The shape of the chin is a classic gender-defining facial feature. While the chin has numerous dimensional aspects to it, the frontal view of it is the most gender specific dimension. Broader and more square chin shapes are identified as masculine while a slender and more tapered chin shape would be seen as more feminine.
While chin reduction surgery often focuses on changing all three dimensions of the chin bone and is a volumetric changing procedure, chin reshaping surgery usually means changing it to look more gender specific. This is not so much about a volume change but a shape change. One type of chin reshaping surgery is that of feminizing or desquaring the broad chin. This is most common in facial feminization surgery. Making the chin, and often along the jawline behind it, more narrow is a gender chin shape change.
While creating more of tapered chin can be done from a submental skin incision, an intraoral approach is more commonly used of narrowing is the only dimnesson of the chin that needs to be changed. In exposing the chin bone, the central soft tissue attachments are maintained. Subperiosteal dissection is done back along the jawline below the mental nerve. Then using a reciprocating saw the entire corner of the chin bone is cut (lateral osteotomy) usually just short of the length of the saw blade.
The cut corner of the chin bone is then removed. In doing so both the internal shape of the chin bone and the external contour the chin are changed.
Making the broad chin less square can be done for both transgender male to female patients as well as the cis female who simply has a chin that is too broad and unfeminine. Removing the more square bony corners of the chin creates a softer shape to it.
Dr. Barry Eppley