Chin
Gender Differences:
A masculine chin tends to be taller, wider and has more of a square shape, while a feminine chin tends to be shorter, narrower and more rounded. Many people think feminine chins are V-shaped, but on average, they are actually U-shaped.
Men's chins also protrude forwards a little more than women's, but I don't think that chin projection is as important as the size and shape of the chin when it comes to gender recognition.
Surgical Options:
Chin surgery is called “genioplasty” or “mentoplasty”.
1. Height and Shape:
Chin corners can usually be removed by burring and/or cutting the bone.
If the chin needs to be reduced in
height, most surgeons will cut a section of bone off the bottom, but some still use an older
technique where they remove a horizontal section of bone from the middle of the chin and
then close the gap.
One reason sometimes given for using the older technique is that
you don't have to detach the muscles from the chin bone in order to shorten
it because they remain attached to the lower section that you are not
working on, but that also means you can only change the height of the chin
and not the shape of the lower section, and in most FFS cases, you need to
change the shape too.
2. Receding Chin:
A receding chin is not really a masculinity or a femininity - it is mainly a beauty
issue, and that means it's down to your personal taste whether or not you like it,
but if you are having a feminising genioplasty, you can take advantage of
the incisions to have the chin moved forwards at the same time.
There are 2 ways of moving the chin forwards. One is to move the chin bone
itself. This is called a "sliding genioplasty". The advantage with this
technique is that it doesn't involve implants, but if it is not done
properly, it can leave an indented area on either side of the jaw behind
the chin. The other technique is to add an implant. This is simpler, but
there are potential complications associated with implants - for example they can
slip, they can become spontaneously infected even years after they were
put in, and they can wear down the bone they are sitting on. For those
reasons, I usually
recommend a sliding genioplasty rather than an implant.
An added benefit of moving the chin forwards is that it tightens up the soft tissues under the chin, and that helps to prevent any slackness in the tissues caused by chin or jaw reduction.
Sometimes the issue is not a receding chin, but an underdeveloped lower jaw, when the jaw itself has failed to bring the chin forwards enough. However, on this page I am only talking about a situation where the jaw is normal, but the chin itself lacks projection.
3. Projected Chin:
Some people have a chin that projects forwards much more than average. As
with a receded chin, this is more of a beauty issue than a femininity
issue, but it is possible to remove bone from the front of the chin, or
slide the chin backwards in a sliding genioplasty to reduce the chin
projection. One downside of reducing chin projection is that it can cause
more slackness in the soft tissues, so I don't generally recommend it
unless the chin projection is severe enough to have an obviously
detrimental effect.
4. Fat Under the Chin:
There is a pocket of fat under the chin called the "submental fat pad".
It's not a femininity issue and everyone has one, but it can vary a lot
from person to person, with some people naturally having more fat in this
area than others.
The most common cause of a very large submental fat pad is being overweight, and in that case, the ideal solution is to lose weight. However, weight loss is not always possible, and some people have an excess of fat here despite not being overweight. In those cases, liposuction under the chin is a way of reducing it.
5. Slack Soft Tissue Under the
Chin:
A similar problem to fat under the chin is excess skin under the chin, and
again, it's not really a femininity issue - it's usually something you
develop with age. The only way to fix it is with a neck lift. However, it is
important to have any lifting done several months after chin and/or jaw
surgery, and not before or during.
6. V-Line chin surgery:
V-line chin surgery involves taking a vertical section of bone out of the
centre of the chin, then bringing the sides together to close the gap. The
idea is to narrow the chin strongly and give it a V shape. Many people
think this is a particularly powerful technique that allows for greater
changes than other techniques, however, you can achieve the same result by
removing bone from either side - basically, it's the position of the
nerves that limits the amount of change, rather than the particular
technique.
Also, it's important to understand that typical feminine chins are U-shaped rather than V-shaped.
7. Labio-mental fold reduction:
The "labio-mental fold" is the horizontal crease between the chin and the
bottom lip. If you feel that yours is too deep, you can have it reduced.
This can be done with an injectable filler or even by adding a small bone
graft during chin surgery in some cases. This is a cosmetic treatment and has no particular effect on femininity.
Chin Clefts:
A small study I made suggests chin clefts might be a little more common in men than women. This simply involved counting the chin clefts on 50 male and 50 female faces – all randomly selected and I found that 58% of males had a visible cleft against 38% of women (a larger study might come up with different figures).
So although they are a little more common on men, they are still very common on women and I don't think they can be considered an important masculinity - they are really more of personal preference issue.
There are procedures that can remove a cleft but it is often not possible to remove one completely. This is because it typically exists not just in the bone, but also in the soft tissue layers. For example, there is usually a cleft in the muscle too. This makes correcting it quite difficult, however, you can usually reduce it during surgery, and then reduce it further once everything is healed by using an injectable filler like your own fat.
Facelifts and Chin Surgery:
For older FFS patients, chin and jaw surgery can leave the soft tissues around the lower face and neck more slack than they were before. This happens partly because the bones have been reduced but also because chin and jaw surgery can cause quite a lot of swelling and that swelling stretches the soft tissues. Younger patients don't have this problem as their soft tissues are very elastic and will easily tighten back up around the new jaw and chin as the swelling goes down.
The age at which you might need to consider a facelift after chin and jaw surgery will vary from person to person – one 50-year-old for example, might have very elastic soft tissues while another 40-year-old might already be having noticeable sagging.
It is very important to have
any lifting done after jaw/chin surgery and not before it, or during it.
There are 2 main reasons for this:
1. Chin and jaw surgery cause a lot of swelling and it's
impossible to know in advance how much swelling a particular patient will
experience.
2. It's not possible to know in advance how well your soft
tissues are going to adapt to the new bone structure. You can certainly
make a guess based on the patients age and by feeling how elastic the
tissues are, but there is still a lot of guesswork involved.
This means that the best way to achieve the optimum result is to wait a few months for the swelling to go down and for any re-adaptation to take place - you can then see clearly exactly what, if anything, needs to be done with the soft tissues.
And remember that you don't need to go to an FFS specialist for a facelift - there are only a handful of good FFS surgeons, but there are very many good facelift surgeons.
The Nolichi Rule:
In both males and females, the opening of the mouth is, on average, just under a third of the distance between the base of the nose and the base of the chin - the male chin is taller, but the lip to nose distance is also longer so the proportions are actually the same. I call this the "Nolichi rule" and you can read more about it in part 5 of my thesis.
The balance between these features is important because if you shorten a chin, you can make the lip to nose distance seem longer by comparison and conversely, if you shorten the lip to nose distance, you can make the chin look proportionately taller so these features usually need to be considered together.
Some Questions:
Where should the incision for
chin surgery be?
To access the chin, the surgeon can either make an incision in the
mouth ("intra-oral"), or under the chin. An incision in the mouth is the
more advanced technique and will not leave a visible scar. It is also
safer to work through the mouth for the following reasons:
1. You can't reposition the chin muscles from below, and
this
can be important because in some cases, not repositioning the muscles
correctly can leave them drooping. This is called "chin ptosis" or a
"hanging chin".
2. There is a very important nerve that gives movement to
your chin and bottom lip (mandibular branch of the facial nerve) and it is
much easier to traumatise this nerve when working from below. This can
cause some paralysis of the chin and bottom lip (this is quite a common
complication with
this approach) and if the nerve is severely damaged, the paralysis may be
permanent.
3. You can't work on the area where the chin blends into
the jaw from under the chin and in some cases that means that you will
feel a step between the chin and jaw after the surgery.
For these reasons, I always recommend finding a surgeon who puts the
incision inside the mouth.
Can you do chin surgery
through the same incision as Adam's apple surgery?
Technically, yes you can, however, it is still best to do the chin surgery
through the mouth for all the reasons listed above, but also because the
small incision that is used for Adam's apple surgery has to be made a lot
bigger to do the chin, and that means a bigger scar.
Which is more important - the
shape of the chin or the height?
Something I have discovered through doing Virtual FFS is that in terms of feminisation the shape of the chin is more important than the height. This partly because a square chin has a flat base and this flat base clearly underlines the height of the chin, while a rounded shape gives a more vague sense of height. Another reason is that rounding a chin by
removing the corners does actually reduce the height of either side of the chin –
it's only the central point is left at the same height as before so more of the chin is shortened than is left the same.
Is a chin reduction done by
cutting the bone, or by shaving it down?
Usually, when the surgeon has to remove bone from the bottom of the
chin, they cut it off, but if they have to remove an area of bulging bone
from somewhere on the chin,
they shave it down.
Is it true that some surgeons
are able to use ultrasound to cut the bone?
Ultrasound is a highly advanced way of cutting bone - it's much more
accurate than a conventional bone saw, and it doesn't cause damage to the
surrounding soft tissues. That means there is less risk, much less
swelling and bruising, and that means a quicker and easier recovery with
fewer risks of complications. Not all FFS surgeons use ultrasound cutters,
so it's well worth searching for one who does.
I am young and have no
sagging but my surgeon says I will need a facelift at the same time as
chin surgery. Is this true?
If you are still in your 20s, you are extremely unlikely to need any
lifting as your soft tissues are almost certainly elastic enough to
re-adapt to the smaller bone structure. This is generally true for people
in their 30s too. As you get older, the chances of FFS causing some
slackness in the soft tissues become greater, but even then, you should
have the facelift several months after FFS and not during.
Can a sliding genioplasty
also reduce the projection of the chin by sliding the chin backwards?
Yes, that is possible, but there's no need because you can remove bone
from the front of the chin to achieve the same effect.
Does chin surgery cause
permanent numbness?
The “mental nerve” exits through the chin about 2
cm or so below the corners of your mouth. It is a branch of the “inferior
alveolar nerve” which runs along inside the jaw and it supplies sensation
to the chin, lower incisors and bottom lip. As long as the surgeon is
using the correct technique and avoids the mental nerves you should have
no problem. However, temporary numbness after chin surgery is normal and
it can take a few weeks or even months for sensation to fully return. It's
partly caused by swelling - this presses on the nerves and stops them
working temporarily. It's the same effect as you experience when your arm
goes numb in your sleep because you have been lying on it.
Can chin surgery cause a
"hanging chin"?
If the surgeon doesn't take care to reattach the soft tissue under the chin,
the soft tissues can droop down after the surgery. This is called a
“witches chin” or “chin ptosis”, but there are techniques that can correct it like “mentopexy”.