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Genioplasty (Chin Surgery) - Iranian Society of Plastic and Aesthetic Surgeons

Genioplasty (Chin Surgery)

Chin Surgery

Chin surgery, or mentoplasty, is a surgical procedure to reshape the chin either by enhancement with an implant or reduction surgery on the bone.

Plastic surgery, and other minor office procedures, can often be performed on the lower jaw line and chin area to improve proportions of the face and to help with one’s confidence and self-esteem. These types of interventions are frequently suggested by board-certified plastic surgeons to improve the harmony of facial features and improve the chin/jaw/cheek/forehead balance.

Sometimes bone from the jaw itself can be moved forward in an operation called a mentoplasty or genioplasty. Alternatively, shaped silicone implants can be used to give more projection to the chin. Conversely, bone can be removed to decrease an overly projecting chin. Furthermore, modifications to the upper and/or lower jaw can be advised for improved chewing dynamics and occlusion—or how the teeth fit together. These operations can range from simple to very complex.

Many times a plastic surgeon may recommend chin surgery or procedures to a patient having a rhinoplasty in order to achieve better facial proportions, as the size of the chin may magnify or minimize the perceived size of the nose.

Additionally, with recent advances in technology, and after obtaining informed consent after reviewing all options, risks and benefits, your plastic surgeon may suggest off-label use of FDA approved gel filler material as an alternative for providing augmentation of the chin area that may last for a shorter duration.

The profile of your chin needs correction because the bones of your face and jaws are out of balance with each other. Surgery to change position of the chin is called genioplasty. The surgery will take place under a general anaesthetic, ie: you are going to be put to sleep completely. Genioplasty is often carried out at the same time as other corrective surgery on your jaws but you may well find that your surgeon has advised you to have it carried out at a later stage.

Genioplasty is most frequently a cosmetic surgery, meaning people choose to have it for looks and not because of a medical problem. For this reason, it’s often not covered by insurance.

How do I choose a plastic surgeon for chin surgery?

Chin surgery involves many choices. The first and most important is selecting a board-certified plastic surgeon you can trust who is a member of the Iranian Society of Plastic Surgeons (ISPAS).

ISPAS member surgeons meet rigorous standards:

  • Board certification by the Iranian Board of Plastic Surgery® (ISPAS) .
  • Complete at least six years of surgical training following medical school with a minimum of three years of plastic surgery residency training
  • Pass comprehensive oral and written exams
  • Graduate from an accredited medical school
  • Complete continuing medical education, including patient safety, each year
  • Perform surgery in accredited, state-licensed, or Medicare-certified surgical facilities

There are several ways to conduct this procedure:

  • advancement, or moving the chin forward
  • pushback, or moving the chin backward
  • side-to-side, which can help with asymmetrical chins
  • vertical changes, such as making the chin longer or shorter

Types of genioplasty

There are two main types of genioplasty: sliding genioplasty and chin implants.

Sliding genioplasty

In a sliding genioplasty, a surgeon uses a saw to cut the chin bone away from the rest of the jaw and move it to correct a chin deficiency. This is also called an osseous genioplasty.

This type of genioplasty is recommended for people with severe retrogenia, or people whose chin is too far back in relation to the rest of their face. It can also help with correcting chins that are pushed too far forward and are too long.

Chin implants

Chin implants can be used to reshape, enlarge, or push forward the appearance of the chin. This can be accomplished via surgery or injection.

Surgical chin augmentation involves implanting a plastic material into the chin and adhering it to the bone. Alloplastic implants (those made from synthetic materials) are the most common.

Nonsurgical chin augmentation involves using needles to inject fillers, such as body fat, to enhance the appearance of the chin.

Sliding genioplasty surgery

This procedure can take place in a hospital or an office operating room. Most have general anesthesia for the procedure.

To start, your surgeon pulls down your lower lip and cuts on the gum of the lower lip below your bottom teeth. Then the soft tissue is separated from the chin bone. Your surgeon uses a saw to cut a small vertical line in the chin for reference. This ensures the bone stays straight when it’s moved forward or backward.

The doctor then makes a horizontal cut along the chin bone. If you’re getting your chin moved backward or made smaller, your doctor also cuts out a wedge of bone. Then they slide the bone forward or backward and attach screws and possibly a metal plate to ensure it stays in place.

To make your chin longer, they reattach the bone with a gap between the rest of the jaw and the chin. Bone will grow back over time and fill this gap.

To make your chin shorter, they remove the wedge of bone and reattach your chin to the rest of your jaw.

If you’re having your chin moved forward, surgery may create a “step” in the bone. Steps are much more visible in women than in men because of a lack of facial hair. If you have a step, your surgeon may shave some of the bone down to avoid it showing.

Then the incision is stitched closed. Your doctor then puts compression tape on the outside of your mouth and chin to ensure the area is protected during early healing.

Aftercare

Following your surgery, your surgeon will instruct you to take oral antibiotics for two days. Oral stitches are absorbable, so you won’t have to return to the hospital to get them removed.

You may begin eating normally as soon as you feel you’re ready. A liquid or soft-food diet is recommended. You must rinse your mouth with water or antiseptic oral rinse following every meal.

After three to five days, you can remove your wound dressings and compression tape, and return to your daily routine. Don’t exercise for the first 10 days following surgery. Don’t participate in contact sports for six to eight weeks.

You may notice swelling, redness, or bruising, which should go away after a few days.

If you notice any of the following, you should contact your doctor immediately:

  • fever of 100.4˚F (38˚C) degrees or higher
  • bruising, redness, or swelling that doesn’t go away within a week
  • strong-smelling odor coming from the incision
  • yellow or green discharge
  • bleeding that can’t be stopped with light pressure

Chin implant surgery

For a chin implant, a surgeon can either cut inside your mouth or under your chin. Before surgery, your surgeon will have sculpted the implant to the right size and shape so it’s ready for insertion.

There are several different types of alloplastics used for chin implants, such as silicone, teflon, and medpore. Medpore is a newer material that’s growing in popularity because it has “pores” in the plastic, which allow for the tissue to adhere to the implant rather than around it. Implants are adhered to the bone using screws.

Once the material is implanted, the surgeon stitches up the incision. This procedure can take anywhere from 30 minutes to three hours.

If you choose to have a nonsurgical implant, your doctor may inject dermal fillers or some of your own fat following liposuction.

Aftercare

Fillers are injected with a needle and involve no scarring and minimal recovery time.

Surgical implants have a similar recovery time to sliding genioplasty because the tissue must have time to adhere to the implant. In-mouth sutures are absorbable and don’t need to be removed.

You may begin eating a soft-food or liquid diet as soon as you feel comfortable. Make sure to rinse following every meal with water or antiseptic rinse.

Complications

Complications for genioplasty include:

  • infection
  • allergic reaction to an implant
  • extrusion of implant
  • exposure of screws
  • nerve damage that causes mouth or lip numbness

How much does a genioplasty cost?

It’s difficult to generalize how much genioplasty will cost. The cost of each surgery is as unique as you are. Things that can impact price include:

  • where you live
  • what surgeon you work with
  • how far the jaw is moving
  • how big the implant is
  • material the implant is made of
  • your insurance coverage
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