Transgender Facial Reshaping

Q: Dr. Eppley, I am 35 years old and am seeking a unique transgender facial reshaping procedure. I had a chin reduction ten years ago and it was left slightly uneven. Last year I went to have it fixed along with my mandible contoured. Now I feel my face is too thin looking especially in the prejowl area. Its a very sharp contour somewhat V shaped. Before it was more U shaped and it looked better. I am seeking to widen my lower face. I am not sure if I would need a prejowl implant, a jaw implant or custom jaw implants. I am also a transsexual and being the reason why I had it reduced, I have lived very successfully as a female for many years. Have you worked on transsexual people before? Please see attached images. I am looking to restore to my old face.

A: We have a significant number of transgender facial reshaping patients in my practice. Just based on the two pictures you provided the difference seems to be largely in the jawline behind the chin. While I have not yet viewed a side profile, the horizontal projection of the chin does not seem to be changed very much if at all. I suspect that the lower facial restoration would involved bone augmentation from just behind the chin (prejowl area) all the way back to the jaw angles. Whether just widening the prejowl alone would be enough I can not say just based on these two pictures alone. I would have to see some more pictures from different angles and then do computer imaging on them to see exactly what type of lower facial change looks best to you.

Dr. Barry Eppley

Indianapolis, Indiana