Walking into a first consultation for lower third facial feminization surgery can feel intimidating, especially when jaw and chin reshaping, sometimes called V-line surgery, feels like one of the bigger decisions in a transition journey. At Evolve Your Life in Chicago, IL, Dr. Amir Dorafshar structures the first visit to be thorough but unhurried, so patients leave understanding exactly what a lower third facial feminization surgery plan would involve for their specific anatomy.
What happens during the physical evaluation
The visit typically opens with a physical exam of the jaw angle, mandibular border, and chin, alongside a discussion of dental and bite alignment, since jaw contouring and genioplasty need to preserve healthy occlusion. Dr. Dorafshar explains why jaw and chin work are usually planned together as part of a lower third facial feminization surgery plan, since narrowing one without the other can leave the lower face looking disproportionate. Our in-depth article on jaw feminization surgery and V-line mandibular contouring covers the surgical techniques discussed during this stage of the visit.
Consultation also covers how the lower third relates to the rest of the face. Because a dramatically narrowed jaw without corresponding attention to the cheeks or forehead can look disproportionate, Dr. Dorafshar often discusses middle and upper third considerations even for patients focused primarily on lower third facial feminization surgery, an approach explained in our three-zone approach to facial feminization surgery article.
How imaging shapes the plan, and what to bring
CT-based imaging is central to lower third planning because jaw thickness, nerve position, and tooth roots vary considerably between patients, and a plan built without imaging risks either under-correcting or compromising dental health. During consultation, Dr. Dorafshar reviews imaging with patients directly, discussing realistic limits based on individual bone structure rather than presenting a single idealized result. Patients often find it useful to review our resource on lower third facial feminization, jaw, V-line, and chin before this conversation so the terminology feels familiar.
Patients get the most out of a first visit by bringing a list of questions about recovery timeline, dietary restrictions during jaw healing, and how the practice handles staging if other procedures are also being considered. It is reasonable to ask directly about the surgeon’s experience with genioplasty and mandibular contouring specifically, since these are more technically demanding than soft-tissue procedures. Our broader FFS recovery week-by-week guide is a helpful companion resource for understanding the fuller timeline discussed during consultation.
Candidacy criteria discussed at consultation are generally informed by the World Professional Association for Transgender Health’s Standards of Care, which address documented gender dysphoria and informed consent. A 2025 systematic review on genioplasty published through the National Institutes of Health’s PubMed database found high patient satisfaction and low complication rates for chin-narrowing procedures performed by experienced surgeons, and Mayo Clinic describes jaw and chin reshaping as a standard component of facial feminization surgery.
Patients from Chicago’s downtown neighborhoods as well as Peoria and Oak Brook, IL travel to the Gold Coast-area office for this lower third facial feminization surgery consultation, and many find that leaving with a clear, individualized plan, rather than a generic procedure list, is what makes the decision to move forward feel manageable.
