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Procedure guide · Face
GenioplastyGenioplasty reshapes the chin by cutting the chin bone and repositioning it, rather than by adding an implant on top of it. Working through an incision inside the lower lip, the surgeon moves the freed segment forward, backward, up, down or sideways and fixes it with titanium plates and screws. The operation takes 60 to 90 minutes under general anaesthesia, swelling settles over 4 to 6 weeks, and the final shape appears at 3 to 6 months.
Genioplasty is the operation that moves the chin rather than adding to it. Through an incision inside the lower lip, the surgeon exposes the front of the chin bone and makes a horizontal cut across it, safely below the roots of the teeth and below the nerves that supply the lower lip. The freed segment of bone, which carries the muscle attachments of the chin with it, is then repositioned and held in its new place with small titanium plates and screws. Because the segment is completely mobile once cut, it can be moved in directions that no implant can achieve: forward, backward, upward, downward, or rotated to one side.
That range of movement is the entire argument for genioplasty over a chin implant, and it matters more often than patients expect. A chin can be deficient in three dimensions. It can sit too far back, which an implant also treats. It can be too long, giving a lengthened lower face that implants make worse rather than better, and only removing a wedge of bone will shorten it. It can be too short, which requires the segment to be brought down and the gap grafted. And it can be deviated off the midline, visible in every photograph, which an implant placed on an asymmetric base tends to emphasise. Only genioplasty addresses all four.
There is a second, quieter advantage. Because the chin muscle stays attached to the bone segment that is moved, advancing the chin also advances the muscle and the soft tissue slung beneath it. This tightens the tissue under the chin in a way that placing an implant on top of the bone does not, and it is one reason surgeons often prefer genioplasty in patients who also have a soft, poorly defined submental area. Conversely, if the muscle is not carefully resuspended when the wound is closed, the soft tissue can sag away from the repositioned bone, producing the deformity known as chin ptosis. That is a technical point, but it is a useful one to raise at consultation because it distinguishes surgeons who do this operation regularly from those who do not.
Genioplasty is also the safer choice in one specific circumstance that is easy to overlook: it introduces no foreign material. There is no implant to become infected, to shift, or to be felt through thin skin, and no device that might need removing in 20 years. For patients who are uneasy about permanent implants, or who have had an implant become infected before, this is decisive. The titanium plates that hold the bone are far smaller than an implant, lie flat against the bone, and stay permanently without causing problems in the overwhelming majority of cases.
The operation is more involved than an implant and the recovery reflects that honestly. Genioplasty takes 60 to 90 minutes under general anaesthesia. The chin and upper neck swell substantially, considerably more than after an implant, and the swelling takes 4 to 6 weeks rather than 2 to 3 to settle. The first week is liquid and soft food with antiseptic rinses after everything, because the wound is inside the mouth. Pain is generally modest and controlled with simple analgesia within a few days, which surprises patients who expect bone surgery to be agonising.
What dominates the early weeks is numbness rather than pain. The mental nerves run immediately above the bone cut, and after genioplasty numbness of the lower lip and chin is the rule rather than the exception. The lip feels dead, hot drinks cannot be judged accurately, and speech feels unfamiliar. Sensation returns gradually and patchily over 3 to 6 months, often heralded by tingling and pins and needles, and the great majority of patients end with normal or near-normal feeling. A small minority retain a permanently altered patch, and this is the single most important risk to weigh when choosing genioplasty over an implant.
A frequent misunderstanding is worth correcting directly: genioplasty does not involve the bite and the jaw is never wired shut. The bone cut is made across the chin, well below the tooth roots, and does not touch the dental arches, the jaw joint or the way the teeth meet. This is what separates genioplasty from orthognathic surgery, which moves the whole upper or lower jaw and does change the bite, requires orthodontic preparation, and has a much longer recovery. Patients who need their bite corrected need orthognathic surgery; patients whose bite is fine but whose chin is wrong need genioplasty. Occasionally both are done, the genioplasty refining the chin at the end of a jaw operation.
Planning is where good genioplasty results are made. Because the bone is being moved by measurable amounts, the operation lends itself to planning from a CT scan, and increasingly to virtual surgical planning, in which the movement is simulated on a three-dimensional model and a cutting guide is produced for theatre. This is particularly valuable for asymmetry, where judging rotation by eye during surgery is unreliable. Asking whether the surgeon plans from a scan, and asking to see the plan, tells you a great deal about how the operation will be conducted.
Finally, a word about expectations in asymmetry, because it is where genioplasty is most often sought and most often over-promised. Rotating the chin segment can bring a deviated chin point back to the midline with real precision. What it cannot do is correct asymmetry in the soft tissue above it, or in the rest of the facial skeleton, and no face is symmetrical to begin with. The realistic aim is to make the asymmetry unremarkable rather than to abolish it, and a surgeon who says so at the consultation is more likely to deliver a result you are happy with than one who promises symmetry.
Surgeons look for these points at the consultation.
Genioplasty suits adults with a markedly recessed, over-projecting, long, short or deviated chin, whose facial growth is complete, whose dental health is good, and who accept a longer recovery than a chin implant in exchange for the ability to move the chin in directions that an implant cannot.
Reasons a good surgeon will ask you to wait or choose something else.
Genioplasty is avoided where the true problem is a jaw discrepancy that requires orthognathic surgery and orthodontics, in active dental or gum infection, in uncontrolled diabetes, in heavy smokers who cannot stop, in patients on bisphosphonates or with previous radiotherapy to the jaw, and before facial growth is complete.
Ask your surgeon which technique they recommend for you and why.
A horizontal cut is made across the chin bone below the tooth roots and the lower segment is slid forward, then fixed with a titanium step plate. This is the standard operation for a chin that sits too far back.
A wedge of bone is removed to shorten a long chin, or the segment is moved down and grafted to lengthen a short one. This is the capability that separates genioplasty from any implant.
The freed chin segment is rotated to bring a deviated chin point back to the facial midline, correcting asymmetry that is visible on every photograph.
The chin segment is moved backward to reduce an over-projecting chin, an operation for which there is no implant equivalent.
Step by step, from arrival to discharge.
Genioplasty is planned from a facial CT scan or cephalometric radiograph, so the direction and distance the chin segment will move are measured rather than judged by eye.
General anaesthesia is used, with antibiotics given at induction because the wound is inside the mouth.
An incision inside the lower lip exposes the front of the chin bone, and the mental nerves are identified and protected on both sides before any cut is made.
A horizontal cut is made across the chin bone below the tooth roots and below the nerves, freeing the lower segment completely while its muscle attachments remain.
The segment is moved to the planned position, forward, back, up, down or rotated, and fixed with titanium step plates and screws. Symmetry is checked against the facial midline before fixation is completed.
The chin muscle is deliberately resuspended over the repositioned bone to prevent the soft tissue sagging, then the wound is closed with dissolving sutures and a supportive dressing applied.
Frequencies follow published guidance; your personal risk depends on your health and the surgeon.
Genioplasty is a bone operation, and the risk profile reflects that. Numbness of the lower lip is not a complication but an expected part of the course, because the nerves that supply the lip run along the bone that is being cut; what matters is that it recovers, which it does in the great majority of patients over 3 to 6 months.
The complications that change an outcome are chin ptosis, where the soft tissue is not resuspended over the repositioned bone and sags, and asymmetry of the new chin point. Both are decided during surgery rather than during healing. This is a procedure where asking how many genioplasties the surgeon performs a year, and whether they plan from a CT scan, is a more useful question than any statistic about infection.
Genioplasty swells more than an implant because bone is cut. The chin and neck are visibly swollen for 2 weeks and firm for considerably longer.
The mental nerves are immediately adjacent to the bone cut, so numbness after genioplasty is the rule rather than the exception. It recovers over 3 to 6 months in the great majority of patients.
The titanium plate can sometimes be felt through the chin, particularly in thin patients. It causes no harm and is removed as a minor procedure if it is troublesome.
The soft tissue of the chin can sag away from the repositioned bone if the muscle is not resuspended properly at closure. Prevention at the time of surgery is far easier than correction afterwards.
The segment can be fixed slightly off the midline. Careful planning and intraoperative measurement reduce it; correction means a second operation to reposition the bone.
The intraoral wound can break down over the plate, which usually settles with antibiotics and wound care but occasionally requires plate removal after the bone has healed.
Lasting numbness of the lower lip, or failure of the bone segment to heal in its new position. Both are uncommon after genioplasty in experienced hands, and both are the reason this operation belongs with a maxillofacial or facial plastic surgeon who performs it regularly.
Recovery from genioplasty asks more of a patient than a chin implant does, and it is worth planning for honestly. The first week is liquid and soft food, mouth rinses after everything, and a lower lip that feels completely dead. Pain itself is modest and usually controlled with simple analgesia within a few days; it is the numbness and the swelling that dominate.
Allow 2 weeks before returning to work if your job involves speaking to people, 6 to 8 weeks before the bone is solid enough for sport, and 3 to 6 months before the chin looks and feels like yours again. Sensation in the lower lip returns gradually and in patches, often with pins and needles as it does, and that is a sign of recovery rather than of damage.
Days 1-3
The chin and neck swell substantially and the lower lip is numb. A supportive dressing is worn, food is liquid or very soft, and antiseptic mouth rinses are used after everything you eat.
Days 4-7
Swelling begins to fall and speech becomes easier, though the lip is still numb. A wound check confirms the intraoral suture line is intact. Flying is generally cleared at around day 7.
Weeks 2-4
Most visible swelling settles and office work resumes. The chin feels hard and immobile, chewing is limited to soft food, and the lower lip is recovering sensation in patches.
Weeks 6-8
Normal diet and full exercise resume. The chin shape is now broadly visible. Contact sport is avoided until the surgeon confirms bony union.
Months 3-6
Deep swelling resolves, the chin softens to the touch and lip sensation returns in the great majority of patients. This is the point at which the result of genioplasty should be judged.
Genioplasty changes the lower third of the face decisively. A recessed chin brought forward transforms the profile and sharpens the line under the jaw; a long chin shortened brings the lower face into proportion in a way patients often find more striking than they expected; a deviated chin returned to the midline changes how symmetrical the whole face reads, because the chin point is one of the features the eye uses to judge alignment.
The change appears slowly. Swelling is substantial for 2 weeks and firm for considerably longer, the chin feels hard and immobile for a month, and deep swelling takes 3 to 6 months to resolve fully. The result should be judged at 6 months, not before. Patients who compare photographs at 6 weeks are looking at a swollen chin and a numb lip, not at the operation.
Because the bone itself has been moved, the result is permanent and does not depend on any device remaining in place. The titanium plates hold the segment only until the bone unites, which takes 6 to 8 weeks, after which the chin is a single piece of bone in its new position. Soft tissue continues to age over it in the normal way.
Sensation is part of the result and deserves to be stated as such. Most patients regain normal or near-normal feeling in the lower lip between 3 and 6 months, and the recovery is usually complete enough that they stop noticing. A small proportion keep a permanently altered patch of sensation, which does not affect movement or appearance but is irreversible, and is the trade-off accepted in exchange for what genioplasty can do that an implant cannot.
Genioplasty costs more than a chin implant, and the difference is explained by what the operation involves rather than by the material used. It takes longer, always requires a general anaesthetic, uses titanium plates and screws, and needs a surgeon trained in facial osteotomy, usually a maxillofacial or facial plastic surgeon. Planning from a CT scan, where it is used, is an additional cost.
The comparison worth making is not implant against genioplasty on price, but on what each can actually deliver for your chin. If the chin only needs to come forward modestly, an implant achieves it for less. If the chin needs shortening, lengthening or straightening, an implant cannot achieve it at any price, and the cheaper operation is simply the wrong one.
Before comparing quotes, establish what is included: theatre, the anaesthetist, the plates and screws, imaging and planning, follow-up, and the revision policy. Ask specifically whether removal of a plate, if one becomes palpable, is covered, because it is the commonest minor secondary procedure after genioplasty.
Why quotes for the same procedure differ, so you can compare packages fairly.
Options to weigh before deciding, surgical and non-surgical.
A shorter, reversible operation that adds forward projection only. The right choice for a modest deficiency with a normal bite, and the wrong one for a long, short or deviated chin.
Where the chin is set back because the whole lower jaw is short and the bite is wrong, moving the jaw corrects both the function and the profile. Genioplasty may then refine the chin at the end.
A temporary, non-surgical way to add a few millimetres of projection, useful for previewing a change but incapable of altering chin height or correcting asymmetry.
Where the concern is the whole jaw outline rather than the chin point, treating the angle and body of the jaw addresses it more completely.
Ask the same questions at every consultation so you can compare answers.
Genioplasty moves your own chin bone; a chin implant adds a shaped piece of silicone or polyethylene in front of it. That difference determines what each can do. Genioplasty can move the chin forward or backward, raise or lower it, and rotate it to correct asymmetry, because the bone itself is being repositioned. An implant can only add projection to the front.
The trade-off is invasiveness and reversibility. Genioplasty needs a general anaesthetic, cuts bone, carries a higher rate of temporary lip numbness and cannot be undone easily. An implant is a 30 to 60 minute operation that can be removed in 20 minutes. For a modest forward deficiency, most surgeons offer both and let the patient weigh that trade-off; for a long chin, a very recessed chin or a deviated one, only genioplasty will work.
No. Genioplasty is performed entirely through an incision inside the lower lip, so there is no scar on the skin at all. The intraoral wound is closed with dissolving sutures and heals within 2 to 3 weeks. This is one of the few advantages genioplasty has over the submental approach used for many chin implants.
No. Genioplasty does not involve the bite or the jaw joint, so the teeth are never wired together and the jaw is not immobilised. This is a common confusion with orthognathic surgery, which moves the whole jaw and does affect the bite. After genioplasty you eat soft food because the area is swollen and sore, not because the jaw is fixed.
Numbness of the lower lip and chin is expected after genioplasty, because the mental nerves lie directly over the bone that is cut. Most patients notice sensation beginning to return between 6 weeks and 3 months, often as tingling or pins and needles, and the great majority have normal or near-normal feeling by 6 months. A small proportion are left with a permanently altered patch, which is the most important risk to weigh before choosing genioplasty over an implant.
Not usually. The plates and screws used in genioplasty are small, made of titanium, and designed to stay permanently. They do not set off airport security, do not react to cold and do not interfere with dental work or MRI scanning. They are removed only if a patient can feel one through the skin and finds it troublesome, which is a minor procedure done after the bone has fully healed.
Yes, and it is the only chin procedure that can. Because the bone segment is freed completely, it can be rotated to bring a deviated chin point back towards the facial midline, and planning this from a CT scan makes the correction measurable rather than judged by eye. An implant placed on an asymmetric chin tends to make the asymmetry more obvious, not less.
Be realistic about what remains. Bony correction does not change asymmetry in the soft tissue above it, and no face is symmetrical. The aim is to make the asymmetry unremarkable rather than to eliminate it.
Plan on 7 days after genioplasty, which is longer than for a chin implant. The wait allows the intraoral wound to be checked, swelling to pass its peak and the surgeon to confirm that the bone segment and plates are correctly positioned. Take soft food and mouth rinse for the journey, keep the head elevated during the flight, and expect swelling to increase temporarily in the cabin.
Considerably less than patients expect from an operation that cuts bone. Most people take prescribed painkillers for 3 to 4 days and simple analgesia thereafter, and the chin is more numb than sore. The genuinely difficult part of the first week is practical: liquid and soft food, rinsing the mouth after everything, and speech that feels unfamiliar because the lower lip has no sensation.
Bone pain, when it occurs, is a deep ache rather than a sharp pain and settles within the first fortnight as the swelling falls. Persistent or increasing pain after the first week is not normal and should be reported, because it can be the first sign of infection around a plate.
Occasionally, and it is a legitimate plan in specific circumstances rather than a way of doing more surgery. Where a chin needs to come forward further than a genioplasty alone can safely move it, or where the bony advancement leaves a contour that is still slightly flat at the front, a small implant can be added over the repositioned bone. This is uncommon and is a decision for a surgeon who does a lot of chin work.
For most patients the two are alternatives rather than partners, and being offered both together should prompt the question of why one alone is not sufficient.
Chin ptosis, sometimes called a witch’s chin, is when the soft tissue of the chin sags away from the bone beneath it, producing a drooping pad of tissue that hangs below the chin point and is particularly visible when smiling. After genioplasty it happens when the chin muscle, which has been lifted off the bone to make the cut, is not deliberately reattached over the repositioned segment when the wound is closed.
Prevention is entirely a matter of technique at the end of the operation, and it is far easier than correction. Surgeons who perform genioplasty regularly resuspend the muscle as a routine step. It is a specific and revealing question to ask at consultation, because the answer tells you how familiar the surgeon is with this operation.
A sliding genioplasty typically advances the chin by 6 to 12 millimetres, and experienced surgeons will move it further where the anatomy allows, which is beyond what an implant can achieve safely. Vertical reduction usually removes a wedge of a few millimetres, which sounds small but changes the proportion of the lower face noticeably. Rotational correction for asymmetry is measured in degrees rather than millimetres and is planned from imaging.
The limit is set by the bone available, by the soft tissue that has to stretch over the new position, and by the blood supply to the segment. Asking for a specific figure at consultation is reasonable; a surgeon planning from a CT scan should be able to tell you the exact movement they intend.
Not permanently. Because genioplasty does not touch the bite, the jaw joint or the tongue, the mechanics of speech and chewing are unchanged once healing is complete. Temporarily, both are affected: the lower lip is numb, the chin is swollen and stiff, and food is restricted to liquid and soft consistencies for the first week and soft for the second.
Speech normally sounds normal to others within days, even while it feels strange to you, because the numbness affects sensation rather than muscle control. Chewing returns to normal as the bone unites, at around 6 to 8 weeks.
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