Jaw & Chin Feminization Surgery with JAWContour®

With over 2000 jaw and chin procedures performed since 2008, JAWContour® is the state of the art in jaw and chin feminization surgery.

Jaw Feminization Surgery, often referred to as Jaw FFS, is an umbrella term for those procedures involved in modifying the size of the mandibular body, to have a more feminine appearance. With feminization of the jaw we decrease the mandibular height and volume with different techniques on the bone.

Chin Feminization Surgery, also known as Chin FFS, refers to the various types of chin procedures that can make changes to the position, format and volume of the chin.

Chinplasty, contouring or sliding genioplasty are examples of techniques which modify the gender markers of the chin. The features of the chin can be harmonized on several planes, all of them give the face a more typically feminine appearance:

  • height;
  • width;
  • projection.

With over 2000 jaw and chin procedures performed since 2008, Facialteam equals excellence in jaw and chin feminization surgery. Yet we do not stop in the operating theater – our academic research team continually generates scientific publications in the field of facial gender affirming surgery.

Your jaw and chin feminization surgeons at Facialteam take a comprehensive care approach to every case, where your gender identity is respected. Our philosophy is designed on core pillars to provide the best gender-affirming experience: personalized assessments, quality of care services at every stage and natural looking results. Your satisfaction and safety is a top priority, which means rigorous quality control is a routine, inside and outside of the operating room.

Am I a good Candidate for Jaw and Chin Feminization Surgery?

Both cisgender and trans or gender nonconforming people who wish to modify the width, angularity and volumes of the jaw and/or chin, often for more harmonious and feminine facial features, are candidates for FFS with JAWContour®.  Jaw and chin gender affirmation is for anyone who wants to feel more confident in themselves, as well as how their gender identity is perceived by others.


Our JAWContour® method is indicated for a diversity of genders seeking to soften the masculine or excess bone structure of the lower facial third.

Objectives

The jaw and chin may influence how a face is unconsciously gendered, be it masculine, feminine or androgynous. The main objectives of Jaw Feminization Surgery are, when necessary:

  • create smaller mandibular angles with a height reduction;
  • narrow the width of the lower jaw at the rear angle and/or the widening “flare” along the length of the jaw bone;
  • modify the shape of the jaw for a more feminine or harmonious format.

Chin Feminization Surgery aims to give the face a more feminine appearance, whilst still looking natural. The changes will vary depending on the patient’s anatomical characteristics and the desired results. A well-defined chin with balanced projection can improve the overall aesthetics of the lower jaw-chin region.

What is involved in Jaw and Chin Feminization Surgery with JAWContour®?

JAWContour®, backed by over 14 years of experience and more than 2000 jaw and chin surgeries performed, offers minimally invasive options with millimetrical accuracy. Its 3D pre-planning and ultrasonic techniques have been supported with scientific evidence published by our research group.

Key technological highlights include:

  • 3D Photography: Utilizes VECTRA® H1 technology for high-resolution, multi-positional facial scans, crucial for precise diagnosis.
  • 3D CT Scans: Before consultations, we perform detailed three-dimensional reconstructions to study the frontonasoorbital complex, tailoring our approach to individual anatomical structures.
  • Ultrasonic Surgical Instruments: The piezoelectric scalpel allows for clean cuts in bones, ensuring precision, minimal tissue damage, and reduced postoperative complications.

JAWContour® – Procedures and Techniques

With over 14 years of experience, our methodology, backed by the outcomes of over 2000 successful procedures since 2008, has been recognized and acclaimed in renowned scientific journals.

Planning Phase

  • Initial Assessment and Imaging: A 3D CT scan is conducted, offering a comprehensive visualization of the facial structure.
  • Surgical Planning: Using specialized software, we evaluate the facial structure to determine the personalized contouring needed for each area.
  • Creation of Surgical Guide: Based on the data collected, an anatomically precise 3D surgical guide is generated. This guide, permits us to offer mandibular and chin feminization surgery with millimetrical accuracy, while respecting nerves trajectory and improving symmetry.

Initial Surgical Steps

  • Incisions: The procedure begins with 3 small incisions hidden inside the mouth which will be invisible after the operation. This means the intraoral tissue (or mucosa) is kept intact and the mental nerve-endings are better protected
  • Placement of the Cutting Guide: The previously 3D-printed anatomically accurate surgical guide is fixed in position, setting the stage for precision bone work.
  • Bone Cut with Ultrasonic Technology: Using advanced ultrasonic technology, a bone cut is made along the guide, enhancing the safety and predictability of the procedure.

Removal of the 3D Cutting Guide and final shaving

  • Removing the cutting guide together with the bone fragment: The 3D Cutting Guide is carefully removed along with the bone fragment inside it.
  • High Speed Burring: As a final touch this high speed bur is then used as a final shaving to leave the bone surface smooth.

Resulting Changes

This innovative process created by our team delivers a highly precise and symmetrical bone cut which also provides safer and more predictable outcomes. Our cutting-edge technology combined with the expertise of our skilled professionals ensures that each patient receives personalized care tailored to their unique needs.

Furthermore, our dedication to continuous improvement drives us to stay at the forefront of advancements in the field, enabling us to offer state-of-the-art solutions that maximize effectiveness and minimize risks.

Gender of the Jaw and Chin Region

There is debate on whether the jaw expresses gender since there are many examples of beautiful women with prominent, strong jaws. So this facial feature should be assessed in the frame of your unique facial balance.

The stereotypical female jaw exhibits a series of characteristics that commonly influence gender recognition, especially when combined with other social constructs associated with femininity, such as hair, skin, dress, voice, and behavior. However, let’s deconstruct our perception of the jaw into two areas: the mandibular angle and the length of the mandible for explanatory purposes:

  • The mandibular angle
    In men, the angle of the jaw is usually more square-shaped. It also often has larger, well-defined corners. Therefore, these are typically considered masculine traits, although it is true that many attractive cis female faces have these characteristics without reading masculine.
  • The mandibular body
    The male mandibular body, or the bone between the mandibular angle and the chin, typically has a greater volume of bone as well as an outward flare that’s not as common in the 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 where a more rounded look is desired. This area generally corresponds with the point where the mentonian nerves emerge, meaning it must be handled with great care as it involves combining jaw and chin feminization techniques..

The male chin tends to be more square-shaped than the female chin, with more pronounced and defined transitions between the chin and mandibular body. Also, there is usually greater bone volume in male chins. Similarly, tall or long chins are commonly perceived as a masculine trait.

The position of the chin is not necessarily a gender marker, as retro-positioned and over-projected chins are found in people of all genders.

Leading Technology in Surgical Techniques

Facialteam is a leading expert in jaw and/or chin feminization, dedicated to innovation. Years of commitment to pioneering techniques, developing protocols and establishing best practices in the field of facial gender surgery is in our DNA.

Our contributions to improving the gender transition experience, in the area of jaw and/or chin surgery, include:

  • in-house advancements in ultrasonic instrument design specific to jaw angle surgery;
  • creation of a 3D-printing methodology with customized cutting guides as well as practice model surgery, when required, for risk prediction;
  • personalized, fixed biocompatible prosthetics.

Our drive to revolutionize everything we do in surgery, on a technical level, offers patients concrete advantages– let us explain in greater detail:

Piezoelectric scalpel (ultrasonic technology)

Piezosurgery® is the ultrasonic instrument employed in bone incisions and surface modification. Facialteam has worked with the Piezosurgery® developers to create new versions of the tool specially adapted for jaw angle surgery, capable of thick and vertical incisions. Combined with the cutting guides, results are controlled to the millimeter. Advantages of this surgical tool are multiple:

  • precise cuts that only act on mineralized tissue (bone);
  • predictable and safer osteotomies that practically eliminate irregularities typical of traditional practices with a manual scalpel, chisel or saw and that have been associated with uncontrolled bone fractures;
  • does not cause soft tissue trauma, thus avoiding injury to the mucosa, muscle, nerves or blood vessels during the procedure, favoring a smoother recovery with fewer postoperative complications.

On the other hand, the only perceived disadvantage is the surgery duration, which is longer compared to other instruments. However, the benefits in results and recovery far outweigh the extra time required.

Cutting Guides

Our cutting guides are personalized “templates” that pilot the ultrasonic instrument to follow bone incision lines when surgical fields are affected by limited visibility, such as in the case of lower jaw feminizing surgery. This is how they work:

These anatomical guides are like splints or casts uniquely created to address both the jaw and chin in a single, smooth osteotomy (angle to angle). Other surgeons may address the rear jaw angles and the chin independently, without including the mandibular body.

This segmentation may result in aesthetically unacceptable results. The application of these 3D guides in mandibular feminization surgery, developed and validated by our surgical team, represent a revolution in the field.

PEEK® customized Prosthesis

At times, we are presented with cases which require increasing volumes where fat transfer is not ideal. In this situation, an anatomically fitted prosthetic is personalized to your needs, be it a fuller feminine shape or to correct an anomaly, for example, to recuperate volume in a previously operated area with unsatisfactory outcomes.

From a three-dimensional CT, prostheses can be printed in biocompatible PolyEther-Ether-Ketone (PEEK) material, which does not generate rejection in the body. Rigid fixation with titanium screws secures the molded prosthetic in place.

Recovery after Surgery

After your jaw and/or chin feminization surgery, you will likely be on your feet and able to return to the comfort of your own accommodations the day after your surgery. In case of combining jaw surgery with other procedures, an additional night at the hospital may be required. Nevertheless, that does not mean the initial nights are easy, on the contrary, be prepared for the commonly reported symptoms after any invasive intervention performed under general anesthesia: nausea, swelling, bruising, light bleeding, etc.

  • Short-term Healing
    The first 48 hours are challenging for many FFS patients, whilst others report only minor discomforts. Each body will react differently and there is little way to know how it will be for you. It is best to try to remain as tranquil as possible as the team of nurses, coordinators, doctors and specialists are here to support you in any way.
  • Two – Twelve Weeks after Surgery
    In the following weeks, potential complications requiring surgical attention are much less likely to arise at this stage. Once the bruising has diminished, you should be able to resume your normal routines and work on regaining full jaw and/or chin strength and movement. 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.
  • Long-term Recovery
    Residual swelling and sensitivity continue to evolve. Throughout the course of your entire recovery process, our post-operative department is always on hand to assist and answer any questions that arise or arrange a consultation if needed.

Results

Thanks to the use of specific 3D software, we may conduct a detailed analysis of the actual results obtained, evaluating the short-term effect of the changes incurred at your final postoperative consultation before leaving our center.

We are able to clearly visualize the differences in three-dimensions, delivering a complete analysis to each patient for quality control and transparency purposes.

These standardized diagnostics allow the team to discuss early outcomes with each patient from the most objective point of view possible. One year after your surgery, you will receive a satisfaction and evolution survey, which helps us to constantly improve.

Complications

All surgical interventions, especially if under general anesthesia, are associated with an array of potential complications which are detailed in the informed consent documents. Minor incidents such as swelling, bleeding, or numbness, for example, may occur in varying degrees and are typically temporary symptoms that subside in time.

Major complications are rare and normally detected within days after surgery. Our patients have the security of our medical insurance coverage in case any unforeseen medical attention related to the jaw surgery is required.

At Facialteam, the average incidence of complications of jaw surgery that require another surgical intervention is 2,63%.

How much does Jaw and Chin Feminization Surgery cost?

The price tag of jaw feminization surgery can vary greatly, as the combination of diagnostics, techniques and procedures are diverse and highly personalized to each individual.

Jaw Feminization Surgery with Facialteam (including hospital fees and anesthesia) may range anywhere from 12 900 € to 13 900 €. Chin feminization with Facialteam (including services, hospital fees and anesthesia) may cost anywhere from 13 500 € to 14 500 €.

A combination of both jaw and chin feminization surgery normally ranges between 17 100 € and 18 400 €.

Depending on the details of complexity and if you choose optional aspects, the final cost may be higher or lower.

The following services are included in all our quotes;

  • pre-operative consultation, standard pre-operative preparations and necessary revisions;
  • preoperative and postoperative CT-scan;
  • material costs;
  • costs for the operating theater and general anesthesia;
  • 1 night in hospital;
  • postoperative accommodation (average of 12 nights, variable according to procedure and surgery dates in case your surgery is in Marbella. For Barcelona patients we can suggest a nearby Hotel);
  • lymphatic drainage massage;
  • acupuncture service;
  • 24-hour coordination support;
  • post-operative nursing care;
  • health insurance for surgical complications up to 30 days after your surgery.

Our recommendation is to obtain budgets from multiple centers, as each will have a different approach and include (or exclude) certain important aspects such as aftercare, accommodations, medications, local transportation, wellness services, etc.

Book your Consultation

So, the first step in obtaining a personalized evaluation and a quote is to have a consultation with the FFS surgeon. An orientation with the facial gender specialist will begin with a discussion of your objectives.

We offer both online as in-person consultations in our clinics in Marbella and Barcelona, Spain. Our consultations are free of costs and a great aid for those patients seeking advice to start their journey.

Frequently Asked Questions

Research and Education in Jaw and Chin Feminization Surgery

The development of Facialteam’s jaw and chin surgery method JAWContour® is the result of years of research and clinical practice. We aim for the maximum degree of excellence in everything we do.

Scientific studies are continually carried out by our team. In addition, the top-level academic investigation involved in a Doctoral Thesis helps us to innovate options and improve results for patients. Most recently, Dr Javier Gutiérrez received his PhD at the Universitat Autònoma de Barcelona in October 2020 for his Thesis, “Customized cutting guides for the mandibular lower border: development, validation and applications in facial feminization and harmonization surgery.”

Facialteam’s experience in mandibular feminization surgery includes more than 2000 jaw and chin procedures.

Publications

Our academic literature is a record of our dedication to the science of feminization surgery of the lower facial third since 2008.

Professionals interested in the technical specifics of lower jaw recontouring may access the article on lower jaw techniques published in Plastic and Reconstructive Surgery®, the leading journal for every specialist who employs plastic and reconstructive surgical techniques:

Logo of PRS, Plastic and Reconstructive Surgery.

Facial Gender Confirmation Surgery: The Lower Jaw. Description of Surgical Techniques and Presentation of Results

Daniel Simon, Luis Capitán, Carlos Bailón, Raúl J Bellinga, Javier Gutiérrez Santamaría, Thiago Tenório, Anabel Sánchez-García, Fermín Capitán-Cañadas
This article describes the surgical techniques and material used to feminize the mentomandibular complex, including bone contouring, chin and mandibular body and angle ostectomies, and osteotomies to reposition the chin.
Logo of PRS, Plastic and Reconstructive Surgery.

Facial Gender Confirmation Surgery: A New Nomenclature

Luis Capitán, Daniel Simon, Jens U Berli, Carlos Bailón, Raúl J Bellinga, Javier G Santamaría, Thiago Tenório, Anabel Sánchez-García, Fermín Capitán-Cañadas
The term Facial Gender Confirmation Surgery indicates that although the surgical techniques are the same, their objective is very distinct and, moreover, they are intended for specific patients with well-defined needs.
Logo of PRS, Plastic and Reconstructive Surgery.

Facial Gender Confirmation Surgery: A Protocol for Diagnosis, Surgical Planning, and Postoperative Management

Luis Capitán, Javier Gutiérrez Santamaría, Daniel Simon, Devin Coon, Carlos Bailón, Raúl J Bellinga, Thiago Tenório, Fermín Capitán-Cañadas
During the past 10 years, academic publications that address facial feminization surgery have largely examined the technical aspects of the different surgical procedures involved and clinical evaluations of postoperative results. This Special Topic article focuses on aspects that are underdeveloped to date but useful with regard to taking the correct therapeutic approach to transgender patients who are candidates for facial gender confirmation surgery.
International Journal Of Transgender Health logo

Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care

Jens U Berli, Luis Capitán, Daniel Simon, Rachel Bluebond-Langner, Eric Plemons, Shane D Morrison
Based on new studies, increasing evidence points to the need to include FGCS among medically necessary gender-confirming surgeries, though more-prospective studies are needed. Updates to the WPATH SOC 8 are proposed based on available quality of life studies.