What is genioplasty?

Genioplasty is a surgical procedure that uses several measures to increase chin projection.

It can be done on its own with local anaesthesia and IV sedation or in conjunction with other surgeries, such as orthognathic surgery, rhinoplasty or facelift.

mentoplastia

This procedure is done in patients with microgenia (unusually small chins with normal jaw size and position). One very common error is to turn to a genioplasty (with prosthesis or with osteotomy) to camouflage retrognathia or micrognathia (meaning lower jaws that have posterior positioning or that are too small on the whole, not just the chin), which leads to a worse final aesthetic result (leading to “witch chin“). These cases should be treated with orthognathic surgery and orthodontics before and after surgery, not with genioplasty. There are two techniques:

1. With sliding osteotomy

(recommended by the Birbe Clinic)

This surgery is normally conducted by Dr Birbe, given his extensive experience in facial osteotomy. This procedure involves an intraoral approach (no external scarring) with an incision along the jaw below the roots of the teeth and the dental nerve in order to move the chin forward, which is later anchored in place with a tiny plate.

This procedure has better long-term results (as there is no prosthesis, there’s no risk of rejection, fibrosis or movement) and it also makes it easier to correct asymmetrical jaws than with a prosthesis (particularly in the canines). In expert hands, this technique is very safe and highly satisfactory.

2. With prostheses

A small prosthesis made of silicon or another material is implanted, of the same texture and hardness as the bone, so there is no notable difference between the natural chin and one improved with a prosthesis.
The approach can be intraoral (which has a greater risk of infection and encapsulation of the prosthesis) or through the neck below the chin (with minimal scaring). This procedure has the risk of the body rejecting the prosthetic material and can lead to serious fibrosis around the implant, which increases discomfort and can make the implant noticeable to others.
Given these issues, this procedure is not recommended in younger patients (with a long life expectancy).

FAQ

The normal position of the chin relative to the lips in a person with good facial proportions is that the lower lip is 1-2 mm behind the upper and the chin is 1-2 mm behind the lower lip. There are great variations in facial harmony according to genetics, gender and ethnicity.

There are also too long or short ​chins, susceptible to being treated by impaction or descending ​the chin.

When ​a​ chin is very ret​ru​ted or prot​ruted in relation to the lips, ​moving the chin in the right direction reduces the relative distance from the lips to the chin. Dr.Birbe uses reference points of the face to evaluate proportions, however, there is an artistic component in ​genioplasty planning that takes into account aspects such as sex, ethnicity and chin shape.

​Genioplasty is often combined with orthognathic surgery and with rhinoplasty. Both have the objective of improving facial proportions and make the final result better. Liposuction of the neck can be convenient in patients with fat located under the chin.

In cases with signs of facial aging, such as laxity of the skin, ​double chin, deep facial lines and folds in the skin of the neck, the facelift associated with ​genioplast​y is the treatment of choice.

There are different designs of ​genioplasty such as the oblique, “Chin Wing” or “Chin Shield”. Simple advance​ments or retrusions are good ​movements for oblique mentoplasties. Chin Wing design is indicated when we try to change the shape of the jaw angle, while Chin Shield helps to compensate ​patients with deep labiomental folds.
Yes, but we do not recommend it. It would be the placement of silicone prostheses, Medpor and Polytetrafluoroethylene (ePTFE), which are associated to complications such as infections, displacement and reabsorption of the jaw bone.
Small changes in the chin can be treated with bulky fillers (for example, hydroxyapatite); but the change is only temporary and must be repeated.

Other volume increases, with fat, are less predictable and less effective in replacing bone deficiency.

In the hands of Dr Birbe, bone​ ​​genioplasty is highly predictable ​with ​ fast recovery​ and ​at the same time​ expressing a ​ natural​ result​.

The results of the surgery are immediate. Edema and rare local hematomas take approximately 1 week to resolve. There is a small incision in the mouth and the sutures are removed ​at a ​ week. There is therefore no visible external scar. Patients are advised to take a soft diet during the first few days and to avoid strenuous activities 3 weeks after ​genioplasty​. Generally there is no pain, and if ​so​, it responds to oral analgesia.
Every aesthetic surgery has some risks, in general, chin surgery is very safe. As with all surgeries, there is a small risk of infection, or slight bleeding. You can have a tingling sensation in the lip the first days.
Dr. Birbe is a specialist ​of​ the face, ​ and ​does not perform body surgery. The facilities, experience of the team of more than ​20​ years, and surgical material used, as well as virtual planning ensures that Dr Birbe can provide the desired result. Birbe removes every year ​chin ​implant​s​ placed by other surgeons because the implant is unbalanced with the face of the individual or is moving out of place, or causes a resorption of the mandible bone in contact with the implant.
​I​solated ​genioplasty or associated to a rhinoplasty, ​are an excellent ​procedures to be​ ​done under endovenous sedation.
​Genioplasties associated with orthognathic bimax​i​lar surgery ​are ​usually done with general anesthesia.
The extraction of the chin implants depends on the type of implant that has been inserted and its method of fixation:
Silicone implants are removed well. Non-silicone implants like Medpor (high density porous polyethylene), hydroxyapatite, mesh and teflon (polytetrafluoroethylene) are more difficult to remove​.
If you have no problems ​in your bite ​​ and the shape of the jaw angle is correct, a ​genioplasty ​ is all you need.
If you have a malocclusion caused by a short ​mandible , or the shape of the mandibular angle is not good, you will need ​orthognathic ​surgery ​, ​sometimes associated with a ​genioplasty.
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