GENIOPLASTY

Pros

• This outpatient procedure balances facial features, creates a more defined jawline, and slims a double chin. 
• The improvement in facial harmony can increase confidence and self-esteem. In one study of patients who had a chin implant or a sliding genioplasty, all the patients from both groups reported improved self-esteem. 
• Scarring is minimal, since the incision is hidden inside the mouth.
• A genioplasty can be combined with other procedures for more dramatic improvement. 
• In one study, sliding genioplasty patients had a 90–95% satisfaction rate.
• RealSelf members give the procedure a 79% Worth It Rating.

Cons

• All surgical procedures have a chance of complications, such as scarring, infection, asymmetry, and nerve damage that leads to (usually temporary) numbness. 
• This chin surgery won’t remove excess fat. To fully get rid of a double chin, you may also need chin liposuction or a nonsurgical fat reduction procedure, like CoolMini.
• While results are immediately noticeable, it can take months for the swelling to fully resolve so you can see the final contour.

• Average Cost:
• $9,195

• Range:
• $2,900 - $18,000

Fees for plastic surgery procedures like this one vary considerably based on where the surgery is performed, the expertise level of your surgeon, and the complexity of your procedure. 

Chin surgery is almost always considered a cosmetic procedure, so it’s not usually covered by medical insurance. The exception: “If a patient has moderate or severe obstructive sleep apnea, then a sliding genioplasty is covered by insurance,” reports Dr. Majid Jamali, an oral and maxillofacial surgeon in New York City.

Genioplasty is considered a cosmetic procedure in most cases, so it’s not covered by insurance plans. Most surgeons offer payment plans or accept third-party financing options, such as CareCredit.

See our complete guide to genioplasty costs

The genioplasty photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

The most common reason that patients opt for a genioplasty procedure is to augment a weak chin, says Dr. Barry Eppley, a plastic surgeon in Carmel, Indiana. “A short chin makes the neck look full, the jawline ill-defined, and the nose larger than it is.” 

Good candidates for chin augmentation are nonsmokers in good health who are over the age of 18. “The mandible has probably not completely finished growing until age 18,” says Dr. William Portuese, a facial plastic surgeon in Seattle. The most recent statistics from the American Society of Plastic Surgeons showed that 78% of chin augmentation patients were female, and 30% were between the ages of 40 and 54. 

Genioplasty is recommended for people with a normal bite. If you need to improve your bite and the appearance of your chin, a combination of orthodontia and corrective jaw surgery (orthognathic surgery) may be a better option.

During an in-office consultation, your prospective surgeon will conduct a clinical evaluation that may involve X-rays, to determine which type of genioplasty will be best for you, or if another type of treatment plan would better achieve your goals. 

Providers often use 3D computer imaging to help genioplasty patients visualize the expected result, from the side and front views.

Looking at surgeons' before and after photographs can also help you determine the degree of additional chin projection you want. These real-life examples can also give you a sense of a provider’s surgical style and whether or not it aligns with your aesthetic goals.

Genioplasty surgery is a more complex, aggressive surgery than placing a silicone chin implant because it involves cutting and repositioning the jawbone. Because of that, it's more expensive and comes with some additional risks.

Chin implants can be placed through the mouth or through an incision under the chin. 

During a sliding genioplasty, cuts (osteotomies) are made to the bone, which is then moved forward and held in place with titanium screws. For patients who feel their chin is too big, the bone is moved backward. 

In the U.S., plastic surgeons tend to recommend chin implants more often, while oral surgeons tend to recommend a sliding genioplasty (aka osseous genioplasty). Consider consulting with surgeons who perform both techniques. A sliding genioplasty is often not offered to patients by doctors who are inexperienced in the procedure. “It’s a technically more difficult procedure, but when done correctly it can provide natural and long-lasting improvement in your chin,” says Dr. Jamali.

Both procedures have advantages and disadvantages. 

These are the primary benefits of a chin implant:

• Chin implants are manufactured in a variety of shapes, sizes, and projections to customize your look. “They are much better than the old button-type implants that gave chin implants a bad name for many years,” says Dr. James McMahan, a plastic surgeon in Columbus, Ohio. You and your surgeon will determine which implant is best for you based on your goals. 
• Chin implants are usually made of solid medical-grade silicone and have a long history of safe use.
• The average cost of a chin implant is significantly less than a genioplasty procedure.
• When placed in the correct position, the implant looks and feels natural.
• The complication rate is very low.
• The implant can be removed, replaced, or repositioned if need be.

However, there are potential drawbacks:

• This surgery can leave a scar, though it’s usually small and placed under the chin. 
• If the wrong implant size or shape is chosen, it can look unnatural.
• An implant can cause some jawbone erosion. Over time, the implant can sink into the bone and lose its projection. If this happens, the implant can be removed relatively easily and replaced with a new, larger implant. 

A sliding genioplasty has several advantages over a chin implant:

• It doesn’t require the use of a prosthesis. “The patient’s own bone is used, so the result looks and feels natural,” says Dr. Jamali.
• By repositioning your chin bone, it’s capable of a wider array of dimensional changes than a chin implant. The procedure is more versatile and can correct a broader range of concerns, including a large chin (macrogenia), a small chin (microgenia), and an asymmetrical chin. 
• It’s the procedure of choice if your chin needs to be moved forward and vertically shortened, something an implant just can’t do. 
• A sliding genioplasty can also correct lip incompetence, the inability to keep your lips together without straining. 
• It won’t leave a visible scar.
• Recovery is relatively quick. Though the bone takes 3–4 months to fully heal, 50% of the swelling disappears after a week. “At that point, people usually can enter back into their daily lives without any notice that a procedure was done,” says Dr. Jamali. 
• It's generally a better procedure for people who have a severely receding chin (aka weak chin), when the chin slopes back toward the neck, according to doctors on RealSelf. “In cases that require more than 5 mm of projection, I prefer to perform a genioplasty,” says Dr. Michael Morrissette, an oral and maxillofacial surgeon in Ventura, California. “The results of genioplasty are precise and the benefit is that the natural chin and chin pad soft tissue is moved forward. I think it gives the most natural results and I perform both chin implants and genioplasty.” 
• The procedure is relatively low-risk. “The most significant risk is sensory nerve dysfunction or loss of feeling in the chin,” says Dr. Morrissette. “This can mostly be avoided with an experienced surgeon and protection of the nerve bundle during surgery.” 

There are some cons to a sliding genioplasty:

• It’s a more extensive procedure that comes with a higher cost.
• The procedure is performed under intravenous or general anesthesia (one of the reasons it's more expensive).  
• There’s a greater risk of permanent lip numbness, though this is still rare. 
• “Inferior border notching,” which looks like two small grooves on either side of your chin, often occurs after a sliding genioplasty. The larger the bone movement, the more likely it will occur. But there are ways to lessen it, such as a low-angled cut, or filling in the notch with fat grafts or fillers. 

An experienced surgeon who regularly performs both types of chin surgery can help you weigh both options and recommend the best procedure for your facial anatomy, goals, and budget.

RealSelf Tip: If you’re not ready to commit to surgery, temporary chin fillers can allow you to “try on” chin augmentation.

A sliding genioplasty is typically performed as an outpatient procedure, under IV or general anesthesia. 

• First, the surgeon makes an opening about 3 inches long inside the mouth, on the inner portion of the lower lip, directly in front of the gumline.
• Through this opening, they access the chin and separate it from the jawbone. 
• The chin bone is then precisely cut and either brought forward or back, shortened, or altered to correct any asymmetry.
• Once the bone is repositioned to create the desired shape and size, it is permanently secured in place using a small titanium plate and screws. Over time, new bone will naturally form around the area. 
• Finally, the incision is closed with tiny, dissolvable sutures.

“Genioplasty is performed under intravenous or general anesthesia, and local anesthesia is administered, so you won’t have any discomfort during the procedure or immediately after,” says Dr. Michael P. Morrissette, a board-certified oral and maxillofacial surgeon in Ventura, California.

Some post-surgery soreness is expected, but it’s manageable with prescription or over-the-counter pain medication.

Most patients take one week off work for their initial recovery time and head back to work within seven to 10 days post-op. You may be able to return to work even sooner than that, if you have a desk job. 

You’ll have detailed aftercare instructions from your surgeon, based on the complexity of your procedure and your healing rate, but here’s what you can generally expect during recovery.

• Swelling can be significant, but it will gradually decrease over the first few weeks.
• You may be asked to consume only liquid or soft foods for a few days to limit jaw movement, to brush your teeth carefully and gently, and to rinse regularly with saline or mouthwash to promote healing.
• They may also recommend sleeping with your head elevated for the first few nights after surgery, to reduce swelling.
• Bruising is usually minimal. 
• Soreness and discomfort are also common but should be easily controlled with pain medication and cold compresses. 
• Limit yourself to light activity during the first week after surgery. 
• Light exercise can be added to your daily schedule at about the two-week mark, but avoid vigorous exercise for 4–6 weeks.  
• It’s normal to experience numbness and stiffness in your chin and lip for several months as you heal. This is due to interference with the nerves supplying sensation to these areas. 
• You may also have difficulty moving your lower lip, which may make it hard to speak clearly and to smile, as well as a sensation of drooling or drooping of the lower lip. This should gradually resolve over the first few weeks.  

You’ll see a change immediately. There will be swelling, though, so you’ll need to wait before trying to judge the results. 

“This is facial bone surgery, which creates a large amount of swelling and distortion early on,” explains Dr. Eppley. He advises giving it at least six to 12 weeks before trying to judge the results. “What may look too big at one week after a sliding genioplasty will look completely different in another month,” he explains.

Genioplasty results are considered permanent and can help patients age more gracefully. One study published in the Journal of International Oral Health found that the procedure "produces predictable results and the bony and soft tissue stability were generally very good," with only minor changes detected two years post-op.

The skin over the top of the chin bone will continue to age normally, but “adding structural support to the face can help delay skin sagging, particularly along the jawline, since this is the step-off into the neck area,” says Dr. Eppley. “But besides adding tissue support, a stronger jawline is a desirable asset at any age for both men and women.”

When performed by a qualified, experienced surgeon, genioplasty surgery is considered very safe and associated with very few complications. 

Risks that accompany any type of surgery include infection, hematoma (internal bleeding), poor scarring, and side effects from the anesthesia. Chin surgery patients are usually given a course of antibiotics to help prevent infection during healing.

With sliding genioplasty, the main risk is numbness to the lower lip and chin. All nerves, including the mental nerve (which exits the mandible on either side of the chin), “are extremely delicate, and can easily ‘fall asleep’ temporarily from indirect manipulation, without ever touching the nerve itself,” says Dr. Burke Robinson, a facial plastic surgeon in Alpharetta, Georgia. “It’s not uncommon to temporarily lose some sensation on one or both sides of the lip and chin.”

Chin surgery can be performed solo, but it’s often combined with other procedures for an enhanced result. It often dramatically improves the results of rhinoplasty, the most common plastic surgery procedure. This is why a trained surgeon will assess both areas during a consultation. 

“While these two areas of the face may not seem to be connected, they’re very important for overall facial balance,” says Dr. Portuese. He explains that many patients have an overly projecting nose and an under projecting or recessive chin. Performing either surgery by itself can still leave a face out of balance. As a result, chin augmentation with nose reshaping surgery is one of the most common facial contouring combinations.

Another common surgical combo is genioplasty and neck liposuction. While chin enhancement always helps improve a double chin, and in some cases may completely eliminate it, the addition of chin lipo to remove excess fat assures the most complete elimination of it, Dr. Eppley says. 

Sleep apnea (aka obstructive sleep apnea or OSA) is a condition that occurs when the muscles that support the soft tissues near the back of your throat, including your tongue, temporarily relax during sleep and partially close off your windpipe. 

According to the Mayo Clinic, when these muscles relax, your airway is narrowed or closed, and breathing is momentarily cut off. This can be dangerous since reduced airflow into the lungs lowers blood-oxygen levels. 

If untreated, it can lead to serious health problems, such as high blood pressure and heart trouble. Snoring is a common symptom of OSA; as air passes by these soft tissues, they can vibrate, causing snoring. 

A sliding genioplasty may improve OSA to a small degree. Because the procedure cuts the chin bone and moves it forward, it brings some of the muscles of the tongue, which attach to the bone, along with it. This pulls the tongue forward, which can help open an obstructed airway. The improvement, however, is slight—only 3% to 5%, according to Dr. Jamali, which is why sliding genioplasty is not recommended as a sole procedure to correct OSA. “The combination of jaw advancement and chin surgery is probably the best solution for OSA,” he says. 

If you think you have OSA, it’s important to see your doctor for a complete medical exam, which will likely include a sleep study to help diagnose sleep apnea.

A chin implant is the most popular option for chin augmentation. It's a less intensive surgery than genioplasty, performed under local anesthesia with sedation. The recovery is also easier, and the average cost of a chin implant is significantly lower. Talk with a board-certified surgeon about whether this might be a better option for you.

People who want a more streamlined chin commonly choose V-line surgery, which reshapes the jawline from a “U” shape to a more feminine “V” shape, or another type of jaw reduction surgery. These procedures can be combined with a sliding genioplasty, moving the chin either back or forward, to create a dramatic change in your facial structure. 

If you’re not ready for surgery, chin fillers provide a nonsurgical option for augmentation. When injected into the soft tissue under the skin, they provide many of the same benefits as chin surgery, but their effects are temporary. The most common fillers used in the chin area are Radiesse and Juvéderm Voluma, which is the first and only filler approved by the U.S. Food and Drug Administration (FDA) for use in this area.

Related: Jawline Sculpting—Why It’s Not All About Filler

Kumar BL, Raju GK, Kumar ND, Reddy GV, Naik BR, Achary CR. Long term stability following genioplasty: a cephalometric study. Health. 2015 Apr;7(4):44-50. PMID: 25954070; PMCID: PMC4409795.

Guyuron, B. A critical comparison of osteoplastic and alloplastic augmentation genioplasty. Aesthetic Plast Surg. Summer 1990;14(3):199-206. 

Mohammad, S. Medpore versus osseous augmentation in genioplasty procedure: A comparison. Natl J Maxillofac Surg. 2010 Jan-Jun; 1(1): 1–5.

Mayo Clinic: Obstructive Sleep Apnea.