Feminizing mandibuloplasty is a complex procedure that re-shapes the jaw in order to attain gender congruence of the lower third of the face to commonly associated female anatomic norms. Hormones influence the growth and development of the mandible and contribute to sexual dimorphism of the human face. As such, feminizing mandibuloplasty typically involves surgically reducing the flaring of the mandibular angle and body and decreasing the height and width of the chin to better align with female cephalometric measurements. The preoperative visit for patients considering feminizing mandibuloplasty should include a thorough history, photo-documentation, facial analysis, physical examination, and discussion of goals and expectations for surgery. Preoperative maxillofacial CT with three-dimensional reconstruction can help with surgical planning. The surgical procedure involves many technical considerations that are highlighted within this chapter. There is a low risk of major complications after mandibuloplasty, and postoperative patient satisfaction is high.