Can My Jawline Be Made More Feminine Looking?

Q: Dr. Eppley, I am a 35 year-old transgendered woman who is interested in more of a feminine face. I do believe that my jawline and chin is what needs to be changed and would be the most beneficial to me. I have been living full-time as a woman since my gender transition eight years ago. At this time, other than having two teeth extracted and dental work, I have no other facial surgery or injuries. As a woman, I do have occasional passability problems. I feel that my face currently absolutely needs improvement and will boost my self-esteem and self-worth.

A: In looking at your pictures, I do agree that your jawline from the chin back to the jaw angles, is the most masculine appearing part of your face. Softening your jawline would be a beneficial step towards your aesthetic facial goals and is a potential part of many facial feminization surgeries. Reducing the entire jawline is never as easy as making it bigger but there are procedures that can help your its prominence. The jawline angle can be reduced by angular ostectomies where the sharpness and prominence of the angles are reduced along with some width reduction. This is done through an intraoral approach where a saw is used to removed the bony jaw angles (makes them less square) and taking the outer cortex of the mandibular ramus to make it thinner as well. Your chin needs to be vertically reduced and narrowed combined with lateral prejowl ostectomies to make the whole front part of the jaw more narrow. This also is done from inside the mouth where the chin bone is downfractured, shortened and narrowed and put back together. Then behind the chin osteotomy the body of the jaw is then narrowed by outer corticotomies. I have attached some predictive imaging of those potential jawline reduction results.

Dr. Barry Eppley