Chin Surgery (Genioplasty)
Successful surgery is a result of good rapport
between the patient and surgeon. Trust, based on
realistic expectations and exacting medical expertise, develops in the
consulting stages before surgery. We hope that this information is valuable to you for basic understanding of how this particular
surgery works. We discuss many alternatives, their benefits and their risks and
complications. These procedures are elective in nature and no one is forced to
undergo surgery. Finally, your body immune system may
react differently and healing process could be shorter or longer. In extremely
rare cases, some procedures may need to be repeated.
This is one of the most rewarding procedures in facial profile correction since
so many patients are not aware of the possibility of correcting a receding chin.
Chin surgery can be one
of the most striking cosmetic facial procedures. Many individuals have very
recessive profiles due to the fact that their lower face and jaw have not
developed properly. This is frequently a genetic situation and other family
members may exhibit similar traits.
If you are wondering how
chin surgery could improve your appearance, you need to know how the surgery is
performed and what you can expect from this procedure.
WHAT IS CHIN
Depending to the position of your chin there are several ways
this question could be answered:
Small Chin: If
you have a small, receded chin and it bothers you or makes you self conscious
about it then you may benefit from chin augmentation or advancement genioplasty. Chin augmentation is an operation that
changes a person's profile by moving the chin outward to enhance the facial
appearance. In some cases it is done for make you breathe better and sleep
which is supported by many major scientific organizations including the American
Association of Oral and Maxillofacial Surgeons and
American Sleep Disorder Association concludes that a considerable number of patients with a receded chin
may in fact suffer from breathing problems. When the
lower jaw does not grow properly or may be too small, the tongue may drop back in the patients throat blocking the airway passage and has
the potential for causing obstructive sleep apnea. Many times, patients who have a receded chin have a very narrow windpipe. To
artificially cover the chin with a plastic type chin will hide this problem and
patients will continue to have sleep apnea disguised with chin surgery. At our
center, this condition is carefully analyzed and put
into consideration when planning such a procedure.
This procedure could be done simply by itself or in combination with orthognathic surgery. In addition to complimenting the profile, chin surgery can also
tighten and enhance the saggy or fatty tissues in the neck.
Chin: If you have a very large,
protruded chin then you may benefit from chin reduction (also known as reduction
genioplasty). Chin reduction surgery involves removing excess bone from the chin
bone. In most cases the very bottom tip of the chin is carefully separated and
positioned backward to correct the problem. The two
segments are then secured with a space age technology using titanium and called rigid fixation. In some cases the whole lower jaw in
addition to the lower jaw is moved backward to correct this problem. This type of surgery needs coordination with an
orthodontist as well to make sure patient’s bite is corrected as well.
Large Lower Jaw: In many cases
where the teeth do not fit together well or there is a severe underbite or
overbite, jaw surgery (orthognathic
surgery) may be required at the
same time. It is very important that a very strong chin with severe protrusion
once corrected only by a lower jaw surgery alone may also lead to obstructive sleep apnea when
patient is much older. Simultaneous upper and lower jaw surgery in combination
with chin augmentation may prevent that.
WHAT ARE THE DIFFERENT TYPES OF
There are many types are
surgery available to correct a receded chin. We will describe each in detail to
inform you of what is done at present time. An intelligent patient must be aware of the benefits, advantages, risks and
complications of these procedures and as with all surgical procedures, look at the surgeon’s credentials and his or her background. A simple procedure
may not always give a long lasting result.
WHAT IS ADVANCEMENT GENIOPLASTY?
One of the most advanced, precise and sophisticated types of chin surgery is to
take the lower front part of your chin and bring it
forward. This procedure is called advancement genioplasty. It uses your
natural bone and if done properly will not move around at all! This procedure is more involved than placing a chin
implant and requires making incisions in the bone and also stabilizing it at the
end with space age technology of rigid fixation. In some cases bone grafting in
front and the top of the chin plate may be necessary to create an attractive
final results. A great advantage of this procedure is that we can actually
bring the muscles that are attached behind the chin (your tongue muscles)
forward and you’re your airway significantly. We have made a special
modification for people with obstructive sleep apnea to perform a special type
of chin surgery to address their problem. One of the potential side effects of
this procedure is numbness of the lips and chin, usually temporary but it could
be permanent. Your jaws do not need to be wired together with this procedure at
all. There will be some swelling and surprisingly moderate (not severe) pain
involved. We cover all our patients with antibiotics and steroids to control
infection and swelling. We encourage our patients to return to work as soon as
they can within few days after surgery.
This procedure is favored
by most oral and maxillofacial surgeons and not liked by other specialist
performing chin surgery because of its complexity. We perform most
genioplasty procedures in our state-of-the-art-center. You will be asleep (sedation
or general anesthesia without nasal intubation) while the surgery is performed.
genioplasty, the tip of the chin is detached, moved and then reattached.
CAN MY CHIN BE MOVED BACKWARDS OR COULD
IT BE SHORTENED IF I HAVE A VERY LONG OR LARGE CHIN?
Yes! One of the other
great benefits of genioplasty is that we can shorten a long chin or move the
chin back if the chin was too long or protruded. This procedure is exactly like
the advancement genioplasty with exception of removing a portion of bone from
the incision sites.
I HAVE A GUMMY
SMILE LONG FACE AND RECEDED CHIN WHAT SHOULD I DO?
If you have a significant
bite and chin problem you might consider repositioning of your jaw with
orthognathic surgery. This surgery necessitates being in braces first then the
whole jaw is moved to harmonize your facial as well as dental balance. Normally
no jaw wiring is needed and depending to your needs upper jaw may be operated on
as well. If you have a gummy smile, open bite, overbite or a long face and a
receded chin you should consider orthognathic
WHAT IS CHIN
The most simple and unfortunately common
procedure performed across the world is chin implant surgery. Unfortunate
because the patient will look better but the underlying problem is not corrected
and only bandaged. A receded chin could be associated with bite deformity or
even narrow airway structure and this procedure will address none of those
problems. The procedure is fairly simple and there
lies its popularity. An incision is made either inside the mouth or outside
under the chin exposing the bony part of the chin. Then a chin implant of a size
agreed both by patient and the surgeon is placed in front of the chin. It is
very commonly sutured in place, some surgeons may use a pin or wires to secure
the chin implant in. The incisions inside or outside the mouth are closed with
sutures and a dressing / tape is applied.
chin implant is made of soft medical grade solid silicone, Gore-Tex, hydroxyl appetite or even gel.
These materials have a long history of use and they are generally well tolerated
by the body. But they have several inherent risks and complications. Foreign
body reactions and true allergic reactions are very rare. As with any other
implants infection, 'rejection', loss of substance could occur. If the implant
got infected it may be relatively easily removed. Cases of implant displacement
(moving to the side of the chin and not in the middle) and even resorbing the
natural chin and causing bone infection has certainly been a concern with some
of these materials and with this procedure.
a silicone implant is used for chin augmentation, an incision will be made
beneath the chin or inside the mouth behind the lower lip.
WHAT IS POROUS
HYDROXY-APPETITE (HA) IMPLANT?
This implant is taken from either coral or
cultured appetite crystals. Just like Silicone HA has its benefits and
disadvantages as described above. Our preference is your own natural chin with many additional benefits.
The procedure is relatively simple and is generally
done in the office. The implant eventually becomes incorporated as part of the
bone. Infection, rejection or implant movements can be problems.
WHAT IS FAT
One of the least stable procedures in cosmetic surgery is injection of fat into
the chin area. Fat transfer is used to increase the
projection of the chin. Fat can be obtained from the neck when it is suctioned
or it can be taken from other parts of the body.
Usually the amount of projection provided is not a lot and results are
temporary. Other facial tissues obtained from face-lift procedures have also
been used for the same purpose with the same short-term results. Reabsorption
(shrinking) is the most common problem. In our center this procedure is not recommended
to our patients at all.
WHO PERFORMS CHIN SURGERY?
Our center with board certified oral and maxillofacial surgeons (OMFS) usually
perform chin augmentation and reduction. Some plastic surgeons or
otolaryngologists (ENT) may perform the implantable chin as well. Our knowledge
of facial and dental harmony plus a clear understanding of obstructive sleep
apnea puts us in a very unique position of being able to provide the most
sophisticated procedure in convince of an office and at the same time possibly
correcting your airway problem. We have made this procedure more of a science
than a cover up for cosmetic surgery alone. We invite you to see our photo gallery of patients.
WHO IS A CANDIDATE FOR CHIN
As with all elective surgery, good health and realistic expectations are
prerequisites. The chin surgery concepts have
changed so drastically for the last several years that this question takes a lot
more thinking for patients. Most people do it to make their face look good. Our new concept and findings is that
it could improve your breathing, and obstructive sleep apnea as well. It does
not cure these problems but in some cases the degree of improvement is very
have a small chin - one that recedes or is not prominent enough. A small chin
can make a persons nose appear more prominent than it really is, whereas a chin
that is more in harmony with other facial features can draw attention away from
the nose and give the entire profile a more pleasing balance. Building up a
small chin also can improve dramatically the results of other facial surgery
procedures. As stated above the latest concept is to correct the position of
chin in combination with its muscle attachment is most desirable to improve
obstructive sleep apnea. So you look good and you could breathe better when
sleeping. It can reduce the sound of snoring as well! On the other hand, a
chin may protrude excessively, either because of an abnormally large "chin bone"
or because of a too long jawbone.
sure to inform us about any medical conditions or allergies you may have and
whether you are a smoker or have dental or gum problems. Also, tell us about any
medications, herbal supplements or natural supplements you are taking (both
prescription and non-prescription).
WHERE IS THE
Our state of the art Center For Corrective Jaw Surgery is well equipped for chin
augmentation or reduction. You must stop eating or drinking for at least 8 hours
prior to your procedure and must be accompanied by an adult driver. (Do not
bring young children with you since you will be in our center for several
hours). You will able to go home without undue difficulty after the procedure.
The operation is carried out under I.V. sedation, or general anesthesia.
surgery, the chin may be taped to prevent swelling. This must remain in place
until you are seen in the office or until you are directed to remove the bandage
and tape. You will be on a soft diet for few days and avoid chewing hard food
for a week. You are encouraged to talk and move your lips as much as you like
and of course smile a lot!!
You will be
given prescriptions for swelling, pain and infection. For your convince our
center offers in house pharmacy you can fill up your prescriptions in our
center. Please finish all prescriptions as directed. If you have any problem
with any medication, please call our center.
HOW DO I PREPARE FOR SURGERY?
Remember a pre-operative consultation and detail evaluation is defiantly
needed. If you travel from other states or countries we can make a very special
arrangement to do the evaluation a day before your surgery and we
will also assist you with finding a convenient hotel nearby. You can mail or
email photos of your face and chin taken from a front view as well as a side
views so we can access your problem. But first follow these simple instructions.
- Avoid aspirin, any aspirin containing
medication or any other non-steroidal anti-inflammatories (NSAID), such as
Motrin® or Advil®, for one week prior to treatment. Because aspirin thins the
blood, it can interfere with normal blood clotting and increase the risk of
bleeding and bruising
- Smoking inhibits the healing process, so stop
smoking before your procedure and if you start again, make sure it is after
you are completely healed
- Avoid drinking alcohol a few days before your
- Make sure to not to eat or drink for at least
8 hours prior to your surgery
- Make sure that you arrange for
someone to bring you home
WHAT IS THE
The recovery period varies with
each patient and what type of surgery they had. If the surgery included only
the chin patients can return to work within few days after surgery. You can
actually fly the next day if you traveled from another state for this purpose.
If you required a combined lower jaw surgery and chin surgery or even an upper
jaw surgery a 10-12 day recovery period is commonly recommended.
AM I GOING TO
BE SWOLLEN OR IN SEVERE PAIN?
The majority of patients experience only very mild discomfort for a short time
after surgery, which can usually be controlled easily with medication.
Significant pain is uncommon. After the operation, swelling and bruising can be
expected. Most of the swelling usually subsides within the first 2 week. After
the operation, black and blue marks may be visible around the chin and neck.
You will be placed on antibiotics and anti-swelling medications as well.
Numbness of the lip, gum, chin, even teeth almost always occurs following
surgery below the lower lip, this could be temporary or in very rare cases
WHAT ARE THE
POST OPERATIVE INSTRUCTIONS?
- Ice to face for 24 hours
- Your chin will be taped
following surgery. Do not remove the tape and reinforce it with additional
tape if needed.
- Take your medications on time and finish the
course of treatment
- Liquid food for the first day. Cold food for
24 hours. Soft food for the next five days. Choice of food such as soup, ice
cream, milkshakes, puddings, possibly ground meat, but nothing that requires
chewing or is highly salted or spiced.
- Rinse your mouth with Peridex rinse (A
special prescription mouth rinse) only twice daily
- Rinsing your mouth three or four times a day
with warm salted water
- You may brush your teeth
if the brush is soft and you are quite careful to keep the bristles away from
- Do not rinse or use straw the
first 24 hours
- Smoking or using straws not advised
immediately after surgery
- After a chin implant you can usually go back
to work within a week.
HOW MUCH IS THE
COST OF GENIOPLASTY?
The cost for
genioplasty in our center is $ 4,400.00. Additional expenses are the anesthesia
and facility fees of $ 1,000 and the prescription are only $ 40.00. All costs
of pre-operative studies, work ups and the x-rays are included in most cases.
Insurance does not generally cover surgery that is purely for cosmetic reasons.
Surgery to correct or improve genetic deformity or traumatic injury to the may
be reimbursable in whole or in part. It is the patient's responsibility to check
with the insurance carrier for information on the degree of coverage.
WHAT ARE THE
As with any surgery, there is always a possibility of
complications following chin surgery, including infection, bleeding, a reaction
to the anesthesia,
swelling filled with blood resulting from a break in a blood vessel),
seroma (a mass or
extrusion (the implant works its way back up to the skin’s
capsular contracture (excess tightening of the scar tissue) which may
distort the implant, asymmetry, nerve damage and bone erosion.
facial implant can shift slightly out of alignment and a second operation may be
necessary to replace it in its proper position. Whether you are interested in
chin surgery for functional or cosmetic reasons, your choice of a qualified
surgeon is extremely important. During the consultation, we will thoroughly
examine your face and chin to pinpoint problems. In some instances, we may
suggest chin surgery as a supplement to orthognathic surgery. We will weigh
other factors that could influence the outcome of surgery such as your age, skin
type, and attitudes toward surgery. The surgical procedure will be described in
detail along with reasonable projections. If you opt for surgery, we will
describe the technique indicated, the type of anesthesia to be used, the
surgical facility, any additional surgery, and risks and costs.
Make your appointment online now for consultation & evaluation.
is one of the pioneers of a laser surgery and radiofrequency treatments of
snoring, chronic nasal congestion and tonsillar problems. His main field
of interest in orthognathic surgery. He is board certified by the
American Board Of Oral & Maxillofacial Surgery. The material contained
herein is provided for informational purposes only and should not be
considered as medical advice or instruction. Individuals with jaw
deformity, sleep apnea or other conditions discussed in this site should
consider a personal evaluation in our facility for further treatment.
Are you a candidate for orthognathic surgery?
Call now to set up an appointment: