Facial Gender-Affirming Surgery: Lower Face Feminization.

Feminization surgery of the lower face transforms a masculine chin, lower jaw, and neck to create a softer, more beautiful appearance. Chin feminization may be performed with a narrowing genioplasty. Lateral mandibular jawline contouring may be performed with angle resection, inferior border resection reciprocating saw shaving, or orthognathic jaw surgery (clockwise occlusal plane rotation) depending on a patient's anatomy and personal preferences. Neck feminization may involve a tracheal shave, platysmaplasty, or a deep neck procedure to provide a smoother neck. Facelift may be necessary with jawline bone reduction in older patients or to improve undesired cheek ptosis from silicone injections.