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As a pre-dental student (and TS) I thought I might be able to add my two cents to the internet resources on surgery for transsexual women.
Males have wider mouths than females. Horizontally, the male mouth has about 10 to 15 mm more length from left to right. This is one of the greatest differences in the faces of the sexes. Most TS women have this larger mouth, even the most feminine-looking and even after hormones and FFS
As anyone familiar with facial feminization surgery (FFS) is aware, the male jaws are wider and the chin blunter, but thats not the end of the story. The jaws' function is to support the teeth, which are also different in the male. The teeth are arranged like a horse shoe. As you would expect, the male horse shoe is wider (from a frontal view), just like the jaws. You can think of the female teeth as a 'U' shape, and the male's as a 'C'.
Here are two suggestions that might help -
a. Makeup. Apply lipstick, not extended to the corners of your mouth. Try to leave off half a centimeter at each side, or as much as you can get away with. To go a step further, extend the color up past the lip line, to make the mouth appear smaller in relation to the lip size. To go even further, cover the corners of your mouth with foundation.
b. Tooth arch reduction. I NO LONGER RECOMMEND THIS PROCEDURE FOR ANY TS WHO IS OVER AGE 18 AND NO LONGER GROWING. I'm not sure that it actually shrinks mouth size - I now think it just takes away the necessity for the mouth to continue growing in patients who have not reached physical maturity.
Other related procedures I recommend are (in order of importance) jaw reduction, chin reduction, maxillary bone shortening (the bone holding your upper teeth). Aside from these, most transsexual women would also benefit from an alar base reduction of the nose, a rhinoplasty procedure in which the nose is made thinner, to simulate the thinner female nose. (This is just as important as the more typical TS rhinoplasty procedure, reduction of the profile - actually more important, but less well-known). The underlying bones can also be brought in and sutured together to make the nose thinner as well.
the wonderful Ms. Carol Burnett (doesn't show her profile, but just to remind you who she is).
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