Facial Feminization – Jaw

The shape of the jaw can have a significant influence on the overall impression of the femininity or masculinity of the face.

It’s one of the areas that commonly comes into question, often viewed in combination with the chin.

What is Facial Feminization Surgery of the jaw?

Jaw width is determined by different facial structures: the skin, subcutaneous tissue, adipose tissue, musculature and bone.

During jaw FFS, we decrease mandibular width and volume with different techniques on the bone, such as shaving, also known as contouring, and osteotomies.

Why is FT a pioneer in Facial Gender Affirming Surgery for the jaw?

Facialteam prides itself for excellence in FFS surgery in general, and FFS jaw surgery in particular. The team is active not only in researching relevant aspects of jaw surgery, with scientific publications in the field. They are also known for technological advancements such as the employment of ultrasonic instrumentology and development of 3D technologies to create personalized osteotomy templates (cutting guides) for a more precise and, therefore, more predictable outcome.

Our priority is to always achieve natural looking results and deliver the highest quality of care and results possible, totally personalised to each and every patient. This approach means our rate of satisfaction with the results is very high, and people from all over the world trust in us for this life-changing process.

Gender differences of the jaw

The male jaw has a set of characteristics that may influence our perception of facial gender. It is easier to understand if we separate our perception of the jaw into two areas: the mandibular angle and the mandibular body.

The mandibular angle

In men, the angle of the jaw is usually more square-shaped. It commonly presents well-defined, sharp corners.

This is stereotypically perceived as masculine traits in the lower facial third, although it is true that many attractive cis female faces also contain these characteristics without reading masculine.

The mandibular body

The male mandibular body typically has a greater volume of bone and outward flare than it’s feminine counterpart.
In addition, the transition between the lower jaw and chin is another key area that must also be dealt with in some facial feminization cases. This area generally corresponds with the point where the mentonian nerves emerge, meaning it must be handled with great care.

Objectives of Jaw Feminization

As mentioned, the jaw line is sometimes perceived to be a key difference between typically masculine and feminine faces. Therefore, the objective of jaw feminization surgery is to give the jaw a softer, rounded and more feminine appearance.

Having facial features that are typically associated with one’s gender identity can make a huge difference to the life of a trans woman. They may feel more in consonance with their own appearance, so gain in self-esteem. Also, they may be misgendered less by others as a result, allowing them to feel more confident in social situations and at work.

How is a Jaw Feminization performed?

Jaw recontouring decreases the bone volume (width), improves and softens the jawline and decreases the jaw height, when necessary, using bone sculpture (high-revolution burring) and osteotomies (removal of excess bone segments).

For patients who require jaw recontouring from the angle area to the chin, Facialteam has developed a triple approach technique. The areas addressed include the length of the body of the jaw as well as the transition between the jaw and chin.

With this technique, the entire jaw surface can be approached via three small incisions inside the mouth. This prevents major scarring, protects the mentonian nerves (responsible for sensation in the jaw and lips) and accelerates post op recovery for a quickerreturn to normal life.

Certain areas are complicated when it comes to getting good visibility of the specific parts of the jaw being addressed (for example, in the rearmost part of the mandibular angle). Facialteam surgeons employ endoscopic methods to improve their view and control of the surgical procedures.

Osteotomies in lower jaw and chin feminization are executed with latest generation ultrasound technology. This allows the surgeons to make highly precise bone cuts without damaging the adjacent tissue (nerves, blood vessels, muscles).

Lower jaw feminization techniques should not affect the teeth nor the “bite” (occlusion).

Post-op and Results: What to expect after a Jaw Feminization

After your jaw reduction surgery, you will be on your feet and able to return to the comfort of your own accommodations within just a few days.

After a few weeks, once the bruising has diminished, you should be able to resume your normal routines. We do ask that you wait at least six weeks for any high intensity activities.

Things will continue to settle and improve over the following months, You may request a final assessment after the surgery.

Throughout the course of the year, our post-op department is always on hand to assist and answer any questions.

Paired FFS procedures

It is very common for a jaw feminization procedure to be paired with a chin feminization procedure.

This is because at Facialteam we take a holistic approach to surgery and often combine procedures to help maximise the feminizing effect and minimise trauma and scarring typical of multiple interventions.

In this case, the jaw and chin procedures are both performed via the same small incisions inside the mouth that will be totally invisible after surgery.

FFS and aesthetic procedures

For patients with masseter hypertrophy (excessive development of the musculature due to hyperfunction), treatment with several botulinum toxin infiltrations can atrophy the muscles and partially reduce the mandibular volume.

The first botox application is done during facial feminization surgery. Following sessions can be done locally, where you live, or during one of your check-up consultations (when appropriate).

In the event additional volumes in the cheeks are desireable, facial lipofeminization (FLF) may also be recommended to rejuvenate sunken areas as well as deep lines and wrinkles.



If you are interested in learning more about the lower jaw and chin recontouring tecnniques, please read our chapter on Facial Gender Confirmation Surgery in the most definitive book on transgender healthcare to date:

Facial Feminization Surgery: A Global Approach

By Luis Capitán and Daniel Simón

In: Gender Affirmation: Medical and Surgical Perspectives

Editors: Salgado, Monstrey, Djordjevic
Thieme Medical Publisher, Inc.
November 2016