Procedure guide
How chin augmentation works, implant vs genioplasty, and what to expect.
Written by Orr Shauly, MD, plastic surgery resident. Updated .
For information and education only, not medical advice.
The short answer.
Chin augmentation brings a small or retruded chin forward with an implant, by moving the chin bone itself in a sliding genioplasty, or temporarily with filler.1,2 Implants suit mild to moderate forward deficiency, while genioplasty can also correct height, asymmetry and larger deficiencies.1,2 A systematic review of 56 studies and 4,844 patients found high satisfaction with both surgical and filler approaches, with no single technique clearly superior.3
- 3,104 Patients
- in an implant review
- Patients across 39 studies of chin implants, which found low complication rates for all common materials.4
- 90% - 95%
- satisfied after genioplasty
- Reported satisfaction after osseous genioplasty, compared with 85% - 90% after chin implants.2
- 7.6%
- reoperation after genioplasty
- Patients needing a second operation in a 10-year series of 157 genioplasties.5
- 2 - 6 Weeks
- for stretch numbness to recover
- Typical recovery time for temporary chin and lip numbness from nerve stretching.2
What chin augmentation is.
The chin has a large effect on the facial profile. In a balanced profile, a line touching the most forward points of the upper and lower lips also touches the chin.1,2 The chin is assessed together with the nose and lips because their proportions are linked, and an oversized chin, particularly in women, can look masculine.1,2
| Approach | Best Suited For | Key Trade-Offs |
|---|---|---|
| Chin Implant1,2 | Mild to moderate forward deficiency with a shallow lip-chin crease | Technically simpler, but cannot correct height or asymmetry well |
| Sliding Genioplasty1,2 | Larger deficiencies, height problems, asymmetry or reduction | Corrects the chin in several directions, with temporary numbness common |
| Filler3,6 | Patients wanting a nonsurgical, temporary change | Quick results, but needs repeat treatment and carries rare vascular risk |
How the chin is evaluated.
- Projection: The chin is compared with the lips in profile, and the lower lip guides how far the chin should come forward.1,2
- Height: The distance from the lips to the bottom of the chin is normally about twice the distance from the nose to the lips.1
- Lip-Chin Crease: A deep crease can look exaggerated after a forward implant, while a shallow crease may be effaced further.1,2
- Bite: Most patients wanting a larger chin have a retruded lower jaw, and a significant bite problem may call for jaw surgery instead.1,2
- Imaging: A side cephalometric x-ray and panoramic x-ray help plan surgery, especially when bone is moved.1,2
Patients with diabetes or a weakened immune system are poorer candidates for implants, and older patients with thin bone may be better suited to an implant than a bone cut.2
Chin implants.
The most common implant materials are solid silicone and porous polyethylene. Silicone is easy to carve and remove, while porous implants allow tissue ingrowth and are less prone to migration and erosion of the underlying bone.1,2 Implants are placed directly on the bone, beneath its lining, and fixing them with screws or sutures reduces malposition.1,2
In a review of 39 studies and more than 3,104 patients, silicone had the lowest rate of numbness (0.4%) compared with porous polyethylene (20.1%), with no significant differences in malposition, infection, extrusion, revision or removal between materials.4 Another review found more infections and displacement with silicone and more visible prominence with porous polyethylene, but noted that follow-up in most studies is short.7
Implants can be placed through a small incision under the chin or inside the mouth. Intraoral placement avoids an external scar but is associated with implants sitting too high and with sagging of the chin soft tissue.1,2 In the implant review, intraoral incisions had higher removal rates (1.5% vs 0.5%) but lower asymmetry (0.7% vs 7.5%).4
Sliding genioplasty.
In an osseous genioplasty, the lower part of the chin bone is cut through an incision inside the lower lip, moved forward, back, up, down or sideways, and fixed with a small plate and screws.1,2 The bone cut is made at least 5 mm below the opening where the mental nerve exits the jaw to protect sensation and the tooth roots.1,2
The soft tissue follows the bone closely. When the chin is advanced, the soft tissue chin moves about 0.9 mm for every 1 mm of bone movement.8 Careful repair of the chin muscle at closure prevents sagging of the chin pad, known as a witch's chin.1,2
Recovery.
Recovery steps come from a surgical textbook and vary by surgeon.2
| Time | What Usually Happens |
|---|---|
| Days 1 - 52 | The head of the bed is kept elevated, and steroids may be given to limit swelling |
| Days 3 - 42 | Tape dressing is removed to check the contour |
| Days 5 - 72 | A chin support garment is worn around the clock, and strenuous activity is avoided |
| Weeks 2 - 32 | The chin support is worn at night only |
| Weeks 2 - 62 | Temporary numbness from nerve stretching usually resolves |
Risks and complications.
| Complication | Reported Rate | Context |
|---|---|---|
| Temporary Numbness, Genioplasty1 | More than half | Usually from nerve stretching, returning over days to weeks |
| Lower Lip Numbness2 | 5% - 6% | Permanent loss is extremely rare |
| Infection, Implant1,2 | About 2% - 5% | Usually requires implant removal, with replacement possible after 12 months |
| Infection, Genioplasty2 | About 3% | The bone keeps its blood supply, so it is rarely at risk |
| Reoperation, Implant1 | 10% | In a series of 162 facial implant patients, mostly for position, asymmetry or contour |
| Reoperation, Genioplasty5 | 7.6% | For loose fixation, appearance or a palpable step in the bone |
Bone erosion under the implant is seen mostly with smooth implants that are not fixed or sit too high.1,2 Genioplasty can injure tooth roots or expose the gums if incisions are placed too close to the teeth.1 Overcorrection is more common in women and can look masculine.2
How the options compare.
In a cohort of 80 patients followed for 12 months, osseous genioplasty had fewer infections and higher satisfaction scores than chin implants, with no significant difference in numbness.9 A larger systematic review found durable improvement and high satisfaction with both surgical approaches, with risks including infection, implant problems, bone resorption and persistent numbness.3
For filler, a randomized trial of 192 adults found that 56.3% of treated patients improved by at least 1 point on a chin retrusion scale at 6 months vs 27.5% of untreated controls, with benefit still evident at 12 months.6 Filler side effects are mostly temporary, but rare serious vascular complications can occur.3
What we don't know yet.
- Best Technique: High-quality prospective studies comparing implants, genioplasty and filler are lacking.3
- Long-Term Follow-Up: Most implant studies follow patients only briefly, which limits complication estimates.7
- Material Choice: Reviews disagree on which implant material has the lowest infection and displacement rates.4,7
Common questions.
Is a chin implant or a sliding genioplasty better?
It depends on the chin. Implants work well for mild to moderate forward deficiency, while genioplasty can also change height, fix asymmetry and handle larger moves. One comparison found fewer infections and higher satisfaction after genioplasty.
Will a chin implant look natural?
When sized and positioned correctly, it should blend with the jawline. An implant that is too large can look unnatural, especially in women, which is why surgeons plan size using the profile and lip position.
Can filler be used instead of surgery?
Yes. Hyaluronic acid filler can bring the chin forward without surgery, and in one trial the benefit was still evident at 12 months. It is temporary and carries a rare risk of vascular complications.
Will my chin or lip be numb after surgery?
Temporary numbness is common, especially after genioplasty, and usually recovers within weeks. Permanent numbness is rare.
Can a chin implant be removed?
Yes. Smooth silicone implants are easier to remove than porous implants, which tissue grows into. After removal, some patients choose a smaller implant or a genioplasty.
Is chin augmentation right for me?
Only an in-person evaluation can answer that. This guide is educational and cannot assess an individual case. A qualified plastic surgeon can assess your profile, bite and goals with you.
Key terms.
- Genioplasty
- Surgery that reshapes the chin, either by cutting and moving the bone or with an implant.
- Microgenia
- An abnormally small chin.
- Pogonion
- The most forward point of the chin.
- Riedel Line
- A profile line touching the upper and lower lips, which the chin should meet in a balanced face.
- Labiomental Fold
- The crease between the lower lip and the chin.
- Mental Nerve
- The nerve that provides feeling to the lower lip and chin.
- Witch's Chin Deformity
- Sagging of the soft tissue of the chin with a deep crease beneath it.
- Porous Polyethylene
- An implant material with pores that allow tissue to grow into it.
References.
- 1.Durand PD, Surek CC, Zins JE. Facial skeletal augmentation with implants and osseous genioplasty. In: Chung KC, editor. Grabb and Smith's plastic surgery. 8th ed. Philadelphia: Wolters Kluwer; 2020. p. 546-54.
- 2.Ghavami A, Guyuron B. Genioplasty. In: Janis JE, editor. Essentials of aesthetic surgery. New York: Thieme; 2018. p. 676-90.
- 3.Alwathnani YK, Alkhwildi LA, Almathami AA, Alawirdhi B, Alqaidi OA, Albogami FA, et al. Surgical vs Non-surgical Chin Augmentation: A Systematic Review of Techniques Satisfaction, and Complications. Aesthetic Plast Surg. 2026;50(11):4292-314. PubMed
- 4.Liao CD, Rodriguez E, Zhao K, Kunda N, George F. Complications Following Alloplastic Chin Augmentation: A Systematic Review of Implant Materials and Surgical Techniques. Ann Plast Surg. 2023;90(6S Suppl 5):S515-S520. PubMed
- 5.Kongsong W, Rochanavibhata S. Reoperative genioplasty: a 10-year retrospective study. Oral Maxillofac Surg. 2022;26(1):91-8. PubMed
- 6.Beer K, Kaufman-Janette J, Bank D, Biesman B, Dayan S, Kim W, et al. Safe and Effective Chin Augmentation With the Hyaluronic Acid Injectable Filler, VYC-20L. Dermatol Surg. 2021;47(1):80-5. PubMed
- 7.Rojas YA, Sinnott C, Colasante C, Samas J, Reish RG. Facial Implants: Controversies and Criticism. A Comprehensive Review of the Current Literature. Plast Reconstr Surg. 2018;142(4):991-9. PubMed
- 8.San Miguel Moragas J, Oth O, Büttner M, Mommaerts MY. A systematic review on soft-to-hard tissue ratios in orthognathic surgery part II: Chin procedures. J Craniomaxillofac Surg. 2015;43(8):1530-40. PubMed
- 9.Tabrizi R, Behnia P, Kavianipour M, Behnia H. Osseous genioplasty versus chin implants: early complications and patient satisfaction. Int J Oral Maxillofac Surg. 2024;53(2):141-5. PubMed