There are many anatomical differences between the male and female Chin & Jaw. The aesthetics of the female ones and the proportion of the size are smaller and more rounded. The “roughness” of the development in men has already been commented, which defines it as larger and squarer. MDM designs the best osteotomy and remodeling for each patient. We try to take an aggressive approach, but safe at the same time. We use the classic sliding genioplasty with ¨T¨ osteotomy to achieve the ¨V¨shape of the chin and jaw. Sometimes we can use prosthesis or fillers to improve the shape. We take care of respecting the vascular and nervous structures found in this region. We use Piezoelectric technology to work the Jaw angles and ramus. Our goal is to obtein the shape and size that the patient want to feminization or masculinization, orthognatic or aesthetic request.