Facial feminisation surgery

Chinplasty

Chin shape generally varies widely between males and females, so it can be extremely important in gender recognition.

Natalie before facial feminisation surgery		Natalie after facial feminisation surgery

Gender of chin

Female chins tend to come to one point in the middle. Men’s tend to have two points directly below the canine teeth and a flat part between the points. This makes men’s chins look fuller and more square. Women’s tend to be more tapered.
Male chins also tend to have more vertical height, with a longer space between the lower lip and the base of the chin.
In some cases, male chins have a vertical crease in the middle, usually known as cleft chin, which is very unusual in women.

Male skull (dark blue indicates were bone is removed)		Female skull

Feminising the chin

Luckily, the chin is an area whose features can all be modified: height, width and if necessary even projection. Various modifications to the chin can be made depending upon the individual anatomy of the patient, and the desired result.

The procedure is called a “sliding genioplasty”. The chin is cut from front to back, separating a horseshoe-shaped segment of bone. A slice of this segment can be removed. This will reduce the height of the chin. The middle part of the horseshoe-shaped bone can be removed to narrow the chin. Also the chin can be moved forwards or backwards to correct a receding or protruding chin (if necessary).

Sometimes liposuction to remove some of the fat that some people have below the chin is needed to add definition to the chin shape.

Procedure

• General anesthesia is given.
• Incisions are all made intraorally, so no scars will be visible on the outside.
  
• The chin is cut from back to front on both sides with a saw, separating a horseshoe-shape of bone.
  
• A second cut parallel to and a few millimetres from the first one can be made, and a slice of bone removed.
  
• The middle part of the horseshoe-shaped bone can be removed to make the chin more pointed.
  
• The final position of the piece of bone is chosen. At this point the chin can be moved forwards or backwards.
  
• The bone parts are fixed using titanium miniplates and screws, which will never be removed.
  
• Liposuction is done when necessary.
  
• The wound is closed with self-dissolving stitches.

Recovery

• Hospitalisation: Most patients will spend two nights in the hospital following surgery.
  
• Compression Bandage: A bandage will be left over the chin to reduce hematoma. It can be removed on the next day.
  
• Swelling: Swelling is comparable to the swelling after jaw surgery.
  
• Numbness: Most women experience temporary numbness.
  Work and sports: If you don’t mind being seen with the swelling, you may be able to return to your social activities 7 to 10 days after the surgery. You will have to wait until the third or fourth week before doing any hard work or physical exercise.
  
• Scars: If a complementary liposuction is needed to add definition to the chin shape, a couple of very little punctures (2mm) will remain for several months and then vanish.

Complications

• Infection: Possible but rare.
  
• Numbness: Extremely rare is permanent numbness of one half of the lower lip and chin due to damage to the mental nerve.