What is Most Indicated in my Perfiloplasty?

I have protruded chin and nose, and my face looks like a new moon. My mouth just disappears between them. I am aware that my nose and chin are big, but my doctor said once I had a rinoplasty I would be happy with the overall facial contour, and that if needed he could do a soft tissue procedure on my chin. I want your opinion under the light of facial proportions, can that really be enough? How is that procedure? Does it really work well, or is it better to see a doctor who can do an osteotomy?

Doctor Answers 8


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I am confident that a rhinoplasty will offer you some improvement, but I don't have enough information to recommend any more than that. You need an evaluation of your occlusion before considering any more than the rhinoplasty.

Columbus Plastic Surgeon

What changes are needed for the harmonious facial profile?

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The initial step in determining what plastic surgical recommendations should be made is to first ask about your teeth (occlusion), bite, and mandible-midface measurements. You may already know the answers to these issues if you have had orthognathic X-rays, oral surgery, orthodontic procedures (braces, etc.). But if you don not know this information, or if your bite is "off", or teeth occlusion is anything other than "perfect," you should start here first. See an experienced oral surgeon for these answers, then seek a board-certified (American Board of Plastic Surgery) plastic surgeon with experience in nose and chin surgery for answers to the rest.

Once these issues are addressed satisfactorily, then you must decide about reduction rhinoplasty, chin reduction (I would not recommend soft tissue removal, just bony manipulation/removal--too much damage can be done to your smile and lower facial animation with over-aggressive soft tissue surgery), and perhaps midface augmentation (Radiesse or hydroxyapatite granules to the sub-nasal area), sub-labial chin augmentation (just above the crease in your mid-chin and just below the lower lip vermilion), and upper and lower lip enlargement with dermal fat grafts or fat injections (I prefer the former as they are uniform, soft, permanent, and natural; fat injections CAN be, but often they can be lumpy or irregular also).

BTW, bony chin reduction does not require osteotomy, this can be nicely sculpted with craniofacial bone burrs and a surgical hand engine (similar to a dermabrader motor). You would require nasal bone surgery to reduce the dorsal hump and restore the nasal pyramid via infracture after osteotomy. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews


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Interesting choice of terms for your rhinoplasty but I think it needs more than just the profile.  The chin can not be repaired by soft tissue alone, that's likely to be a big mistake.  It's the jaw bone that needs to be slid down and then the soft tissue will follow.  Your nose will likely reduce nicely since there's a good amount of reduction that can be done even in the least experienced of hands.  A board certified plastic surgeon in your area will gladly and very likely successfully be able to help you out with this  problem.

Ricardo A. Meade, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 125 reviews

Rhinoplasty with chin reduction

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The rhinoplasty is a sure bet with reduction of the hump and projection, and modest rotation of the tip. This will not of course correct your profile which is concave instead of the usual straight to slightly convex curve. You may wish to see an orthodontist as the shallow profile may be a reflection of the upper jaw and occlusion. Soft tissue reduction in the chin does not work very well, and an osteotomy to slide the chin back slightly is a better option if your bite is normal.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Profile plasty

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From a strictly aesthetic standpoint, reduction in projection of the nose and chin (a difficult procedure because of the sequelae it may cause) and augmentation of the lips may be indicated.

Cannot say exactly without extra views/ a consultation, but an osteotomy would probably be necessary on your nose.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Improving Facial Profile

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On the basis of one picture, it does appear that your profile would be improved  by having a rhinoplasty including a decrease in nasal projection, chin reduction, and lip augmentation. All these procedures can done done during  one operation.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Profiloplasty: Nose, chin, lips

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First and foremost is an assessment of your occclusion to assess the need for orthognathic procedures to enhance the peri-oral region which will effect the overall facial harmony. It is my opinion that you would neeed a reduction rhinoplasty and genioplasty (both requiring osteotomy) with peri-oral fillers/augmentation 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Best Solution for Correction of Profile with Large Projecting Nose and Chin

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Hi Rio,

It does appear that your chin will need to be addressed at some point to give you a pleasing profile.  The type of chin reduction procedure depends on the underlying cause of your chin projection (bone or soft tissue).  Whether the procedures are done simultaneously or at separate times should be determined by your surgeon and you.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

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.