr><td><categorytree mode="pages">Hair Care</categorytree></td></tr>
<tr><td><categorytree mode="pages">Voice</categorytree></td></tr>
<tr><td><categorytree mode="pages">Body Shape</categorytree></td></tr>
<tr><td><categorytree mode="pages">Clothing</categorytree></td></tr>
<tr><td><categorytree mode="pages">Cosmetics</categorytree></td></tr>
</table>
</div>

== Before you read: ==

* Be sure to read the [[estrogen.fyi:General_disclaimer|disclaimer]].
* Remember that the wiki is a living document - nothing is final.
* To contribute, [[Special:CreateAccount|register for an account]] and read the [[Contribution Guidelines|contribution guidelines]].
* On some pages, changes must be approved by an editor before they are displayed by default.
* If you see a mistake, or want to improve a page, please submit an edit.
* Remember to cite your sources!

Estrogen Conversion and Receptors

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[[category:medical]]

The main feminizing effects of estrogen depend on sex-hormone receptors being present in cells and hormone molecules being free to bind to them to affect gene expression. Since sex-hormones also regulate receptor expression<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9934771/</ref>, increasing the amount of receptors or hormone available for binding is thus a desirable goal for feminizing HRT.<ref>https://springerplus.springeropen.com/articles/10.1186/2193-1801-2-214</ref>

Estradiol has a pathway of being synthesized from testosterone in the body through an enzyme called aromatase which allows for certain levels of testosterone to circulate and still be converted to estrogen.<ref>https://www.ncbi.nlm.nih.gov/books/NBK278933/</ref>

[[File:Hormone conversions.png|frameless|400x400px]][[File:Aromatase Conversion.jpg|frameless|480x480px]]

This conversion of sex-hormones has an important effect on sites such as the breasts, fat, bones and brain which are affected by local synthesis of estradiol acting directly on the tissues<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519084/</ref>.<ref>https://academic.oup.com/endo/article/142/11/4589/2988522?login=false</ref> <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286233/</ref>

Estrogen Conversion and Receptors

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The main feminizing effects of estrogen depend on sex-hormone receptors being present in cells and hormone molecules being free to bind to them to affect gene expression. Since sex-hormones also regulate receptor expression<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9934771/</ref>, increasing the amount of receptors or hormone available for binding is thus a desirable goal for feminizing HRT.<ref>https://springerplus.springeropen.com/articles/10.1186/2193-1801-2-214</ref>

Estradiol has a pathway of being synthesized from testosterone in the body through an enzyme called aromatase which allows for certain levels of testosterone to circulate and still be converted to estrogen.<ref>https://www.ncbi.nlm.nih.gov/books/NBK278933/</ref>

[[File:Hormone conversions.png|frameless|400x400px]][[File:Aromatase Conversion.jpg|frameless|480x480px]]

This conversion of sex-hormones has an important effect on sites such as the breasts, fat, bones and brain which are affected by local synthesis of estradiol acting directly on the tissues<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519084/</ref>.<ref>https://academic.oup.com/endo/article/142/11/4589/2988522?login=false</ref> <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286233/</ref>

Estrogen Conversion and Receptors

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File:Aromatase Conversion.jpg

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Aromatase Conversion

File:Hormone conversions.png

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Hormone conversions

Category:Medical

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= Medical Transition Pages =
All people have both estrogen and testosterone (as well as other sex hormones) naturally occurring in their body and it is the levels of those hormones which cause the difference we see between male and female development. The blueprint for development is encoded on the autosomal (non-sex) chromosomes and parts of it are activated or deactivated based on the effects of hormones. Transitioning with the use of hormone replacement therapy (HRT) acts on the tissues in your body and transforms your phenotype<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533072/</ref>: Sex hormones bind to sex hormone receptors in various cells and then translocate into the cell nucleus. In the nucleus, a ligand-bound sex hormone receptor acts a transcription factor by binding to the promoter region of genes containing a hormone responsive element (HRE), leading to regulation of gene expression.<ref>[https://pubmed.ncbi.nlm.nih.gov/16273365/#:~:text=Nuclear%20sex%20hormone%20receptors%20are,the%20expression%20of%20target%20genes. https://pubmed.ncbi.nlm.nih.gov/16273365/#:~:text=Nuclear%20sex%20hormone%20receptors%20are,the%20expression%20of%20target%20genes.]</ref>
[[File:Transcriptional network of steroid hormone receptors.png|center|thumb|[https://www.nature.com/articles/aps2014123 Transcriptional network of hormone receptors]]]
The human body regulates levels of sex hormones using hypothalamic-pituitary-gonadal axis (HPG axis is the endo term used). The axis controls development, reproduction, and aging in animals. Gonadotropin-releasing hormone (GnRH) is secreted from the hypothalamus by GnRH-expressing neurons. The anterior portion of the pituitary gland produces luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and the gonads produce estrogen and testosterone.
[[File:HPG axis.png|center|thumb|[https://www.intechopen.com/chapters/75387 HPG Axis]]]
Modern HRT utilizes "bioidentical" medication which means it has the same chemical structure as the endogenous hormones which your body naturally produces. Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts.<ref>https://www.tandfonline.com/doi/abs/10.3810/pgm.2009.01.1949</ref>

=== Medical Guidelines ===
'''The Journal of Clinical Endocrinology & Metabolism:''' [https://academic.oup.com/jcem/article/102/11/3869/4157558 Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline.]

'''World Professional Association for Transgender Health:''' [https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644 Standards of Care for the Health of Transgender and Gender Diverse People, Version 8]

Please note that the WPATH is a standard used by many healthcare providers including public health services and health insurance companies with policies for covered trans treatments. As of September 2022 the release of SOC 8 includes the following: AMAB: facial feminization surgery (including chondrolaryngoplasty/vocal cord surgery), gender-affirming breast surgery, body contouring procedures, orchiectomy, vagino/vulvoplasty (with/without depth), aesthetic procedures, and procedures designed to prepare individuals for surgery (i.e., hair removal).

For other detailed information, this is currently the best source on transfem hormone therapy: https://transfemscience.org/articles/transfem-intro/

Category:Medical

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= Medical Transition Pages =
All people have both estrogen and testosterone (as well as other sex hormones) naturally occurring in their body and it is the levels of those hormones which cause the difference we see between male and female development. The blueprint for development including is encoded on the autosomal (non-sex) chromosomes and parts of it are activated or deactivated based on the effects of hormones. Transitioning with the use of hormone replacement therapy (HRT) acts on the tissues in your body and transforms your phenotype<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533072/</ref>: Sex hormones bind to sex hormone receptors in various cells and then translocate into the cell nucleus. In the nucleus, a ligand-bound sex hormone receptor acts a transcription factor by binding to the promoter region of genes containing a hormone responsive element (HRE), leading to regulation of gene expression.<ref>[https://pubmed.ncbi.nlm.nih.gov/16273365/#:~:text=Nuclear%20sex%20hormone%20receptors%20are,the%20expression%20of%20target%20genes. https://pubmed.ncbi.nlm.nih.gov/16273365/#:~:text=Nuclear%20sex%20hormone%20receptors%20are,the%20expression%20of%20target%20genes.]</ref>
[[File:Transcriptional network of steroid hormone receptors.png|center|thumb|[https://www.nature.com/articles/aps2014123 Transcriptional network of hormone receptors]]]
The human body regulates levels of sex hormones using hypothalamic-pituitary-gonadal axis (HPG axis is the endo term used). The axis controls development, reproduction, and aging in animals. Gonadotropin-releasing hormone (GnRH) is secreted from the hypothalamus by GnRH-expressing neurons. The anterior portion of the pituitary gland produces luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and the gonads produce estrogen and testosterone.
[[File:HPG axis.png|center|thumb|[https://www.intechopen.com/chapters/75387 HPG Axis]]]
Modern HRT utilizes "bioidentical" medication which means it has the same chemical structure as the endogenous hormones which your body naturally produces. Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts.<ref>https://www.tandfonline.com/doi/abs/10.3810/pgm.2009.01.1949</ref>

=== Medical Guidelines ===
'''The Journal of Clinical Endocrinology & Metabolism:''' [https://academic.oup.com/jcem/article/102/11/3869/4157558 Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline.]

'''World Professional Association for Transgender Health:''' [https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644 Standards of Care for the Health of Transgender and Gender Diverse People, Version 8]

Please note that the WPATH is a standard used by many healthcare providers including public health services and health insurance companies with policies for covered trans treatments. As of September 2022 the release of SOC 8 includes the following: AMAB: facial feminization surgery (including chondrolaryngoplasty/vocal cord surgery), gender-affirming breast surgery, body contouring procedures, orchiectomy, vagino/vulvoplasty (with/without depth), aesthetic procedures, and procedures designed to prepare individuals for surgery (i.e., hair removal).

For other detailed information, this is currently the best source on transfem hormone therapy: https://transfemscience.org/articles/transfem-intro/

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At home manicure

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[[Category:Procedures]]

[https://www.theaestheticsociety.org/ The Aesthetic Society] - organization for compiling and publishing stats by plastic surgeons

=== Dermal Fillers ===
Fillers are special substances usually injected into the dermis to restore lost volume, smooth lines, soften creases, and enhance facial contours. They differ in chemical makeup, firmness and longevity with some being more short term (~1 year) some intermediate (1-2 years with smaller permanent effect) <ref>https://www.routledge.com/Illustrated-Manual-of-Injectable-Fillers/Sadick/p/book/9781138733954</ref>

Short: Hylauronic acid (short term, Juvaderm, Restylane, Elevess, Pervelle, Perlane, Hylaform, Captique, etc), Collagen (short term, Zyderm, Zyplast, CosmoDerm, CosmoPlast)

Intermediate: Calcium Hydroxylapatite (Radiesse), Poly-L-lactic Acid (intermediate, Sculptra)

Permanent: ArteFill, Silicone (Adatosil, Silikon)

[https://www.youtube.com/watch?v=Yt7XtFO0Q5Y Injection Techniques: Best Angles, Depths, How To Aspirate & Stabilise]

'''[https://academic.oup.com/asjopenforum/article/3/4/ojab034/6374028 High Yield Injection Targets and Danger Zones for Facial Filler Injection]'''

=== Botox Injections ===
Blocks presynaptic acetylcholine release from motor neuron resulting in neuromuscular block. FDA Approval- 2002 Frown Lines Between Eyebrows, 2013 Crow’s Feet Lines, 2017 Forehead Lines.

Transient and reversible effect within 3-4 days. Maximum result in 10-14 days. Recall for potential dose adjustment at 2 week check up. Repeat injections 4 times in first year, every 3 months. 3 times in second year and beyond.

Detailed info on botox https://www.eandslounge.com/detailed-information-on-botox

=== Fat Dissolvers ===
Phosphatidylcholine and deoxycholic acid are the most commonly used solutions for injection lipolysis. As we stand today, sodium deoxycholate preparation is approved by the US Food and Drug Administration for the same<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128158/</ref>

Aqualyx uses phosphatidylcholine and Kybella uses deoxycholic acid

[[File:Fat-dissolve.png|frameless|500x500px]]

Fillers, Dissolvers and Botox

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[[Category:Procedures]]

[https://www.theaestheticsociety.org/ The Aesthetic Society] - organization for compiling and publishing stats by plastic surgeons

=== Dermal Fillers ===
Fillers are special substances usually injected into the dermis to restore lost volume, smooth lines, soften creases, and enhance facial contours. They differ in chemical makeup, firmness and longevity with some being more short term (~1 year) some intermediate (1-2 years with smaller permanent effect) <ref>https://www.routledge.com/Illustrated-Manual-of-Injectable-Fillers/Sadick/p/book/9781138733954</ref>

Short: Hylauronic acid (short term, Juvaderm, Restylane, Elevess, Pervelle, Perlane, Hylaform, Captique, etc), Collagen (short term, Zyderm, Zyplast, CosmoDerm, CosmoPlast)

Intermediate: Calcium Hydroxylapatite (Radiesse), Poly-L-lactic Acid (intermediate, Sculptra)

Permanent: ArteFill, Silicone (Adatosil, Silikon)

=== Botox Injections ===
Blocks presynaptic acetylcholine release from motor neuron resulting in neuromuscular block. FDA Approval- 2002 Frown Lines Between Eyebrows, 2013 Crow’s Feet Lines, 2017 Forehead Lines.

Transient and reversible effect within 3-4 days. Maximum result in 10-14 days. Recall for potential dose adjustment at 2 week check up. Repeat injections 4 times in first year, every 3 months. 3 times in second year and beyond.

Detailed info on botox https://www.eandslounge.com/detailed-information-on-botox

=== Fat Dissolvers ===
Phosphatidylcholine and deoxycholic acid are the most commonly used solutions for injection lipolysis. As we stand today, sodium deoxycholate preparation is approved by the US Food and Drug Administration for the same<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128158/</ref>

Aqualyx uses phosphatidylcholine and Kybella uses deoxycholic acid

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2024-01-17T05:59:42Z

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