Jawline Augmentation: Facial Masculinization Surgery

Medically reviewed by Jennifer Richman on December 16, 2024.

Understanding Jawline Augmentation

A mandibular or jawline augmentation is a surgery that increases the size of the jawline, giving it a more defined and angular appearance. This is typically an outpatient procedure, which means that it is performed under general anesthesia and patients are usually sent home the same day after surgery, unless this procedure is combined with other facial or body procedures, which may require an overnight stay. Recovery involves rest, dietary changes, pain and inflammation care. The placement of jawline implants leaves no visible scars, though patients will need up to 12 months to see their final results.

Jaw implants can also be placed as a part of a reconstructive surgery to aid in the treatment of a traumatic injury such as a broken or fractured jaw. Additionally, this procedure has become increasingly popular amongst cisgender men and women for cosmetic surgery.

At the Gender Confirmation Center (GCC), we offer mandibular augmentation as a part of facial masculinization surgery (FMS) for trans, non-binary and gender non-conforming patients. The effects of testosterone hormone therapy can change the contours of the face by altering soft tissue over time. Still, some transmasculine patients seek out surgical interventions, regardless of whether or not they have taken testosterone, to feel greater alignment with their facial features.

You can request a virtual or in-person consultation with one of our board-certified facial surgeons here.

Different Techniques for Jawline Augmentation

The two principle types of jaw augmentations are temporary, non-surgical and permanent, surgical interventions:

Non-Surgical Jawline Augmentation

One safe, less expensive way for patients to undergo a jawline augmentation is to inject medically safe fillers such as hyaluronic acid. The GCC does not offer this service at this time.

Injections are performed with local anesthetics, meaning that the patient will be awake during the procedure. Results are temporary, meaning they will typically last around six months or more, depending on the type of filler.

While this may be a more cost-effective intervention in the short-term, in the long-term, costs can add up with the need for touch-ups over time to maintain desired results. Given that many insurance companies cover the costs of gender-affirming facial surgery, a permanent jaw augmentation has become more accessible to many transmasculine and non-binary patients.

Surgical Jawline Augmentation

The type of mandible augmentation that the GCC offers is the placement of jawline implants, made of medical-grade silicone. This procedure is performed under general anesthesia and leaves no visible scars since incisions are made inside of the mouth.

Recovery for a surgical procedure will take longer than temporary fillers, but results will be permanent.

Who is an Ideal Candidate for Jawline Augmentation?

• Candidacy for surgery: At the GCC, we use the informed consent method to determine surgical eligibility for facial surgery procedures. Meaning, we believe that adult patients that are properly educated about the risks and benefits of a gender-affirming procedure are capable of determining if it is right for them. With facial surgery, the GCC does not have BMI eligibility limits; however, the hospital anesthesia department may not approve operating on someone with a BMI of 60 or more based on safety concerns. 
• Insurance coverage requirements: Many of our patients that come to the GCC are interested in having their insurance companies cover some of the costs of facial masculinization surgery. In this case, patients will need to present a support letter from a licensed mental health professional and may need to be on testosterone hormone therapy for at least a year to be eligible for coverage.

Preparing for Your Jawline Augmentation Procedure

The following steps can help patients prepare for a gender-affirming mandibular augmentation procedure:

• Patients will need to stop smoking and halt any nicotine consumption four weeks before and after facial surgery. Alcohol should not be consumed a week before and after surgery. Quitting tobacco with as much time before surgery as possible can help reduce bleeding and other healing complications.
• The first step in the surgical process is soliciting a free consultation with a board-certified professional. Once you are in the GCC system, our staff can help you acquire all necessary documents to obtain insurance coverage for your procedure.
• Prior to your consultation, you will be asked to submit photos of your face from seven different angles. This will help your surgeon assess what changes could realistically be made through surgery.
• Share with your surgeon what medications and supplements you are taking. You may need to discontinue certain herbal supplements and blood-thinning medications before surgery to prevent anesthesia complications.
• Prior to surgery, you should have a care plan in place for your recovery. This will include soliciting time off work, having someone to bring you and take you home from surgery, and supportive friends or family to take care of you the days after. 

What to Expect During the Procedure

Patients will arrive at the hospital or surgical center and be placed under general anesthesia. A mandible implant procedure can take anywhere from one to two hours. Patients may spend longer under anesthesia if they are undergoing other, simultaneous facial surgery procedures, or top surgery. 

During the procedure, your surgeon will make incisions inside of the mouth, at the bottom of the lower gums. Your implants will be placed and fastened to the jaw. From there, the incisions will be closed with dissolvable stitches that should disappear or start to come out on their own about a week or two after surgery. 

Most patients will return to home the same day as their surgery. However, depending on how many other facial surgery procedures a patient undergoes simultaneously, they may need to spend the night in the hospital for close monitoring. Please note that you will need a loved one to come pick you up from the hospital in order to be discharged. While you are taking prescription pain medications, you will not be able to operate a vehicle.

Post-Procedure Care and Recovery

The following instructions should be followed carefully to help you heal properly and maximize your results:

• Patients will control pain with prescription pain medications during the first few days after surgery. Be sure to pick up your prescription before surgery so that they are ready at-home when you come back from the procedure. During this time you will not be able to drive.
• During the first 72 hours, patients will need to apply ice for 20 minutes every hour to the jaw. This is to help reduce pain and swelling. We recommend placing a small towel between the face and the ice to prevent ice burns as the area will likely be temporarily numb after surgery.
• Patients should rest in bed with their face at an incline (ie, back propped up with pillows or a wedge). This will help manage inflammation.
• Due to the incisions inside of the mouth, patients will be on a soft food diet for the first two weeks after surgery. Likewise, due to swelling, some patients find it easier to drink with the help of a flexible straw.
• During the first week, you can clean your mouth with a gentle mouthwash. Please do not use a hard-bristle toothbrush or vigorous swishing during the first week as this may open up the incisions.

Risks and Considerations in Jawline Augmentation

Like any surgery, there are potential risks involved. Make sure that your surgeon is board-certified and has hospital privileges; having these credentials is necessary to ensure your safety and the integrity of your surgical results long-term.

Patients have a higher risk of healing complications like bleeding, bruising and nerve damage if they are tobacco smokers. Quitting with as much time before your procedure as possible can help you reduce the possibility of these negative outcomes. 

Cost of Jawline Augmentation

The cost of a mandible augmentation can vary due to the practitioner, location and the type of implant used. The estimate that your surgical office gives you may not include facility fees or anesthesiology fees, which vary based on the length of the procedure. 

Trans and non-binary patients with health insurance may be able to significantly reduce the costs of the procedure if they are able to secure coverage. At the GCC, our free insurance concierge service has successfully secured coverage for 90% of interested patients. Once you’ve solicited a consultation, our team will reach out and help you acquire necessary support documentation to apply for pre-approval. Please note that many insurance companies have hormone replacement therapy (HRT) requirements to cover gender-affirming facial surgery. 

Long-Term Results of Jawline Augmentation

Healing from any kind of facial surgery takes plenty of time. It can take patients up to 12 months after surgery to be able to see their final results. Due to the pull of gravity, inflammation around the mandible can take longer to resolve than any other part of the face altered from surgery. Even then, after the 12 month mark, skin may continue to tighten around the jaw, leading to a more chiseled or contoured shape in some patients over time. 

In the long term, gender-affirming surgeries generally have very high satisfaction rates from patients, much higher than similar, cosmetic procedures. However, right after surgery, patients may experience short-term post-operative depression while their body directs its energy to healing tissue after surgery. Even after the initial recovery period, some patients may feel frustration while they wait for inflammation to resolve over the first few months. Others may feel euphoria, gratitude and excitement right away by seeing an augmented jawline. Regardless of your reaction, remember that it is normal to experience a wide array of feelings as you are adjusting to the new appearance of your face.