The genion is the anterior point of the chin. Chin problems can include: under-projection, over-projection, vertical excess, vertical shortness, and angular deformity (crooked chin). Many patients with chin problems have normal dental occlusion, meaning they don’t need movement of their teeth to correct the chin. Under-projection is the most common chin complaint. The best correction of this problem is by surgical advancement of the bony chin, not by insertion of an artificial implant. Correction of all other bony chin problems cannot be solved by an artificial implant.
I perform chin surgery (and all orthognathic surgery) in the hospital, usually as an outpatient procedure under general anesthesia. Genioplasty ideally should not be done before skeletal maturity. Chin alteration is not usually an insurance covered procedure, unless the patient suffers a syndrome or other birth defect.The procedure is done through an intra-oral incision, so that there is no visible scar. If the chin is retrusive, the bone is advanced after separating it from the tooth bearing part of the mandible (jaw). The bone is still attached to its major muscles and their blood supply. The advanced bone is then reattached to the jaw, usually with tiny steel- wire sutures which do not show and are permanent. An external supportive dressing to reduce swelling is worn for 2-3 days, then removed in the office. The oral sutures are self-dissolving. Patients may drink clear liquids immediately and regular food by 3-5 days. An oral narcotic is prescribed but usually discontinued by the patient after 2-3 days. Pain and bruising are minor to moderate in both time and severity. Visible swelling persists for about 10 days. Bone and final healing requires at least 2 months. There are no physical restrictions, however, after 6 weeks.
Genioplasty is a permanent, stable solution to almost all chin abnormalities. The office examination and consultation involves a lengthy discussion of the precise problem, its possible solution by a surgical strategy and the techniques involved, and the risks. Many of my genioplasty patients have been previously treated unsuccessfully with chin implants. It is common to perform genioplasty and rhinoplasty on a patient with combined nose and chin disharmony. As a craniofacial and maxillofacial surgeon, genioplasty represents one of the simplest bony operations that I perform. But if genioplasty were truly “simple”, most plastic surgeons would offer it (most don’t due to inadequate training), especially because its results are vastly superior to a chin implant.