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Facial Feminization Surgery: Mandible Contouring

Some of our patients who are interested in Facial Feminization Surgery express dysphoria related to the shape of their jaw. During a testosterone-dominant first puberty, the jaw bone or mandible often widens and acquires a square shape. Mandible contouring, along with hairline reshaping, helps create more of a rounded shape to the face, which can help reduce feelings of dysphoria or discomfort. To accomplish this, our surgeons make incisions in the mouth, which are used to access the jaw bone, shave down some of the mandible, and reshape the chin to create a softer and narrower look to the bottom third of the face. Given the invasive nature of this procedure, scars are completely invisible, though recovery involves initial dietary restrictions and months-long swelling.

Additional procedures to contour the jaw

In addition to reducing or augmenting the size of the jawbone itself, your surgeon can also use other techniques to contour the jaw area. For example, some patients might elect to have their buccal fat removed and/or to have the skin under their jaw tightened with face-lift techniques.

Recovering from Gender Affirming Jaw Contouring

Following surgery, we ask patients to eat a soft diet for 2 weeks to allow the incisions in the mouth to heal. Introducing hard to scratchy foods before this time can lead to incisions opening, which can expose patients to infections. The incisions inside the mouth will heal over the course of those first 2 weeks.

The swelling on the outside of the mouth and jaw sticks around for significantly longer. Patients can expect to be very swollen the first months following surgery, and for some swelling to remain for up to 6-9 months after surgery. At 3-6 months post-op, the patient’s face returns to baseline (what it may have looked like before surgery) and finally, following this period, around 6-9 months, the effects of surgery start to be visible. As a result, we generally do not consider revisions on a procedure like this until at least a full year has passed.

In Summary…

In the following video, Dr. Facque (he/him) gives a summary of the mandible contouring and other procedures that can sculpt the jawline area: