Q: Dr. Eppley, I wanted to ask you a question about a transgender patient that I have scheduled for a rhinoplasty and chin reshaping. She would like a more rounded anterior chin to give a more feminine appearance. I was planning to make a submental incision and just drill down the parasymphyseal inferior edge to reduce the square appearance to a more rounded appearance. I know you do quite a bit of facial contouring and I would love your thoughts on this case please. I have attached planned areas to show where I plan to reduce.Thank you so much!!!
A: There are two chin reshaping approaches to changing the genetic male chin from square to a more feminine tapered look:
1) Inferior border osteotomies (use a saw not a burr as you need to take a lot more bone than you think) I This is not actually the best approach because it does not narrow the chin that much. But you can up the aesthetics of the result by placing a small central chin button style implant (3/4mms) which helps create an overall more tapered appearance. (the ying and the yang effect so to speak)
2) T-design intraoral osteotomy (midline resection) This is the best method that will instantly change a flat square chin into a more tapered chin in a ‘scarless’ fashion.
I done a lot of both and either one is better than what she has now.
Dr. Barry Eppley