Chin surgery (genioplasty)

A recessed, prominent, short, or long chin changes facial proportions. Chin surgery (genioplasty) is an operation in which we adjust the shape and definition of this area. We can contour or shorten the chin bone, or use an implant to lengthen the chin and add forward projection.

You can describe which part of your chin you would like to change when you look at it from the front or side. We plan different procedures for a small, recessed chin and a long, prominent chin. Your expectations guide the choice alongside the existing chin shape and its proportions relative to other parts of your face.

Chin anatomy

The chin is the front, lower portion of the lower jawbone, called the mandible. The tooth-bearing portion lies above this area. The body and angles of the lower jaw extend to the sides and form the lower boundary of the face. Genioplasty focuses on the front tip of this broader structure, so shaping the entire jawline has a separate surgical scope.

Along with bone, the skin, subcutaneous tissue, and chin muscle called the mentalis contribute to the visible chin shape. The fold between the lower lip and chin is shaped by the relationship between these tissues. The same bone position can produce a different external appearance depending on the thickness of the overlying tissues.

Facial proportions and the chin

When the chin is small and recessed, the lower face appears to have less volume. A long, forward-projecting chin makes the lower face more prominent. When making decisions about the chin, we also look at the proportions of the forehead, nose, and cheeks.

Chin position also affects how prominent the nose looks in profile. A recessed chin can increase the nose’s prominence within the face. Chin position is therefore part of the examination for someone seeking rhinoplasty as well.

Forward projection, vertical height, and horizontal width of the chin are separate features. A chin that looks small may sit back in profile or appear vertically short from the front. Seeing this distinction during the examination can help you explain the direction of your desired change. A plan that adjusts vertical length and one that changes forward projection may require different bone movements.

Who may be a candidate?

If you feel that your chin is recessed, prominent, or off the facial midline, options for this area can be assessed during an examination. A wish to change chin height or shape may also fall within the scope of genioplasty. Completion of bone development and whether the desired change matches chin anatomy are considered in deciding suitability.

Treating only the chin may be insufficient for a condition involving the position of the entire lower jaw or the bite. If there is fat or excess skin beneath the chin, the relationship between these tissues and the lower facial appearance to be changed is also examined. Genioplasty and removing fat beneath the chin are different procedures.

An uncontrolled illness, active infection in the mouth, or ongoing jaw development affects the decision about cosmetic surgery. Dental and gum health are part of the examination for a surgical approach through the mouth. If there has been previous jaw surgery or implant placement, the existing bone and soft tissues are examined with that information in mind.

Examination, occlusion, and jaw relationships

The examination considers the chin’s forward projection, height, and position relative to the facial midline. Bone structure and the overlying soft tissues create the visible chin shape. Front and side views help describe the area to be changed more clearly.

Differences in jaw shape and position that also involve biting or how the teeth meet may require a broader plan that includes dental treatment. Alongside the change you have in mind for your chin, you can share any bite concerns. This allows us to give separate attention to your expectations about chin shape and the way your teeth meet.

A procedure that shapes the chin does not correct the relative positions of the tooth-bearing parts of the jaws. Depending on the source of a bite difference, treatment may be needed for tooth alignment, jaw position, or both.

Occlusion is the way the upper and lower teeth contact each other when the mouth is closed. The examination assesses the relationship between the front teeth, the bite on the right and left sides, and the position of the lower jaw relative to the upper jaw. A recessed-looking chin and an entire lower jaw that sits back are different conditions.

The center of the chin is examined in relation to the midline of the nose, upper lip, and teeth. How the lips close at rest and the fold between the lower lip and chin also affect appearance. Whether a right-to-left difference is confined to the chin or also involves the body of the lower jaw helps determine the limits of the procedure.

Imaging may be added to the examination when bone repositioning is planned. These studies show the relationships between tooth roots, the boundaries of the jawbone, and anatomical structures within the bone. The imaging method is chosen according to whether the plan is limited to the chin or requires assessment of the relationship between the jaws.

A profile photograph shows chin projection, while a front view reveals whether the tip is narrow, wide, or directed to one side. Turning the head can change the apparent position of the chin’s center. Front and profile views recorded with the head in its natural position are therefore parts of the same examination. You can use a photograph to show the angle from which you would like your chin to look different.

If the chin has previously been treated with filler, an implant, or bone surgery, the current appearance is interpreted with that information. Previous procedure records, if available, can help clarify implant placement or the direction in which the bone was moved. Previous orthodontic treatment may also be discussed in relation to the current bite. The new plan is based on the present bone boundaries and overlying soft tissues.

Bone reshaping and chin implants

When the chin needs to be reduced, we contour or shorten the bone. We can use an implant to lengthen the chin or add forward projection.

We reach the chin bone through an incision inside the mouth, below the lower front teeth. We reshape the front of the chin bone and then close the incision with dissolvable sutures. Bone contouring, shortening, and implant-based shaping can be performed through the mouth.

A chin implant is a prosthesis placed on the front surface of the chin bone to add volume to this area. Its shape, forward projection, and lateral extensions affect the chin contour. Implant selection takes into account the chin width seen from the front and its relationship to the lower face as well as forward projection in profile.

In addition to an incision inside the mouth, an incision in the skin crease beneath the chin is a surgical option for placing a chin implant. The chosen approach provides access to the area in front of the bone where the implant will sit. Incision location and implant shape are separate planning decisions.

The front part of a chin implant affects forward projection, while its lateral extensions lie along the transition from the chin to the body of the lower jaw. The implant’s name or a single size measurement is therefore not enough to explain the area it will cover on the face. The bony surface on which it will sit and the tissues covering it are examined together with the implant’s shape. The fold beneath the lower lip also contributes to the profile of this front area.

What is sliding genioplasty?

Sliding genioplasty involves cutting a section of chin bone and moving it to a new position. The term for cutting bone is osteotomy. Depending on the planned change, the chin can be moved forward, backward, or sideways. Adjustments to vertical height may also fall within the scope of this technique.

In sliding genioplasty, the bony surface of the chin is reached through the mouth. A planned bone segment below the tooth-bearing portion is moved into its new position and secured with plates and screws. In this procedure, the change in shape comes from repositioning the person’s own chin bone.

An implant adds volume in front of the bone, while sliding genioplasty changes the position of the chin bone. Reducing the chin, adjusting its vertical height, and changing its midline position are separate needs. The direction of the desired movement, bone shape, and overlying soft tissues are considered when choosing a method.

The difference between genioplasty and jaw surgery

Orthognathic surgery describes operations that address the position of the tooth-bearing parts of the upper and lower jaws. Genioplasty focuses on the chin. If a bite difference relates to jaw position, orthodontics, the treatment that adjusts tooth alignment, may be included in the jaw surgery plan.

Chin fillers aim to shape the chin contour by adding volume to soft tissue. They do not involve cutting or moving bone. The options for someone seeking added chin volume therefore differ from those for someone seeking bone reduction. A concern about the bite is assessed through the relationship between the teeth and jaws.

Profile planning with rhinoplasty

We can perform chin surgery on its own or together with nose reshaping surgery (rhinoplasty). If you are considering changes to both the nose and chin, we plan the intended shapes of the two areas according to the same facial proportions.

Profile assessment shows the positions of the forehead, nasal root, nasal tip, lips, and chin within the same face. Forward projection of the nasal tip and a recessed chin affect the relationship between the middle and lower face. Changes to the nose and chin are described separately using these measurements.

Excess volume in the middle of the cheeks may require assessment for buccal fat removal, while fat beneath the chin may require assessment for neck and chin procedures. Including these procedures in the same plan as chin surgery depends on a separate need being present in each area. Chin bone structure, cheek volume, and tissues beneath the chin are different treatment areas.