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Video

Facial Plastic and Reconstructive Surgery

(A417) Facial Feminization Surgery: A Google Analytics Study

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • ES

    Erika Shock, BS

    University of Missouri School of Medicine, United States

  • Kevin B. Xiao, MD

    Resident Physician
    University of Missouri, Department of Otolaryngology--Head and Neck Surgery
    Columbia, Missouri, United States

    • Senior Author(s)

  • C.W. David Chang, MD

    Professor
    University of Missouri, Department of Otolaryngology--Head and Neck Surgery
    Columbia, MO, United States

Disclosure(s):
Kevin B. Xiao, MD: No relevant relationships to disclose.
C.W. David Chang, MD: No relevant relationships to disclose.


Introduction: Facial feminization surgeries (FFS) have become increasingly more popular in recent years. There is a gap in the literature examining information-seeking behaviors of those considering facial-feminization surgery (FFS). This study aims to identify the most frequently asked online questions and assess reliability of online sources of information for FFS to better address patient concerns.

Methods: A Google search engine observational study was performed using a search engine optimization keyword research tool and the “People Also Ask” (PAA) feature for the search term “facial feminization surgery.” The top 50 PAA questions were extracted and grouped based on similar questions and then classified categorically based on fact, policy, or value-based questions using Rothwell’s classification of questions. The top 50 websites under the search term were categorized by type of information source. Reliability of information was assessed with the modified DISCERN criteria scored 1 to 5 from less to more reliable.

Results: PAA questions were most often fact-based regarding cost (58%) and technical details (24%), followed by policy-based including the indications (12%) for FFS. Sourced websites were most commonly from 15 (30%) academic medical institutions followed by 13 (26%) single-medical providers. On average, reliability of information was fair (3.2+/-1.4). Medical journals had significantly more reliable information (5.0+/-0.0) than non-academic medical single providers (2.8+/-1.1, p=0.02) and non-academic medical groups (2.9+/-0.7, p=0.001). Information reliability from academic medical institutions (3.2+/-1.1) did not differ significantly from other sources.

Conclusions: The most searched questions were regarding cost, technical details, and insurance coverage of FFS. Reliability of information was fair overall with medical journals being most reliable overall. However, there is large variability in the quality of consumer information. This study highlights information that patients seek related to FFS and the need for improving available information online.