What can be corrected
It helps to separate three dimensions, because they are not treated in the same way:
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Projection: how far the chin sits forward or back in relation to the profile. This is the most common reason for consultation.
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Height: chins that are vertically long or short, which alter the proportions of the lower third of the face.
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Width and symmetry: wide, narrow or deviated chins.
The implant acts mainly on projection. For height or a deviation, the usual route is an osteotomy.
When it is indicated
When the chin throws the face out of balance and that imbalance comes from bone or volume. If what bothers the patient comes from the skin of the neck, fat under the chin or the position of the teeth, the right thing is to suggest another treatment or not to operate.
Receding chin (microgenia)
This is the most common case. The chin sits behind the profile line, the nose looks bigger and the angle between neck and jaw looks less defined even without excess fat. Many patients who come in about their nose actually have a receding chin.
Prominent or asymmetric chin
The first step is to find the origin. If the excess is in the chin bone and the bite is correct, a reduction osteotomy can be done. If the bite is altered, the problem lies in the jaws and calls for orthognathic surgery.
Techniques
Chin augmentation with an implant
A prosthesis made of biocompatible material is placed on the bone, through an incision inside the mouth or under the chin. It is simpler, there are shapes and sizes to fit the contour, and it is reversible: the implant can be removed or replaced. It introduces a foreign material and corrects mainly forward projection.
Chin osteotomy (genioplasty)
A segment of the chin itself is cut and fixed in the planned position. Because the patient's own bone is moved, movements in several planes can be combined: forward or backward, up or down, and correction of a deviation. It is technically more demanding and requires more planning.
Chin and nose: the profile as a whole
A chin with little projection accentuates a large nose, and a prominent nose makes a receding chin more obvious. That is why the examination always includes both structures. Sometimes rhinoplasty and chin surgery are done in the same operation as part of a profileplasty; in other cases correcting only the chin is enough.
If the aim is only to define the contour without surgery, there is chin bioosteoplasty, with a different scope and a different duration.
What it does not solve
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A double chin and sagging neck. Better projection defines the angle more, but it does not remove fat or tighten skin; that is what a neck lift is for.
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Bite problems: it changes the contour, not the function.
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Overall asymmetry of the face.
How it is planned
- Interview: what bothers you and what you expect, compared with what surgery can offer.
- Examination of the bone contour, the bite, the soft tissues of the chin and lower lip, and the neck angle.
- Standardised photographs, with attention to the profile.
- Imaging if the bone needs to be assessed in detail or a malocclusion is suspected.
- A joint decision on technique, approach and amount of change, with the risks explained beforehand.
After surgery
In the first days, swelling and discomfort when talking and chewing predominate. A soft diet is usually advised and, if the incision is inside the mouth, specific hygiene care. Numbness of the lower lip or chin is common and in most cases recovers gradually.
Daily activity resumes before impact sports or any activity with a risk of a blow to the face. The contour takes time to settle and is assessed at the scheduled check-ups.
Risks and limitations
- Prolonged swelling of the lower third of the face.
- Altered sensation in the lower lip and chin due to the mental nerve, generally temporary although it can persist.
- Asymmetry or a projection different from the one planned, which sometimes requires revision.
- Displacement or extrusion of the implant, both uncommon, which may require repositioning or removing it.
- Infection and the risks of anaesthesia.
How much change is possible depends on the available bone, the thickness of the tissues and each person's anatomy.
Frequently asked questions
What types of chin surgery are there?
Two main ones. Augmentation with an implant places a prosthesis on the bone through a hidden incision. Osteotomy moves a segment of the chin itself and can also correct height or an asymmetry.
Is an implant or moving the bone better?
It depends on the defect. The implant is simpler and reversible, suitable for bringing a short chin forward. The osteotomy introduces no foreign material and allows movements in several planes.
Can the chin be operated on together with the nose?
Yes, and it is often what is indicated, because a receding chin makes the nose look bigger. The whole is always assessed.
What is the recovery like?
Swelling and discomfort when talking and chewing in the first days, a soft diet and, if the incision is inside the mouth, specific hygiene. Usual activity resumes within a few days and the swelling of the contour takes a few more weeks.
Can the implant be felt or move over time?
It is placed in a deep plane, fitted to the bone, and once integrated it is not usually noticeable. Displacement and extrusion are described, uncommon complications that are explained before deciding.
Is there a non-surgical option?
To define the contour without surgery there is chin bioosteoplasty, with a different scope and a different duration. It cannot change height or correct a deviation.