Jaw Reshaping

Facial Feminization vs. Facial Masculinization

Medically reviewed by Tuan A. Tran, M.D., M.B.A., F.A.C.S. | Written by Nhuhao Do on May 19th, 2021

Overview

Jaw reshaping surgery is a combination of multiple surgical techniques used to reconstruct and feminize or masculinize the lower third of the face. Often, the masculine jawline is more square, sharper, and flatter at the base; while feminine jawline is typically more tapered, round at the edges and the chin is more pointed. In facial feminization surgery, jaw reshaping involves mandibular angle and body reduction as well as chin reduction to narrow the overall width of the face shape and achieve subtle refinement of the jawline. On the contrary, jaw reshaping in facial masculinization involves augmentation of the mandibular angle, mandibular body and the chin. Augmentation can be done surgically or non-surgically with fat grafting and dermal filler. The results will look natural and provide balance and harmony to facial proportions to achieve the goals of facial gender confirmation.

Who is a good candidate?

A good candidate for jaw reshaping is a healthy adult with realistic expectations of what the procedure can help them achieve along with understanding the potential risks. While undergoing facial gender confirmation surgery, jaw reshaping can play an important component to achieving the desired feminine or masculine appearance.

Procedure in Detail

Looking at jaw reshaping in more detail. This procedure is broken down under two main categories, facial feminization and facial masculinization, for better understanding and clarity.

Facial Feminization

Mandibular Angle Reduction: this procedure can be done through a small incision made inside the mouth to allow access to shave the mandibular angle and smooth out bony edges. In patient with more prominent square shape jawline, reduction angleplasty can be performed to effectively remove a small part of the bony edge off from the jawline. The results of this technique alone are most noticeable from the profile view.

Mandibular Body Reduction: involves shaving of the jaw. If you and Dr. Tran decided that it is needed, further mandibular corticectomy can be done to resects the outer cortex of the mandible, giving the jaw a more noticeable contour from the frontal view.

Genioplasty (Chin Reduction): Dr. Tran will shave and reduce the width of the chin, making the lower third of the face appear more slender. In some cases, a small chin implant can be placed to make the chin more pointed to resemble an oval or heart shape face.

Facial Masculinization

Mandibular angle augmentation: there are multiple methods to jaw angle augmentation. A permanent technique is through implant that comes in a variety of shapes to best fit and contour the jaw angle. Other effective non-surgical techniques are fat transfer and dermal filler.

Mandibular and chin augmentation: to achieve a strong and chiseled jawline, dermal filler or fat transfer can be injected to the chin and jawline to instantly increase the width and edges of the jaw. Permanent plant can also be placed only on the chin (genioplasty) or a mandibular implant can be used to provide subtle augmentation to the posterior and anterior chin.

Recovery

Healing time of jaw reshaping is varied in each patient and varied with the invasiveness of each procedure. Since most of the incisions are made inside the mouth, visible scarring is often not an issue in this procedure. An overview of recovery period for each procedure can be examined bellow in the order of least downtime to most downtime for comparison purposes. However, it is best to discuss with Dr. Tran and his team for more personal recommendation and in-depth post-op instructions.

HA Dermal Filler – patient may resume daily routines immediately after the procedure. Result can be seen immediately and can last for up to 2 years.
Fat Transfer – recovery time will vary depending on the area of liposuction. Generally, patient may return to work after 2 weeks and gradually resume their daily activities. Patients should see the final results after about 6 months.
Facial Silicone Implant – patient may return to work and light activities within a week but need to avoid strenuous activities for 4-6 weeks. Full recovery and optimal facial improvement take 3-4 months to set in.
Jaw reduction (angleplasty, mandibular corticectomy, genioplasty) – most people are able to return to work after 2 weeks while complete healing can take up to 12 months.

Result

In facial feminization, jaw reshaping will help reduce squareness in the jawline, turning it to a V-shape. The overall lower third of the face will be more slender, attractive and harmonious to fit the feminine features,

The results of jaw reshaping in facial masculinization is a stronger structured jaw angle and a chiseled jawline.

Cost and Consultation

Many major medical insurances, including CalOptima, cover for jaw reshaping as part of facial gender affirming surgery. If you have more questions or would like to schedule a free consultation with Dr. Tran, please contact us via our website, Tran Plastic mobile app or call us today at 714-839-8000 to speak with one of our friendly staff.

References 

Bettens, R., Mommaerts, M., & Sykes, J. (2002). Aesthetic malar recontouring: the zygomatic sandwich osteotomy. Facial Plastic Surgery Clinics of North America, 10(2002), 265-277.

Deguchi, M., Iio, Y., Kobayashi, K., & Shirakabe, T. (1996, Mar 12). Angle-splitting ostectomy for reducing the width of the lower face. Osaka Shirakabe Institue.

Implantech. (n.d.). Flowers mandibular glove. Implantech Superior Patient Aesthetics. Retrieved from https://www.implantech.com/product/flowers-mandibular-glove/

Jin, H. & Kim, B. G. (2003, June 2). Mandibular angle reduction versus mandible reduction. BK Plastic Surgery Clinic.

Li, J., Hsu, Y., Khadka, A., Hu, J., Wang, D., & Wang, Q. (2010, November 1). Contouring of a square jaw on a short face by narrowing and sliding genioplasty combined with mandibular outer cortex ostectomy in Orientals.. American Society of Plastic Surgeons.