Dorsal hump removed, and tip refinement? How far forward should I have my chin moved? In line with my bottom lip? (photos)

I considered jaw surgery but have settled on sliding genioplasty and rhinoplasty. I have seen three surgeons already, and will be having a planning meeting later in the year. Any advice and/or photo recommendation of what would suit me, to take with me to the planning meeting would be greatly appreciated. Should I just have the dorsal hump removed, or also have the tip refined as well? How far forward should I have my chin moved? In line with my bottom lip?

Doctor Answers 5

Hump and Nasal Tip Reshaping

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Thanks for submitting your photos. A sliding genioplasty is a difficult procedure which I would not offer to you. The best in your case will be a nasal tip reshaping combined with a hump reduction. I advice to you a mental implant procedure w/ medpor or silicone implant. Please consult with a board certified plastic surgeon.

Turkey Plastic Surgeon
4.9 out of 5 stars 32 reviews

Nose and chin

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It may be worth completing either your orthodontic work first or jaw surgery before considering a rhinoplasty 

In isolation a rhinoplasty if the bridge and projection is reduced will have a beneficial effect on the chin making it look slightly larger but this is a small effect only. You could also consider a chin implant or something temporary with a cosmetic filler to make sure that you like the look of chin augmentation

Rhinoplasty and genioplasy

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hi and thanks for the question. If you were considering jaw surgery then it is likely that you had some degree of malocclusion and if your decision was to avoid jaw surgery despite this you would need some orthodontic work to bring your teeth into optimal alignment with your jaws in their current relationship. Movement of the teeth can have some effect on lip position which will,in turn effect the overall balance of your facial features including the nose and chinpoint in profile. Ideally then you should complete any orthodontic work first and then do some imaging studies with your treating surgeon to work out what looks best. Reducing the projection of you nose will make the chin look more prominent while augmenting the chin will make the nose appear slightly smaller. It may be that you only need to do one or the other, more likely the nose , to achieve the appearance you want but if the imaging indicates a combination of the two then both can be done at the same time. If you do decide on genioplasty then either a sliding genioplasty or an implant can be used and your surgeon should be able to discuss the advantages and disadvantages of both to allow you to make an informed decision. It sounds like you are taking your time with this and getting several opinions which is good but ultimately the aesthetic goal needs to be one that you are happy with and your surgeon is there to assist you to make that  choice and then safely and accurately perform the operation.

Take note... you have Jaw asymmetry.

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From your photos I can see that you have a moderate asymmetry of your jaw. Your chin points to your left, probably because of a relative overgrowth of the right side of you mandible which pushes the chin point off to the opposite side. This is why when you compare your 2 profile views, the view of the right side of your profile with regard to your lower face is more pleasing. The chin is more developed on this side and so appears to need less of a movement forward to bring it in line with your lip. This would need to be taken into account with your surgical planning.

The tip of your nose would not require much change I'd have thought. It looks as though it has reasonable definition, however it may need to be refined a little when the hump is reduced to create a balanced overall appearance. 

All the best with your planning consultation!

Chin advancement with sliding genioplasty

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A rhinoplasty and genioplasty are performed together

You should have imaging with your surgeon so as to determine your aesthetic goals

Do you think you require a chin advancement?

A rhinopasty alone may be enough ?

Do you want an advancement or chin implant?

Lots to think about so take your time and seek an expert who does both proceedures in one stage.

Darryl J. Hodgkinson, MD
Sydney Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.