Chin Implant versus Osseous Genioplasty

When a patient comes in with a deficient chin desiring a chin enhancement, they’ve often done some research on the different techniques that can be utilised. A question that is often raised is the choice between using a chin implant versus getting an osseous genioplasty. A chin implant is quite self-defining in what it is and how it can be used to enhance the chin. An osseous genioplasty, where the bone of the chin is actually cut and moved, is less understood.
In most circumstances, a patient’s chin can be enhanced with either an implant or an advancement genioplasty. There are certain circumstances however, whereby an implant will not get a good result and an osseous genioplasty is a better option.
Let’s take an example of a patient who comes in with a deficient chin. Examination may reveal that her chin is deficient more so in vertical height and just a little deficient in terms of projection. She may already have a well defined labial-mental fold (the fold between the lower lip and the chin). If we used a chin implant in this case, it will only increase the projection of her chin, and not address the height of the chin. Doing this runs the risk of resulting in a “witch’s chin”. This is a situation whereby the patient is better suited to an osseous genioplasty, where we can adjust the height as well as the projection of the chin. The ability to define the chin three-dimensionally is one advantage of an osseous genioplasty. The other advantage is the absence of foreign materials, which reduces the risk of infection.
Subtle improvement is the key to chin surgery. Enhancing it such that it no longer is a point of deficiency but, at the same time, not so much that it becomes a point of attention.