Introduction:
Dr. Ed Falces, a surgeon specializing in gender transition surgeries for transgender patients, teamed with Dr. Douglas Ousterhout in 1982 to fulfill a transgender patient's request for a more feminine facial appearance. Dr. Ousterhout, Dr. Tessier's protégé, undertook significant research to determine femininity's facial characteristics. He pioneered surgical techniques to modify and feminize the masculine face, establishing facial feminization surgery (FFS) as a specialization in plastic surgery. Jaw reduction surgery is an important part of facial feminization surgery (FFS) for transgender people who want to change their facial characteristics and look more feminine. This surgical technique, sometimes combined with genioplasty, softens the square, angular jawline prominent in masculine face form.
What Is the Significance of Jaw Reduction in Facial Feminization Surgery?
Jaw reduction surgery is critical to the overall face changes during facial feminization surgery. It is recommended for both transgender and cisgender patients who want to soften the square, masculine jawline and reduce the prominence of the chin. The idea is to achieve a more feminine, tapered jawline that gradually slopes from the earlobes to the chin. Jaw contouring treatments, such as sagittal mandibular excision, are crucial for ideal facial feminization results.
What Are the Differences Between Male and Female Jaw Skeletal Dimensions?
Male and female jaw skeleton proportions differ significantly, which contributes to a sense of gender identity in transgender people. The jawline of the biological male population is often wider, more square, and angular. The masseter muscle is frequently more defined, which results in a strong jaw angle. The female jawline, on the other hand, gently bends from the earlobes to the chin. Surgical procedures such as jaw reduction can change these skeletal characteristics to give a more feminine appearance.
What Are the Indications for Jaw Reduction Surgery?
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Square Jawline: Some people are born with a more prominent or square-shaped jawline, which may be considered less acceptable in some cultures or beauty standards. Jaw reduction is useful in creating a softer, more oval, or V-shaped face.
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Enlarged Jaw Muscles: Enlarged masseter and chewing muscles can result in a wider and bulkier jawline. This could result from heredity, tooth grinding (bruxism), or excessive chewing. These muscles can be targeted to diminish their size and prominence during jaw reduction.
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Gender Transition: Depending on their preferred gender appearance, individuals undergoing gender transition may choose jaw reduction to produce a more feminine or masculine facial look.
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Facial Harmony: Some people desire jaw reduction to improve their facial symmetry. This method might help in achieving better proportions between the various facial features.
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Self-Esteem and Confidence: Jaw reduction, like many cosmetic treatments, can be sought to promote self-confidence and self-esteem. Being more comfortable with one's face look might boost one's mental well-being.
What Is the Technique of Jaw Reduction Surgery?
Radiographic imaging is advised before jaw reduction surgery for surgical planning. Panorex X-rays, Posteroanterior and lateral cephalograms, and 3D CT scans can reveal important information about the patient's facial structure, such as the position of the mental nerve, impacted teeth, and past surgeries. Jaw reduction surgery comprises sagittal resection of the mandible with a saw to smoothly transition from the jaw angle to the mental nerve region. The gonial angle and the masseter muscle are given special attention, as both may require excision for the best results.
Why Is Chin Contouring Often Done Along With Jaw Reduction Surgery?
Along with jaw reduction, chin contouring methods such as genioplasty are frequently used to improve facial harmony and femininity. The male chin is more boxy, but a T-genioplasty method can change it into a softer, more feminine shape. This treatment entails measuring the chin's midline, removing a predefined amount of central chin bone, executing a horizontal osteotomy to mobilize the chin, and rigidly securing the chin with plates and screws. The anteroposterior projection and vertical ratio of the chin should be evaluated to obtain perfect facial proportions.
What Is the Surgical Outcome After Jaw Reduction Surgery?
Studies report that there will be high patient satisfaction with the outcomes of jaw reduction surgery after having over 20 years of expertise in face feminization surgery and treating over 3000 patients. Representative patient cases exhibit how combining jaw reduction and genioplasty can improve chin symmetry; jawline look, and overall facial feminization. These approaches are effective in producing exact and consistent results.
What Are the Risks Associated With Jaw Reduction Surgery?
While jaw and chin contouring surgeries tend to be safe, there may be some potential risks. Paresthesia or anesthesia can develop along the distribution of the inferior alveolar and mental nerves; however, it is usually very transitory. The procedure should be done within the periosteal envelope to reduce damage to the marginal mandibular nerve, retromandibular vein, and facial vessels. Avoiding over-resection of the jaw, chin, and masseter muscle to prevent the destruction of soft tissue support. Soft tissue flexibility must be properly assessed to ensure a satisfactory outcome.
What Is the Non-surgical Method of Jaw Reduction?
Non-surgical procedures are primarily used in cases where the masseter is enlarged. Sometimes, a large masseter muscle can be inherited, but it is more typically an acquired characteristic. It grows in size with activity, just like any other muscle.Gum chewing and bruxism can lead to muscle hypertrophy. Botox injections are a quick and painless technique to treat an enlarged muscle.
Botox has been injected into the muscle, weakening it and producing atrophy over time. There is no downtime, and the patient's improvement is gradual, so people may never know that the patient underwent plastic surgery.
Botox for jaw reduction has been scientifically examined. Generally, no improvement is evident for at least two to three weeks. Peak improvement occurs between 3 and 9 months, with good outcomes still evident one year later in many patients. A rare but serious consequence of the surgery is a temporary paralysis of the muscles that control the lips.
Conclusion:
Jaw reduction surgery is a vital part of facial feminization surgery, which allows transgender and cisgender people to obtain a more feminine facial appearance. The approaches and concerns emphasize the necessity of surgical skills, specific assessments, and the integration of several treatments, such as genioplasty, to achieve desired results. Surgeons can help patients accomplish their desired facial feminization goals by studying the variations in male and female facial anatomy and implementing customized techniques.
