Definition & Overview
A genioplasty is a surgical procedure used to enhance the shape and appearance of the chin. Also known as chin augmentation, it can be performed alone or in combination with other jaw-related surgeries either for medical or cosmetic purposes. Skeletal surgery involving the chin has been in use since the mid-1940s and the technology used in performing such procedures has greatly improved in recent years.
The chin, also known as the mentum, has a significant effect on the facial appearance of a person. By undergoing a genioplasty, patients can alter the overall profile and symmetry of their face.
Who Should Undergo and Expected Results
Genioplasty can be taken advantage of those who have problems with their chins, such as:
- Prominent or over projected chin
- Protruded chin
- Recessed chin
- Angle class II skeletal deformity
- Retruded chin
- Hypoplastic mentum
- Horizontal mandibular hypoplasia
- Chin deformities, such as occlusal or skeletal deformity
- Hemifacial microsomia
- Facial disharmony
The goals of the procedure are to:
- Create an aesthetically pleasing facial contour
- Establish a proportionate facial height
In a study involving 37 genioplasty patients, the majority were generally pleased with the results of the surgery and only one experienced some reservations regarding the results but not enough to seek further adjustments. There were also no significant complications observed during a 2-year follow-up period. The resulting chin appearance and position were maintained well in all cases.
How is the Procedure Performed?
The goals of a genioplasty can be achieved through:
- Chin augmentation
- Chin reduction
- Alloplastic chin implants – These are the primary option for minor abnormalities involving the chin. They are highly effective in creating a more balanced and symmetrical appearance among patients with receding chins.
- Sliding genioplasty – This procedure is reserved for more complex chin deformities, such as those caused by genetics, trauma, or disease. This procedure can resolve problems related with chin deformities, such as airway obstruction. Since this is a sliding surgery, no bone grafting procedure is required.
- Osseous genioplasty
A genioplasty can be performed either horizontally, vertically, or a combination of both. A horizontal genioplasty is ideal for chins that protrude outwards, while a vertical genioplasty is appropriate for removing or adding bone tissue to either increase or decrease chin length. In some cases, however, both horizontal and vertical changes are required to achieve the patient’s desired results. It is normal for surgeons to use pre-bent titanium plates and screws, which sizes range from 3mm to 8mm, to hold the modified chin in place following the surgery.
All genioplasty procedures are performed under general anaesthesia and with an incision either under the chin or inside the mouth. Depending on the goal of the procedure, it may involve cutting or removing a piece of the chin bone or placing chin implants. Most cosmetic genioplasty procedures are performed on an outpatient basis, but in some cases, patients may be admitted to a hospital particularly if the procedure was performed due to a serious disease or traumatic injury.
A soft diet is mandatory for a week following surgery due to the surgical wound in the chin or inside the mouth. It is normal to experience some pain and swelling during the first few days or weeks, but these tend to resolve without treatment or with the use of mild pain reliever. Patients may also be required to take pain medications and antibiotics, and to use a special chin elastic garment to hasten the recovery process and make it as comfortable as possible. Most patients are able to resume their normal activities 2 weeks after the procedure, although full recovery may take up to 6 weeks.
Possible Risks and Complications
A genioplasty is not without potential risks. Aside from the usual pain and swelling that follow the procedure, patients may also suffer from some unpleasant side effects, some of which may require treatment or further surgery. These include:
- Nerve injury, due to the position of the mental nerve, the nerve that exits the jaw near the line where genioplasty incisions are usually made
- Numbness of the surgical site – Numbness is often temporary but may also be permanent in some rare cases.
- Irritation due to the plates and screws used
- Unpleasant aesthetic results
- Allergic reaction to anaesthesia
To prevent risks and complications, patients are required to undergo a pre-surgical screening or physical evaluation and a follow-up checkup after the procedure.
Deshpande SN, Munoli A. “Osseous genioplasty: A case series.” Indian J Plast Surg. 2011 Sep-Dec; 44(3): 414-421. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263268/
Chang E., Lam S., Karen M., Donlevy J. “Sliding genioplasty for correction of chin abnormalities.” Arch Facial Plast Surg. 2001;3(1):8-15. http://archfaci.jamanetwork.com/article.aspx?articleid=479824