Bone Genioplasty in Londrina: the definitive surgery for the chin
If you feel that your chin is too short, too long, recessed, or asymmetrical, you have probably researched various options. Silicone implants, hyaluronic acid fillers, biostimulators. But there is a surgery that solves the problem definitively by moving the patient's own bone: bone genioplasty.
Over more than twenty years performing facial plastic surgeries, I have noticed that the chin is one of the structures that most influences the harmony of the face. A well-positioned chin completely changes the profile, the balance between the nose and face, and even the definition of the neck. And no procedure offers results as precise and long-lasting as mentoplasty.
Bone genioplasty involves making a controlled cut in the jawbone, in the chin area, and repositioning it exactly where it needs to be. I can advance, retreat, shorten, lengthen, or even correct lateral asymmetries. All in a single procedure, with a permanent result, because we are working with the patient's own bone.
Why bone genioplasty is superior to alternatives
The mentoplasty with silicone implant is a valid surgery in many cases, but it has limitations. The implant only pushes the chin forward; it cannot shorten, lengthen, or correct asymmetries in a three-dimensional way. Additionally, there is always the risk of bone resorption in the long term and implant displacement.
On the other hand, hyaluronic acid fillers are temporary by nature — lasting twelve to eighteen months and needing to be repeated indefinitely. For those who desire a definitive correction, it makes no sense to rely on constant reapplications.
Bone genioplasty resolves everything at once. It is your own bone, in the ideal position, fixed with titanium mini-plates that remain forever. No foreign body, no maintenance, no resorption.
Indications: when bone genioplasty is necessary
Facial beauty depends on proportions. When I analyse a face, I assess the relationship between three thirds: the upper third (forehead to eyebrows), the middle third (eyebrows to base of the nose), and the lower third (base of the nose to chin). The chin is the protagonist of the lower third, and its position influences the entire perception of harmony.
Retrognathism or microgenia: short or recessed chin
This is the most common indication. A retracted chin makes the nose appear larger than it really is, diminishes the definition of the angle between the chin and neck, and can create an appearance of a "weak" or infantilised face. With advancement genioplasty, I position the bone forward, creating a balanced profile and an elegant cervico-mental angle.
Prognathism or macrogenia: overly prominent chin
Less common, but equally bothersome. An excessively projected chin can harden the features, especially in women who desire a more delicate profile. The retreat osteotomy resolves this with millimetric precision.
Vertical excess or deficiency: long or short chin
Some patients have the chin well positioned in the anteroposterior sense, but with inadequate height. A vertically long chin elongates the lower third of the face and can hinder lip closure, creating tension in the mental muscle. A short chin, on the other hand, shortens the lower third and can give the impression of a rounded face. Genioplasty allows both shortening and lengthening of the chin vertically.
Chin asymmetries
Facial asymmetry is more common than people imagine. In many cases, the chin is deviated to one side, creating a visible disproportion, especially in photographs. With osteotomy, I can lateralise the bone fragment to correct the symmetry.
Combination with rhinoplasty
Frequently, genioplasty is performed together with rhinoplasty. When the chin is recessed, the nose appears proportionally larger. By correcting both simultaneously, the result is a harmonious and natural profile. This combination is especially powerful in male rhinoplasty, where a strong and well-defined chin perfectly complements a straight nose.
The surgical technique: how I perform bone genioplasty
The surgery is performed under general anaesthesia or deep sedation, depending on its complexity and any associated procedures. The duration varies from one to two hours.
Intraoral access: no visible scars
The incision is made inside the mouth, in the groove between the lower lip and the gum. This means there are no visible scars on the face. Through this route, I expose the entire anterior region of the mandible with direct and secure vision.
Protection of the mental nerve
The mental nerve emerges from the mandibular bone on each side and is responsible for the sensitivity of the lower lip and chin. Before any cuts on the bone, I carefully identify and protect both nerves. This step is crucial to preserve sensitivity in the postoperative period.
Horizontal osteotomy
With an oscillating or piezoelectric saw, I make a horizontal cut in the mandible bone, below the roots of the teeth and the mental foramen. This cut separates the lower fragment of the chin (the mentum) from the rest of the mandible, creating a bone segment that I can move freely.
Three-dimensional repositioning
Here lies the beauty of bone genioplasty. The fragment can be moved in any direction:
Advancement: I slide the fragment forward, increasing the projection of the chin.
Retraction: I move it backward, reducing the projection.
Vertical reduction: I remove a horizontal slice of bone and bring the segments closer together, shortening the chin.
Vertical augmentation: I separate the segments and, when necessary, use bone graft or biomaterial in the created space.
Lateralisation: I shift laterally to correct asymmetries.
Combinations: I can combine movements — for example, advancing and shortening simultaneously.
Fixation with titanium miniplates
Once the fragment is positioned in the ideal position, I fix it with titanium miniplates and screws. These are tiny, biocompatible pieces that remain in the bone permanently without causing any problems. They do not trigger alarms at airports and do not need to be removed.
Closure and dressing
The oral mucosa is sutured with absorbable threads. I apply an external compressive dressing (micropore and bandage) that helps control swelling and keeps the soft tissues accommodated over the new position of the bone.
Surgical planning: the importance of precision
Genioplasty is not a surgery that is planned "by eye". Every millimetre of movement makes a difference in the final result. Therefore, my planning follows rigorous steps.
Cefalometric analysis
I request a lateral cephalometric radiograph of the face, which allows me to accurately measure the skeletal relationships between the maxilla, mandible, chin, and base of the skull. I use cephalometric tracings to determine exactly how many millimetres the chin needs to advance, retract, rise, or lower.
Photographic profile analysis
I photograph the patient in a natural head position and analyse the proportions of the facial thirds, the nasolabial angle, the cervicomental angle, and the relationship between the lower lip and the chin. This analysis complements the radiographic data and helps define the ideal surgical plan.
Computed tomography
In more complex cases, especially when there are significant asymmetries, I request a computed tomography scan with 3D reconstruction. This allows me to visualise the bone structure in three dimensions and plan the cuts with maximum precision.
Digital simulation
I use simulation software to show the patient a preview of the expected result. Although the simulation is not a guarantee, it greatly helps align expectations and allows the patient to actively participate in the planning.
All this care in planning is what separates a mediocre result from an excellent one. Genioplasty is a millimetric precision surgery, and I treat each case with the rigor it deserves.
Genioplasty versus chin implant: how to decide
This is one of the questions I hear most in the clinic. The answer depends on what needs to be corrected.
When the implant is sufficient
If the patient only needs an increase in the anterior projection of the chin (forward), with adequate vertical height and no asymmetry, the silicone implant can be a good option. It is a simpler, quicker surgery with a shorter recovery time.
When bone genioplasty is necessary
Genioplasty is necessary when:
The chin needs to be shortened or lengthened (vertical dimension).
There is asymmetry that needs to be corrected.
The chin needs to be retracted (an implant does not do this).
It is necessary to combine movements in more than one direction.
The patient prefers a definitive result without synthetic material.
There have been problems with previous implants (resorption, displacement).
Advantages of bone genioplasty
Permanent result: the bone consolidates in the new position in about six weeks.
Versatility: movements in any direction.
No foreign body: it is your own bone.
No resorption: the implant can cause resorption of the underlying bone over the years; genioplasty does not.
More natural feel: it is bone, not silicone.
Relative disadvantages
Slightly more complex and longer surgery.
Initial swelling may be more pronounced.
Requires specific instruments (oscillating saw, titanium plates).
In my experience, when the patient has a clear indication for bone genioplasty, the benefits far outweigh the disadvantages. It is a surgery I perform frequently with consistently satisfactory results.
Genioplasty and facial harmony: the role of the chin in the face
Many patients come to the clinic complaining about their nose, when in fact the main problem lies in the chin. This is a more common situation than one might think. The face functions as a system of interdependent proportions, and altering one structure impacts the perception of all the others.
The chin-nose relationship
In a harmonious profile, the tip of the nose and the most anterior point of the chin should be approximately on the same vertical line (Ricketts line) or close to it. When the chin is retracted, the nose appears proportionally large, even if its dimensions are normal. Correcting the chin can make a rhinoplasty unnecessary — or, when rhinoplasty is needed, the combined result is much more balanced.
The chin-neck relationship
The cervicomental angle — that angle between the chin and the neck — directly depends on the projection of the chin. A retracted chin creates an obtuse angle, giving the impression of a double chin even in slim patients. By advancing the chin with genioplasty, I significantly improve the definition of the neck. This improvement can be enhanced when we combine genioplasty with a neck lift.
The chin-lips relationship
The mentolabial sulcus (the fold between the lower lip and the chin) is deeply influenced by the position of the chin. A very projected chin can flatten this sulcus; a retracted chin can excessively deepen it. In genioplasty, I can modulate this relationship with precision.
Genioplasty in male versus female faces
There are important differences between the ideal male and female chin. In men, a more projected, angular, and wider chin conveys strength and masculinity. In women, a slightly more delicate chin, with soft contours and a more oval shape, is generally more harmonious. These differences guide my planning in an individualized manner.
Procedures frequently combined with genioplasty
Rarely is the chin the only aspect of the face that needs attention. In my practice, I combine genioplasty with other procedures to achieve complete facial harmony.
Rhinoplasty
As I mentioned, the combination of rhinoplasty + genioplasty is one of the most powerful in facial plastic surgery. Correcting the nose and chin simultaneously transforms the profile in a surprising way. The combined surgery is performed in the same anaesthetic time, without significantly increasing the risks.
Facelift
In patients with facial ageing and a retracted chin, I associate genioplasty with deep plane facelift. Advancing the chin improves the mandibular contour and complements the rejuvenation provided by the facelift.
Bichectomy
The bichectomy (removal of the buccal fat pads) can be associated with genioplasty to create even greater facial definition. The combination is especially interesting for patients who desire a more angular and defined face.
Submental liposuction
When there is fat accumulation under the chin, I can associate submental liposuction with genioplasty. The advancement of the bone combined with the removal of fat creates a spectacular cervicomental angle.
Complementary facial filling
After genioplasty, it may be interesting to complement with facial filling in areas such as the mandibular angle or cheekbones to maximise overall harmony.
The consultation: individualised assessment
Each face is unique, and genioplasty requires meticulous planning. In the consultation, I dedicate time to understand exactly what bothers you, assess your anatomy, and determine the best surgical plan.
What I assess during the consultation
Proportions of the facial thirds: measurements that reveal whether the lower third is proportionally correct.
Dental occlusion: the bite directly influences the positioning of the chin. Severe occlusal problems may require orthognathic surgery instead of isolated genioplasty.
Facial symmetry: deviations of the chin or mandibular asymmetries that need to be corrected.
Profile and facial angles: nasolabial angle, cervicomental angle, projection of the nasal tip.
Thickness of soft tissues: the amount of soft tissue over the bone influences the final result.
Mentalis muscle: hyperactivity of the mentalis muscle (the famous "witch chin") can be corrected during surgery.
Pre-operative exams
Complete blood count
Coagulation profile (TAP, INR, KPTT)
Creatinine and urea
Fasting blood glucose
Urine analysis
Electrocardiogram
Cardiological assessment with surgical risk
Lateral telerradiography of the face
Dental panoramic X-ray
CT scan (when indicated)
Medications that should be discontinued
Fifteen days before and fifteen days after surgery:
Acetylsalicylic acid (Aspirin, AAS, Bufferin)
Non-steroidal anti-inflammatory drugs
High doses of Vitamin E
Ginkgo biloba and other herbal remedies
High doses of Omega 3
Smoking should be stopped for the same period. Nicotine compromises circulation and hinders bone and soft tissue healing.
Post-operative: what to expect after genioplasty
The recovery from bone genioplasty is surprisingly smooth for most patients. Of course, there are discomforts, but they are perfectly manageable.
First 48 hours
There will be significant swelling in the chin and lower lip area. This is completely expected. Apply cold compresses as directed and keep your head elevated. Pain is moderate and well controlled with the prescribed medication. A liquid and soft diet is recommended in the first few days.
First week
Swelling peaks between the second and third day and begins to decrease progressively. Bruising (purple spots) may appear in the chin and neck area. Maintain strict oral hygiene with antiseptic mouthwash, as the incision is inside the mouth. Avoid hard foods or those that require vigorous chewing.
Second week
Most of the swelling has subsided. The absorbable sutures begin to dissolve. You may return to light activities. Sensitivity in the lower lip may be altered — tingling or partial numbness is normal and temporary.
First month
Gradual return to normal activities. Avoid contact sports and any trauma to the chin area. Bone consolidation is underway — the fragment is fusing to the mandible in the new position.
Two to six months
Residual swelling continues to subside slowly. Sensitivity in the lip generally returns completely during this period. The final result begins to take shape.
Definitive result
Between six months and a year, the result is complete. Bone consolidation is total, the soft tissues have settled, and the result is permanent. This is the chin you will have for the rest of your life.
Risks and complications: complete transparency
Like any surgery, bone genioplasty has risks. I believe that transparency about them is essential for you to make an informed decision.
Temporary alteration of sensitivity
This is the most common complication. Even with careful protection of the mental nerve, some degree of numbness or tingling in the lower lip and chin is expected in the first months. In the vast majority of cases, sensitivity returns completely between three and six months. Permanent nerve injury is extremely rare when the surgery is performed by an experienced surgeon.
Residual asymmetry
The precision of planning and execution minimises this risk, but small asymmetries may occur. In rare cases, surgical revision may be necessary.
Infection
The oral cavity contains bacteria, making post-operative hygiene essential. I use antibiotic prophylaxis and guide the patient on strict oral hygiene care. The incidence of infection is low.
Problems with fixation
Loosening or fracture of the mini-plates and screws is exceptional but possible. It usually occurs when the patient suffers trauma in the area before complete bone consolidation.
Bone resorption
Unlike prosthetics, bone genioplasty has a minimal rate of resorption, as we are repositioning vascularised bone that maintains its biological connections. Still, some bone remodelling may occur over the years.
Chin ptosis (witch chin)
If the soft tissues are not adequately readapted to the bone, there may be a "drooping" of the skin and musculature of the chin. I prevent this with meticulous muscle reinsertion technique and appropriate compressive dressing.
I discuss all these risks in detail during the consultation. My goal is for you to enter the surgery fully informed and secure.
My training and experience in facial surgery
I graduated from the State University of Londrina and had the privilege of being a student of Professor Ivo Pitanguy, the greatest name in Brazilian plastic surgery and one of the most respected in the world. With him, I learned not only surgical techniques but a philosophy of respect for the patient and an unrelenting pursuit of excellence.
Over more than twenty years of practice, I have performed over eight thousand plastic surgeries. I am a full member of the Brazilian Society of Plastic Surgery (SBCP) and the American Society of Plastic Surgeons (ASPS). I regularly participate in national and international congresses, keeping myself updated with the advances in the specialty.
Facial surgery is my passion within plastic surgery. From deep plane facelift to rhinoplasty, from neck lift to genioplasty, each procedure requires a deep understanding of the three-dimensional anatomy of the face and artistic sensitivity to create harmonious and natural results.
Why trust me with your genioplasty
Bone genioplasty is a surgery that requires mastery of mandibular anatomy, skill with osteotomy instruments, and refined aesthetic sensitivity. My experience accumulated over two decades, combined with meticulous planning and precise technique, allows me to offer predictable and satisfactory results.
If during the consultation I perceive that genioplasty is not the best option for you — if a prosthesis resolves better, if the problem is orthognathic, or if your expectations are unrealistic — I will say this clearly. I prefer to lose a surgery than to make a patient unhappy.
Frequently asked questions about bone genioplasty
Does genioplasty leave a visible scar?
No. The incision is made inside the mouth, in the groove between the lower lip and the gum. There is no visible scar on the skin of the face. The internal scar is practically imperceptible after complete healing.
Is bone genioplasty very painful?
Pain is surprisingly moderate. Most patients report more discomfort from swelling than from pain itself. Common painkillers manage the post-operative period well. It is not a surgery that requires prolonged use of strong medication.
How long does the surgery take?
Isolated genioplasty lasts between one and two hours. When combined with other procedures such as rhinoplasty, the total time increases proportionally, but the procedures are performed within the same anaesthetic time.
When can I return to work?
For activities that do not require physical effort, usually in seven to ten days. The swelling will still be visible but reasonably discreet. For public activities or events, I recommend two to three weeks. Contact sports, only after six to eight weeks.
Is the result permanent?
Yes. Once the bone consolidates in the new position (approximately six weeks), the result is definitive. The chin will remain in this position for the rest of your life. This is one of the great advantages of bone genioplasty over fillers and even over prosthetics.
Does genioplasty affect the bite or teeth?
No. The osteotomy is performed below the roots of the teeth and the mandibular canal. The bite (occlusion) is not altered. If the patient has bite problems that contribute to facial disharmony, orthognathic surgery may be necessary, which is a different and more comprehensive procedure.
Can I have genioplasty along with rhinoplasty?
Yes, and this is one of the most frequent combinations. Correcting the chin and nose simultaneously offers a superior facial harmony result compared to correcting only one of them. The combined surgery is safe and does not significantly increase recovery time.
What is the difference between genioplasty and orthognathic surgery?
Genioplasty only moves the lower fragment of the chin (mentum). Orthognathic surgery repositions the entire mandible and/or maxilla, correcting bite problems and larger skeletal disproportions. Genioplasty is indicated when the occlusion is adequate and the problem is exclusively aesthetic in the mentum.
Can the titanium mini-plates be felt or seen?
No. The mini-plates are extremely thin and are fixed to the bone, covered by soft tissues. They are not palpable in most patients and are not visible. They do not cause rejection, do not rust, and do not need to be removed.
Will I have permanent numbness in my chin?
Temporary numbness is expected and normal in the first months. Sensitivity returns progressively, with complete recovery in the vast majority of cases between three and six months. Permanent numbness is extremely rare when the surgery is performed with proper technique and careful protection of the mental nerves.
Is genioplasty indicated for both men and women?
Yes, for both. The planning is individualised according to the aesthetic pattern of each gender. In men, I generally seek a more projected and angular chin. In women, a softer and more delicate contour. The principle of the surgery is the same; what changes are the aesthetic goals.
Can I combine genioplasty with buccal fat removal?
Yes. Buccal fat removal complements genioplasty very well, especially in patients who desire a more defined and angular face. Both surgeries can be performed in the same surgical time, with independent intraoral incisions.
Book via WhatsApp
If you have made it this far, it is because you are seriously considering bone genioplasty. The next step is simple: book a consultation with me. My team is ready to assist you, answer your questions, and find the best time for your evaluation.
