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The Recessed Chin: Restoring Facial Balance

Dr. Jeffrey Fialkov
M.D., M.Sc., F.R.C.S.C.


mentoplasty1Before and After Mentoplasty by Dr. Fialkov

Often, patients seeking rhinoplasty are surprised when their Plastic Surgeon mentions the size or position of their chin. The combination of an “oversized” or disproportionately large nose and a disproportionately small chin, is a common facial profile seen in the Plastic Surgeons office. In contrast, some patients present for consultation with a disproportionately large chin. This too can compromise a patient’s overall aesthetic appearance

Genioplasty, or mentoplasty (surgically reshaping the jaw or chin) is a very effective means of restoring facial balance, and can often complement the effects of rhinoplasty surgery. The latter can be planned in accordance with the “ideal” nasal size, contour and proportion, without having to overcompensate for a small lower face once this is corrected by the genioplasty.

Genioplasty surgery can reduce or increase the chin size both vertically and in its horizontal projection. Two general options exist in making the chin larger. The native bone can be cut and repositioned relative to the jaw bone and the rest of the face (sliding genioplasty), or a synthetic implant can be placed over (and attached to) the underlying chin bone giving the appearance of a naturally larger and/or more projected chin (augmentation genioplasty). The decision to choose one technique over the other depends on a number of factors, including: the dimensions and direction of change required to achieve the ideal chin shape and size, the pre-existence of asymmetries or bony irregularities, the general health of the patient, and finally the patient’s personal preference.

Depending on the technique used, the surgery can take as little as one hour and the risks are relatively small. The incisions are all hidden inside the mouth (no external scars), and the sutures (stitches) are all dissolvable. Recovery (healing of the incision, and resolution of bruising and the majority of swelling) takes as little as a week to ten days. In spite of these features (short operating time, day surgery, low risk and relatively fast recovery) the effects of chin surgery can be dramatic. Facial balance is restored, patients often look younger, healthier or more physically fit, and facial features that otherwise appeared disproportionate become more aesthetically pleasing.

Dr. Jeffrey Fialkov is Assistant Professor of Plastic Surgery at the University of Toronto and a staff Plastic Surgeon specializing in facial surgery at Sunnybrook Health Science Centre