Genioplasty (Chin Surgery)

Also known as a genioplasty, this is an operation carried out on the chin. This can be for advancing the chin if it is deficient, or to take it back if it is too prominent. It can be used to correct the centerline of the face if there is a left/right discrepancy (asymmetry) of the jaws and face. Chin surgery can address a small and deficient chin. It can also be used to make the lower face look vertically longer or shorter from the front and in profile, depending on the individual patient's needs. Chin surgery can also, under certain circumstances, be used to camouflage a lower jaw deficient in horizontal length. There are, however, other operations also available for the latter (see jaw surgery). A genioplasty can also be used to enhance the results of a cosmetic rhinoplasty to bring the face into full harmony. What particular operation the patient needs, however, can be discussed with a board certified Maxillofacial Surgeon, with an interest in orthognathic, facial aesthetic and cosmetic surgery.

This is a very versatile procedure and can produce face-transforming results. A chin can be augmented (lengthened) or reduced by an operation called an osseous genioplasty (chin osteotomy, also called sliding genioplasty). This is done entirely within the mouth, so there are no external skin scars. In simple terms the bone of the chin is divided in such a way that it slides forwards or backwards to lengthen or shorten the chin and jaw. The chin osteotomy can also reduce or increase the height of the lower face depending on the cosmetic needs of the patient. The bone surgery site on the chin is fixed with very small screws and heals quickly. The most important complications to be aware of are potential numbness to the gums, front teeth, the lower lip and chin. These are usually transient, but may take weeks or months to resolve. Occasionally, there may be permanent numbness to areas of the lip and chin of varying degrees. Even when numbness to the lip is permanent, the brain normally adapts to this change and the patient loses awareness of this problem after a few months. We have never found the latter complication to be a problem that any of our patients have not easily adapted to. In addition, the risk of this happening is small.

A chin implant is an alternative to an osseous genioplasty for augmenting the chin, by placing a prosthetic chin implant. This has its place, but is less popular with surgeons who are able to perform a chin osteotomy. A chin implant should only be used for subtle advancements of 5 mm or less. If it is used for bigger augmentations, long-term it will probably fail by causing bone erosion as a result of the pressure it causes on the bone it is anchored to. A chin implant is almost always placed through an incision in the skin under the chin, which leaves a scar. As it is a foreign material, it presents with a chance of being infected and rejected. As it is a prosthesis, it never integrates with the body and may move as a result of gravity and chin muscle movement from its original position in time.

This is one of the most challenging surgical problems and requires an experienced surgeon in the field, versed not only in the surgical management of facial asymmetries, but in diagnosing the underlying cause which can vary from a dental malocclusion causing displacement of the chin point, and if missed result in unnecessary surgery, to growth disorders of the Temporomandibular Joints and jaws. The surgeon must be expertly versed in osseous genioplasties to manage these cases successfully, sometimes to the millimeter. A discrepancy of as little as 3 mm may cause a very obvious asymmetry. This requires precision technique and we have the requisite experience in tackling such challenging problems.

Unfortunately for patients, the implant genioplasty seems to be the most common procedure currently employed by surgeons to lengthen a short chin and, inappropriately, a short lower jaw. The reason for this is that chin implants are technically much easier to place by surgeons who do not have the technical expertise in osseous genioplasties. This disadvantage limits the patient's options and subsequent results.

Patients are admitted on the day of the operation and are usually discharged on the same day of the procedure, depending on how they feel. The procedure is performed under general anaesthesia.

Patients also often have chin surgery and cosmetic rhinoplasty performed at the same time, as the nose and chin often need addressing together in facial aesthetic surgery, but again this is individually addressed according to each patient's needs and wishes. Chin surgery can also be performed simultaneously with other osteotomies in orthognathic surgery if needed to enhance the facial outcome of this type of surgery.

It usually takes between 25 and 45 minutes to perform a genioplasty. It is not particularly painful afterwards. Osseous genioplasties are routine procedures with very good outcomes in our hands.

Intra-oral sutures dissolve on their own after 2 weeks. There is some swelling which resolves after 7 - 14 days very rapidly. Most people feel comfortable going out after 2 -3 days. No more than 5 to 7 days off work is necessary but this will depend on the patient's circumstances.

In terms of possible complications, see the section under osseous genioplasty and implant genioplasty.

It must be appreciated that all the information given above has been provided in good faith and is meant only as a guide. A personal consultation will be needed for a full understanding of what you may need and expect from any treatment described.

We carry out these procedures in several hospitals across London including Spire Bushey Hospital, The Clementine Churchill Hospital and Trust Plus Northwick Park Hospital in the North West & The Hospital of St John and St Elizabeth and The London Clinic in Central London.

If you would like to get an indication of the cost associated with chin surgery, please contact our secretary.