“Genio” means chin and “Plasty” means to change. Therefore a genioplasty changes the shape and/or position of the chin. This procedure involves a hidden incision inside the lower lip and a precision micro-cut of the chin bone. The chin is therefore freed and can be moved in three dimensions to advance, setback or lengthening. A genioplasty can often be used in place of a chin implant to augment the chin, but Dr. Niamtu prefers to use implants for simple augmentations as they are easier, less recover and cost, faster healing and reversible. There are some conditions where only genioplasty can be performed, such as setting the chin back or lengthening the chin.
Chin lengthening is the most common indication for genioplasty in Dr. Niamtu’s office. Most often this is performed on patients with recessive and short chins. The genioplasty allows lengthening of the lower face which is critical in many patients. Unfortunately, Dr. Niamtu sees patients every month that were improperly diagnosed and treated with a chin implant instead of a genioplasty and require removal of the ill placed chin as well as a genioplasty. I pays to to your homework to make sure you are the correct candidate for the correct operation.
WHEN IS A PATIENT NOT A CANDIDATE FOR A CHIN IMPLANT?
Many patients with a deficient chin (retrogenia) have dental or jaw misalignment (overbite). Some patients are best treated with orthodontics and jaw repositioning (orthognathic surgery). Many patients do not desire this type of treatment and want a simple chin implant. Although many patients are good candidates for chin implants, some are not. Patients that have a deep mentolabial fold (the crease below the lip and above the chin) may not be good candidates and patients that have the lower lip that is behind the upper lip may not be good candidates.
Placing an implant in patients with deep mentolabial folds or lips that are not in line can actually make them look worse as the chin point sticks out in an unnatural manner. A patient with this type of situation should be treated with a lengthening genioplasty (see topic on this page) to add vertical height to the chin. The patient shown on the left had a chin implant placed and instead, should have had a lengthening genioplasty to augment the chin in the vertical and horizontal direction.
The pictures below illustrate situations where a chin implant would be inappropriate and a genioplasty required.
Changing Lower Facial Height
The image below shows a patient with normal lower facial one-third height (left) and a patient with a short lower one-third.
An additional way of moving a chin forward or backward is called a SLIDING GENIOPLASTY. This procedure is performed from an incision inside the mouth below the lower lip. The sliding genioplasty is used in more severe cases or in cases where the chin needs to be lengthened or moved backward. Dr. Niamtu makes an incision in the inside of the mouth and advances or moves back the bony chin segment. This segment is then secured with a micro bone plate. The photograph below shows a model of a sliding genioplasty. The SLIDING GENIOPLASTY advances the patient’s actual chin by moving the lower portion of the Jaw. This procedure will not only advance the chin forward, but it will also increase the lower 1/3 facial height. The picture to the left shows a model of the sliding genioplasty where the lower part of the chin is cut and moved forward (to increase the chin) or backward (to decrease the chin).
While many patients need more chin in the horizontal direction (back to front) some patients need an increase in the vertical dimension of their chin. Patients with a shortened lower facial height lack the proper aesthetics for a natural chin and lip support. Their lower lip looks folded over and unnatural.
The patient below demonstrates what he desires for profile enhancement. His lower face needs lengthening as he demonstrates by pulling down. This can only be achieved with a genioplasty and not with chin implants.
The patients below are selected cases of genioplasty performed by Dr. Niamtu
Dr. Niamtu discusses the important differences between treatment with genioplasty versus chin implants.