Not all "extreme" updates happen on the operating table. Many creators are opting for high-density hyaluronic acid fillers to "stack" the chin.
Cutting the bone in a T-shape to reduce both height and width. extreme ladyboys chin updated
Given the specificity of your query, I'll create a general paper that discusses aspects of gender identity, cultural expressions, and the importance of understanding and respecting individual differences. Not all "extreme" updates happen on the operating table