Chin Surgery
The chin is probably the facial structure with the greatest influence on the profile and the one that receives the least attention. A good share of patients who come asking for rhinoplasty actually have an under-projected chin: the nose looks large because the chin sits back, and operating on the nose alone does not balance the whole. That is why I always analyse the complete profile before proposing any facial surgery.
When is it recommended?
- An under-projected chin that unbalances the profile and makes the nose look larger.
- An excessively prominent or long chin.
- A poorly defined cervicomental angle, with a double-chin appearance despite no excess fat.
- Asymmetry or deviation of the chin relative to the facial midline.
My approach
Whenever the anatomy allows it I prefer sliding genioplasty, which means moving the patient’s own bone into the correct position and fixing it there. Compared with an implant it has advantages that matter in the long run: there is no foreign material, no risk of late infection or displacement, and it allows correction in three dimensions at once — advancing, lengthening or shortening, and centring a deviated chin — which an implant cannot do. Implants remain a valid option in specific cases, especially when only projection is lacking and the patient prefers a simpler operation.
When the problem is not the chin but the jaw
This is the most important distinction in this consultation. A chin can look small for two very different reasons: because the chin bone is under-projected with a correct bite, or because the whole lower jaw sits back, usually accompanied by a bite in which the upper teeth are well ahead of the lower ones. In the first case genioplasty solves the problem. In the second, advancing only the chin camouflages the profile but leaves the cause untouched: the bite is unchanged, with its consequences for chewing, dental wear and sometimes night-time breathing. There the correct solution is orthognathic surgery, repositioning the jaws. Telling the two apart requires assessing the occlusion, not just looking at the profile — precisely what maxillofacial training provides.
Why the chin affects the neck
Many patients consult about a double chin that does not improve however much weight they lose, and the cause lies not in fat but in bone position. When the chin sits back, the angle between neck and jaw opens up and the neck skin loses the support that bony projection provides, so the submental area looks full even when it is not. Advancing the chin tightens that area and defines the cervicomental angle immediately. This is why in well-selected patients a genioplasty improves neck contour more than any fat-directed treatment, and why the two are sometimes combined in a single operation.
Recovery
The incision is made inside the mouth, so no visible scar remains. Swelling peaks between the second and third day and drops clearly during the first week; most patients resume social activity at around 10 days. A soft diet and avoiding impact to the area are recommended for the first weeks. Numbness of the lower lip and chin is common — a temporary change in sensation that recovers progressively over the following weeks or first months.
Frequently Asked Questions
Is a chin implant better than moving the bone?
It depends on what needs correcting. If only forward projection is lacking, both options give good results and the implant is a somewhat simpler operation. But if the chin also needs lengthening or shortening, or centring because it is deviated, an implant cannot do it: it only adds volume in one direction. Moving the patient’s own bone also permanently avoids the risks associated with foreign material which, though uncommon, exist and can appear years later.
Can it be combined with rhinoplasty?
Yes, and in many cases it is what truly balances the profile. When the chin sits back, reducing the nose without addressing it can leave a result that still does not look harmonious, because the problem was not purely nasal. Combining both in a single operation means one anaesthetic and one recovery, and allows the profile to be assessed as a whole rather than in parts.