Genioplasty Procedure | Enlarging Or Reducing The Chin

If you have a congenital chin deformity (a small receded chin, a large prominent chin, or a crooked chin point that creates facial asymmetry), it may not only impact your general health but also your self-confidence. The chin has a significant impact on an individual’s facial appearance as it is a major contributor to the lower face features; providing definition to the jawline and enhancing facial appearance in profile.

Facial harmony is achieved by repositioning the chin to balance other facial features such as the nose, lips and forehead. The chin position also assists in providing lip seal over the teeth (lip competence), thus enhancing the appearance and protecting the dentition.

This article explores everything you need to know about genioplasty, including the types of genioplasty, who genioplasty is ideal for, its advantages and disadvantages, the stages of a genioplasty procedure, genioplasty recovery and complications.

What Is Genioplasty?

Genioplasty is a surgical procedure performed by specialists designed to enhance the appearance of the face by harmonising the jaws, nose, chin and smile. It involves changing the shape of the chin to alter a patient’s facial profile and symmetry. This procedure can be performed alone or in combination with other jaw-related surgeries to produce the client’s desired medical or cosmetic outcome.

What Conditions Does Genioplasty Correct?

Genioplasty is ideal for people who experience chin problems. These may include:

• Congenital chin deformities that produce facial disharmony, such as condylar hyperplasia, hemi-mandibular elongation, hemifacial microsomia, occlusal and skeletal deformities.
• An enlarged chin (macrogenia)
• An unusually small or deformed chin (microgenia)
• A weak, receding or under-projected chin (retrogenia)
• A prominent, protruding or over-projected chin (mandibular prognathism)
• A recessed jaw and overbite (retrognathia)
• A double chin and full lower face
• An ageing neck and jawline
• Sleep apnoea correction to improve tongue position and open the airway

The goals of a genioplasty procedure involve:

• Creating an aesthetically pleasing facial contour
• Improving jawline definition
• Correcting facial asymmetry
• Establishing a proportionate facial height and aesthetic balance to the face overall

Types of Genioplasty

Horizontal Genioplasty

A horizontal genioplasty is useful for reducing the prognathic (large) chin that protrudes forwards.

Vertical Genioplasty

A vertical genioplasty is ideal for increasing or decreasing chin height, where there are discrepancies of facial height, between the lower, middle and upper facial dimensions. Vertical height is increased by adding bone or bone graft material, which is held in place with tiny plates and screws.

Sliding Genioplasty

Most commonly, your genioplasty will be a sliding type whereby the height, prominence and symmetry of the lower face and chin can be adjusted simultaneously.

It is also key for resolving issues such as airway obstruction. This type of surgery involves detaching the chin and moving it (along with the muscles that control the tongue) forwards, or forwards and down.

Alloplastic Chin Implants

Alloplastic chin implants are ideal for minor abnormalities involving the chin. They are highly effective in creating a more balanced and symmetrical appearance among patients with receding chins.

How Is A Genioplasty Procedure Performed?

All genioplasty procedures are performed by creating an incision either under the chin or inside the mouth. Depending on the goal of the surgery, this may also involve cutting or removing a piece of the chin bone or placing a chin implant. These procedures typically require inpatient, general anaesthesia.

Stages Of Genioplasty Surgery

1. The patient is admitted to hospital and is administered local and general anaesthesia.
2. The specialist surgeon will make an incision on the inside of the lower lip or under the chin, down to the bone level.
3. With the chin exposed, the surgeon can identify the mental nerve on each side of the jaw bone.
4. The specialist surgeon will cut the chin bone with a saw, starting from either the left or right side of the chin below and in front of the mental nerve. The muscles attached to the detached chin are maintained to ensure undisturbed blood supply.
5. The chin is repositioned into a more correct position and secured with a titanium plate and screws.
6. The specialist surgeon will close the incision with sutures and apply a pressure bandage for two days.

Advantages of Genioplasty

1. Surgical accuracy – the specialist surgeon analyses the individual’s facial shape using 3-dimensional computer software to simulate and predict the ideal facial dimensions. This virtual surgical plan is then transformed into a custom made surgical guide via 3-dimensional printing technology. Use of this type of surgical guide enables accurate positioning of the chin (better patient outcomes) using minimally invasive surgical approaches resulting in shorter surgery duration (and faster patient recovery) and also reduces the risk of complications for the patient.
2. The bone heals very well and once complete healing and remodelling have completed, there are usually no visible signs of surgery. Very occasionally, the fixation plate and screws may need to be removed.
3. The shape of the chin can be resized and repositioned in any direction.

Disadvantages of Genioplasty

Genioplasty is a surgical procedure, so complications can occur rarely. Transient facial swelling, pain and numbness in the lower lip (due to the proximity of the bone cut to the mental nerves) can occur. Your chin or jaw region may feel swollen, tight and bruised for several weeks.

What’s Involved In Genioplasty Recovery

Pain

Moderate pain is expected for a couple of days after the surgery. Your surgeon will likely prescribe appropriate pain medication to help you manage this pain and discomfort in the days immediately following the surgery. While pain and swelling may disappear over the course of a few weeks, full recovery can take up to six weeks.

Care

To minimise the risk of infection, you will be given a course of antibiotics. You can help reduce swelling by applying a cold pack to the area over the first several days after surgery. Your surgeon may also recommend you use a special chin elastic garment to speed up healing and improve your comfort throughout the recovery process.

Most patients can safely resume their normal activities two weeks after the genioplasty.

Timeline

Recovery tips

• Spend 10 minutes every 2 hours engaged in light walking indoors as you recover.
• Recline but do not lie down. Keep your head elevated without bending forward or over.
• Take all medication, exactly as prescribed.
• Use an oral rinse as instructed, after every meal, before bedtime, and at least 6 times per day.

Activities to avoid

• Avoid driving for at least 48 hours after surgery.
• Avoid hard or difficult to chew food for several weeks. Instead, choose soft, bland, nutritious food for the first 24 hours.

Genioplasty Complications

When performed by an experienced and well-qualified specialist surgeon, genioplasty is associated with a low incidence of complications. However, it is not without potential risks. Possible risks include:

• Nerve damage (lower lip and chin)
• Temporary or permanent numbness at the surgical site
• Damage to lower teeth
• Bleeding
• Infection
• Persistent facial asymmetry

To reduce risks and complications, all patients must participate in a pre-surgical physical evaluation and attend follow-up reviews after the genioplasty procedure.

Speak with the surgical specialists at Dental Implant & Specialist Centre about what genioplasty can achieve for you. Get in touch today on (07) 5503 1744.