Chin reshaping (Genioplasty) at Wolverhampton Hospital

What is chin reshaping?

Genioplasty is surgery to change the size or shape of your chin, either by adding to it with an implant or moving the chin bone, or by removing bone to make it smaller. The aim is to bring your chin into better balance with the rest of your face.

What conditions does it treat?

Genioplasty is usually chosen for cosmetic reasons, when a chin looks too small, too large, recessed, protruding or asymmetrical compared with the rest of the face. It can also be needed for reconstructive reasons, such as a birth defect, a traumatic chin injury, or after surgery to remove a tumour from the lower face.

What are the benefits of having chin reshaping?

Chin reshaping can add definition and contour to your lower face, and create a more symmetrical look between your chin, jawline and profile. It can also realign a chin that's recessed, protruding or crooked, and help you feel more confident in your appearance.

Are there different types of surgical approaches?

• Chin implant: usually made from silicone, this is placed in a small pocket in front of the chin bone, through an incision inside the mouth or under the chin, to make a small chin bigger or more defined.
• Sliding genioplasty: the chin bone itself is cut and moved forward, backward or sideways, or a wedge of bone is removed to reduce its size, then held in place with small plates and screws.
• Non-surgical filler: for milder cases, a dermal filler can add temporary volume and contour to the chin and jawline, usually lasting around a year, though severe cases of a receding chin usually need surgery.

Both surgical approaches are usually performed under general anaesthetic, through an incision inside the mouth to avoid visible scarring. Chin reshaping is often combined with other facial surgery, such as rhinoplasty, for the best overall balance.

What happens before the operation?

Your surgeon will check you're a suitable candidate, which usually means being a non-smoker in good general health, having normal jaw and tooth alignment, and having reached full skeletal maturity so your bones have stopped growing.

In the run-up to your operation:

• you'll have X-rays or other imaging to examine your chin bone and plan your surgery, along with photographs of your chin and jawline
• tell your surgeon about all medicines, herbal remedies and supplements you take; some, including aspirin, anti-inflammatory drugs and blood thinners, may need to be stopped beforehand
• stop smoking at least 6 weeks before your operation, since it can interfere with healing
• arrange for someone to drive you home afterwards, and prepare a comfortable space to recover in.

What happens during the procedure?

1. You're given an anaesthetic, usually a general anaesthetic, though sometimes local anaesthesia or sedation is used instead.
2. Your surgeon makes an incision, usually inside your mouth to avoid visible scarring, though a chin implant can sometimes be placed through an incision under the chin instead.
3. For a chin implant, a pocket is created in front of the chin bone and the implant is placed and centred. For a sliding genioplasty, part of the chin bone is cut and moved into its new position, or a wedge is removed to reduce its size.
4. The bone or implant is secured with small plates and screws, and the incision is closed with dissolvable stitches.
5. A bandage or wrap may be placed over your chin to support it and reduce swelling.

The operation usually takes around 1 to 3 hours, depending on which technique is used and whether it's combined with other procedures.

What does recovery look like?

Most people go home on the same day as their surgery, after being watched for a few hours as the anaesthetic wears off. Some clinics arrange for a private nurse to help care for you at home for the first 48 to 72 hours.

For the first few days, stick to liquids or soft foods, rinse your mouth regularly to keep it clean, and avoid touching or irritating your stitches. You may be sent home with an antiseptic mouthwash to use regularly or even a course of antibiotics.

Bruising and swelling are normal and tend to peak after about 2 days, settling within 2 weeks, though it can take up to 6 weeks for swelling to fully go down.

Avoid heavy lifting, bending or strenuous exercise for at least a week, and sleeping with your head elevated can help with swelling. Most people return to work and daily activities after about a week, depending on their job and healing, and it can take 2 to 6 weeks to see your results emerging, with full recovery over 6 to 12 months. You may also have numbness in your chin or lower lip for around 3 months while the nerves recover.

Remember you will not be able to drive or operate machinery for 48 hours after your general anaesthetic.

What are the risks and complications?

Although uncommon, possible risks include:

• bleeding and bruising
• infection
• poor wound healing or scarring
• complications from anaesthesia
• issues with the implant or hardware, such as it shifting position
• tingling or numbness in your lower lip or chin, which is usually temporary but can occasionally last longer.

Contact your care team if you develop breathing problems, chest pain, a fever or flu-like symptoms, pus or discharge from your incision, numbness that isn't improving, or swelling and pain that lasts longer than a few weeks.