Facial feminization surgery / Jaw and chin
Jaw and Chin Contouring
The jaw and chin are among the areas that change the most in facial feminization surgery. Mandible contouring narrows and softens the angles and lower border of the jaw, and genioplasty reshapes the chin bone to change its width, height, or projection. Both are done through incisions inside the mouth.
Overview
Narrowing and softening the lower face
A wide, square jaw and a broad or long chin give the lower face a masculine shape, and they are features that hormones do not change, because they are bone. Jaw and chin contouring reshape that bone so the lower face tapers from the ears toward a rounder, smaller chin.
Like the forehead work, this is craniofacial surgery. The bone is reshaped directly, so the change is permanent, and it is planned on a CT scan so that the nerves and the roots of the teeth that run through the jaw are respected.
Dashed: a wide, square jaw and chin. Gold: the tapered jawline and rounded chin after contouring.
Jaw
Mandible contouring
The lower jaw, the mandible, is contoured along its angles and its lower border.
The angles of the jaw
Behind and below the ear
A square, flared angle at the back of the jaw widens the lower face. The angle is contoured by removing bone along its edge so the jawline tapers rather than turns a corner.
The lower border
The line of the jaw
The lower border of the jaw is contoured from the angle toward the chin to narrow and soften the lower face. The amount removed is planned so the jawline stays smooth from one end to the other.
The masseter muscle
Soft tissue, not bone
Some of the width at the angle of the jaw comes from the chewing muscle rather than the bone. Dr. Ovadia assesses how much of the width is muscle and how much is bone, because they are addressed differently.
From the inside
Where the incisions are
Jaw contouring is done through incisions inside the mouth, along the lower gum line, so there are no visible scars on the face or neck.
Chin
Genioplasty
Genioplasty reshapes the chin bone to change its width, its height, or its projection, alone or in combination.
Width
A broad, square chin is narrowed. The chin bone is reshaped so the front of the chin is rounder and tapers toward a point rather than finishing in a flat edge.
Height
A long chin lengthens the whole lower face. In a genioplasty the chin bone is cut, a measured segment can be removed, and the chin is fixed in its new, shorter position.
Projection
How far the chin sits forward or back is adjusted by moving the cut segment of bone. A chin that is set too far forward is brought back; one that is set back is brought forward.
Genioplasty, not an implant
Genioplasty changes the shape of the bone itself, which makes it possible to reduce the chin as well as to move it. A chin implant can only add. For most facial feminization patients the goal is reduction and reshaping, which is why the bone is moved rather than covered.
Which of these your surgical plan includes depends on your anatomy and your goals. Dr. Ovadia goes over the jaw and chin together, because the two set the shape of the lower face as a pair.
Recovery
What to expect afterward
Recovery follows the same course as the rest of facial feminization surgery, with a few points that are specific to the jaw and chin. The full guide is on the recovery page.
Swelling in the lower face
Swelling is normal and expected, and the lower face and neck swell noticeably in the first weeks. As a general guide, about half settles by 6 weeks and the rest by 6 months. Everyone is different, and this is only a rough guide.
Numbness of the lip and chin
Temporary numbness is common after jaw and chin surgery, because the nerve that supplies the lower lip and chin runs through the jaw. It comes from the nerve being stretched during the operation, and it improves over time. Permanent numbness is very uncommon.
Eating and the mouth
With incisions inside the mouth, a soft diet and gentle rinsing after meals are part of the first weeks of recovery. Dr. Ovadia's team goes over exactly what to eat and how to keep the mouth clean.
Compression and sleeping position
A facial compression garment is an important part of recovery, and sleeping with the head of the bed elevated helps limit swelling, especially early on.
Normal swelling comes on slowly. A rapid increase in swelling is something to watch for, and it should be brought to your physician's attention right away. See the recovery after FFS page for the timeline and the rest of the guide.
Your surgeon
Reshaping the jaw is skeletal surgery
Contouring the mandible and moving the chin are operations on the facial skeleton, with the nerve to the lower lip and the roots of the teeth running through the bone being worked on. That is craniofacial surgery, and Dr. Ovadia completed a fellowship in craniofacial and pediatric plastic surgery at UT Austin and Dell Children's Hospital, and a fellowship in gender-affirming surgery at Johns Hopkins.
He is board certified by the American Board of Plastic Surgery and sees patients in New York City and in Jersey City and Millburn, New Jersey. Read more on the facial feminization surgery page.
Questions
Common questions about jaw and chin contouring
What is jaw contouring?
Jaw contouring, or mandible contouring, reshapes the lower jaw to narrow and soften the lower face. The angles of the jaw, behind and below the ear, and the lower border of the jaw are contoured by removing bone along their edges. It is done through incisions inside the mouth, so there are no visible scars.
What is genioplasty?
Genioplasty reshapes the chin bone itself. The bone is cut, a segment can be removed, and the chin is moved and fixed in a new position. That makes it possible to change the chin's width, its height, and how far forward or back it sits, in one procedure. Unlike a chin implant, it can make the chin smaller.
Will there be visible scars?
No. Jaw contouring and genioplasty are both done through incisions inside the mouth, along the lower gum line.
Will my lower lip and chin be numb afterward?
Temporary numbness of the lower lip and chin is common, because the nerve that supplies them runs through the jaw and is stretched during the operation. It improves over time, and permanent numbness is very uncommon.
Can the jaw and chin be done with the rest of facial feminization surgery?
Yes. Jaw and chin contouring are often done in the same operation as the forehead work and rhinoplasty. Some patients choose instead to do the upper face first and the lower face at a later stage. Dr. Ovadia plans the staging with you.
How long until I see the result?
The lower face swells noticeably at first and the new shape shows through gradually. As a general guide, about half of the swelling settles by 6 weeks and the rest by 6 months. Normal swelling comes on slowly. A rapid increase in swelling should be brought to your physician's attention right away.
Next step
Start with a consultation
Dr. Ovadia will examine your jaw and chin, review your CT scan, and explain which changes to the bone make sense for you and how they fit with the rest of your plan.
225 Broadway, Suite 3100, New York, NY
377 Jersey Ave, Suite 440, Jersey City, NJ · 90 Millburn Ave, Suite 206, Millburn, NJ
Phone and video consultations available · info@ovadiaps.com