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Why Some Patients Need a Genioplasty

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By Jerome Edelstein, MD

A genioplasty is an alternative to the chin implant. By using a patients own bone, the surgeon can change the projection, height, shape and proportion  of a person’s chin.  It therefore offers more versatility than an implant chin augmentation, which can really only give the chin more projection and to some degree change the shape. The results of a sliding or osseous genioplasty are dramatic, making the face and its other features more proportional.  A genioplasty can move the patient’s chin forward or backward, up or down and even make it wider  and more square or narrower and more rounded. An osseous, or sliding genioplasty can also change a persons facial shape, giving them a more striking “V” line shape, as opposed to a rounded lower facial shape.  It has the added effect of tightening the neck line and jaw line, making the patient more youthful looking by reducing the signs of aging such as jowls and double chins.

There are significant benefits to undergoing the osseous genioplasty. In a sliding or osseous genioplasty, the patient’s chin bone is cut and slid forward, up, or down , (or side to side if there is an asymmetry), to position the chin in the ideal position,  which is determined with pre-operative x-rays and very precise measurements.  There is still bone to bone contact in the new chin position, and that position is secured by a very small titanium plate. In approximately 4-6 weeks the cut in the chin bone heals and the chin becomes one complete bone again with a new more proportionate shape and position, bringing with it all the muscles fat and skin and thus tightening these soft tissues which, when loose can show signs of aging, even in younger patients.

Silicone, or silastic chin implants, can shift position and sometimes cause the underlying bone to change shape. This can result in post-operative asymmetry. With genioplasties, this won’t happen because the bone heals as a solid single bone.  Some implants are made of hard synthetic material, and these can be secured to the underlying bone with titanium screws.  Ask your surgeon about this option as well.  Once again, a plastic surgeon who specializes in facial bone surgery will be familiar with all of the advantages and disadvantages of each of the available chin procedures.

Why Someone Would Need to Undergo Chin Surgery

Some of the reasons why a person might need a genioplasty includes dealing with one or more of the following situations:

Congenital Chin Deformity: Genioplasties can fix different types of congenital chin conditions.

Large nose: When a patient has a weak or receding chin, it can cause their nose to appear bigger. To achieve an aesthetically pleasing balance of the facial features, the surgeon can change the shape, size and projection of the chin. A rhinoplasty (nose job) may then not even be necessary. A qualified plastic surgeon with expertise in facial surgery, such as a craniomaxillofacial surgeon, will be able to point this out and potentially save you from an unnecessary added procedure.

A small lower jaw or underbite: A mandible, or lower jaw that is too small for a person’s face is known as mandibular hypoplasia. Mandibular Proganthism is the term for a jaw that is too large. Both of these conditions can and often are treated with braces and jaw surgery.  A genioplasty can mask the disproportionately large or small lower jaw and thus preclude the need for major, risky jaw surgery.

Double chin and full lower face: Many younger patients may have a disproportionately full lower face and double chin as a result of a weak chin or small lower jaw.  This is in spite of them not being overweight.  The lack of bone structure in the chin, however, can make them appear overweight.  Genioplasty will give them a thinner more structured lower face, more proportionate to the rest of their face and give the appearance of being fit and thin.

Aging Neck and Jaw line: When a patient ages, the fatty tissue, skin and muscle bands of the neck can begin to lose its former elasticity. This can cause the patient’s tissues to sag, and to lose definition between their neck and chin. Jowls will also develope. Chin augmentation surgery either with an implant or an osseous genioplasty, supports the sagging soft tissues, reducing jowls and defining the neck line in an often dramatic way.

Call or email us if you’re interested in correcting a troublesome chin with a genioplasty. Our staff will be happy to assist you in any way we can.

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