Learning Center: Aesthetics of the Chin

Access information in greater detail.

Use the search tool or scroll down for your topic of interest.

“Weak” or small chin

In brief

The chin anchors the lower face and shapes how the nose, lips, jawline and neck are perceived. A chin that looks weak or too prominent can reflect the chin bone, the overlying soft tissue, or the position of the whole lower jaw and bite. Treatment follows the cause: an implant or sliding genioplasty for an isolated small chin, orthodontics and jaw surgery when the bite is off, filler for a smaller temporary change, and bone and soft-tissue reduction for a chin that is too large. This page explains how the chin is evaluated and what the published evidence shows about each option.

What a “weak” chin is

Microgenia means the bony chin is small. Retrogenia means the chin sits too far back, either on its own or because the whole lower jaw is short or rotated backward. In 684 patients with normal bites and chin deformities, microgenia was the most common pattern (63.6%), followed by an overly large chin (macrogenia, 24.9%); smaller groups had asymmetry, a sagging soft-tissue chin, or a normal chin that only looked small because a long face rotated the jaw backward [1]. That last pattern is a reminder that the chin cannot be judged in isolation: an implant does not correct a long face. More on the range of chin problems is on the chin conditions page.

Facial profile analysis

Evaluation uses standardized photographs, especially the side profile, plus examination of the bite, lower lip, the crease between lip and chin (labiomental fold), and the chin-neck angle. A common reference is a vertical line dropped from the base of the nose (subnasale). When the chin of an otherwise ideal profile was moved digitally in 2 mm steps, raters preferred the soft-tissue chin on or just behind that line; changes of up to about 4 mm were essentially unnoticeable [2]. Pushing the chin too far forward was among the least favored profiles in a later study, so more projection is not automatically better [3].

The chin, the nose and the neck

A small chin makes the nose look larger and a dorsal hump more prominent. Chin deficiency is therefore common in patients seeking rhinoplasty, and chin augmentation or reduction is often planned with it [4]; in one series of 426 rhinoplasty patients, 72 also had jaw or chin surgery [5].

The chin also shapes the neck. A retruded chin shortens and blunts the chin-neck angle, so the neck can look full without much fat. Advancing the bony chin pulls forward the muscles attached behind it and tends to sharpen that angle; an implant lengthens the apparent jawline but does not move those attachments [6]. When the complaint is a full neck, chin projection is assessed alongside fat, skin and muscle (see aging neck conditions). For excess fat under the chin, injectable deoxycholic acid is an option: in a phase 3 trial, 70.0% of treated patients improved by at least one grade versus 18.6% with placebo [7].

Malaligned bite as a cause for chin weakness or prominence

Chin position is tied to the lower jaw, and the lower jaw shows up in the bite (occlusion). A chin that looks weak or overly strong is sometimes a sign of a skeletal jaw imbalance rather than a chin problem alone.

  • Class II malocclusion (overbite pattern): the lower jaw sits behind the upper. The chin recedes, the lower lip rolls outward and the chin-neck angle is obtuse. In 40 adults with a short lower jaw, a weak chin was present in 80%, a deep labiomental fold in 90% and an obtuse neck-chin angle in 85% [8].

  • Class III malocclusion (underbite pattern): the lower teeth sit in front of the upper, from a large lower jaw, a small upper jaw, or both, and the chin looks prominent. Class III was the most common pattern (62.3%) among 403 patients referred for jaw surgery at one center [9].

When jaw surgery is the right answer

If the bite is significantly off, a chin implant or genioplasty can disguise the profile but leaves chewing problems, jaw strain and sometimes a narrowed airway untouched. Orthognathic surgery repositions the upper jaw, lower jaw or both, usually after orthodontic treatment aligns the teeth to the jaws, and a genioplasty is often added to fine-tune the chin [10]. In the series above, jaw surgery with genioplasty achieved the planned bite in 98% of patients and maintained it in 88% at more than five years, with long-term correction of the facial contour problems in 86% [8]. A meta-analysis found significant quality-of-life improvement after orthognathic surgery [11].

The trade-off is scale: months of orthodontics, general anesthesia, a hospital stay and a longer recovery. Some patients with a mild discrepancy, or who decline jaw surgery, choose chin surgery alone and accept an unchanged bite.

Orthodontic evaluation

A noticeable overbite or underbite, jaw pain, or an off-center chin warrants evaluation by an orthodontist, and often an oral and maxillofacial surgeon, before chin surgery. Dental scans and a lateral skull x-ray (cephalogram) or cone-beam CT measure the jaw relationships. If the bite is acceptable, the options below apply; an overview is on the chin treatments page.

Chin implants

A chin implant adds projection by placing a shaped implant on the front of the chin bone. It is the most frequently reported method: in a systematic review of 54 studies and 4,897 patients, 3,344 had implants and 885 had bone cuts (osteotomy) [12]. Implants suit a normal bite and a chin that mainly needs forward projection; they do not change vertical length or correct asymmetry well [1, 4].

Materials

Solid silicone is the most widely used; it forms a capsule rather than growing into tissue, so removal or exchange is straightforward. Porous polyethylene (Medpor) allows tissue ingrowth and is often screwed to the bone, which improves stability but makes removal harder [13]. In a review of more than 3,100 patients, malposition, infection, extrusion and removal rates did not differ significantly by material, but numbness was far less common with silicone (0.4%) than with porous polyethylene (20.1%) or expanded PTFE (3.2%) [14].

Technique

The implant goes in through a short incision inside the lower lip or a 2 to 3 cm incision in the crease under the chin. The intraoral route avoids a skin scar; the submental route is often preferred for larger implants or when combined with neck liposuction or a neck lift. In pooled data, intraoral placement had a slightly higher removal rate (1.5% vs 0.5%) but less asymmetry (0.7% vs 7.5%), and placing the implant under the lining of the bone (periosteum) had lower malposition and removal rates than other pockets [14]. In one series of 105 silicone implants placed through the mouth, there were no infections, displacements or nerve injuries among patients followed at least a year [15].

The mental nerves, which supply feeling to the lower lip and chin, exit the jaw on each side, and the pocket is kept below and between them. Temporary numbness from stretching is common; across the large review, nerve injury after implants was 2.4% (mostly transient) versus 16.4% after osteotomy [12].

Complications

The pooled complication rate for implants was 15.7% [12]. Implant-specific problems include infection that may require removal, shifting, extrusion, asymmetry, and under- or over-correction. In a comparison of 42 implant and 38 genioplasty patients, infection was significantly more common with implants [16], and individual series in a 2025 review reported implant infection rates as high as 23.8% [17]. Most of this evidence comes from retrospective case series [18].

Bone resorption

Implants press on the bone, and some remodeling beneath them is common. A systematic review of 28 radiographic studies found resorption with all materials, mostly averaging less than 2 mm and deeper with longer follow-up [19]. In 15 patients with silicone implants, 14 had erosion of 2 mm or less and none had symptoms [20]. A CT study linked resorption to a thicker mentalis muscle and thinner outer bone [21], and a 2025 review noted that new bone formation around silicone implants is also common and that significant resorption is rare [22]. Small degrees of resorption rarely change the appearance.

Satisfaction

Satisfaction is high across published series [12]. The main sources of dissatisfaction are asymmetry, a result that looks too small or too large, and revision.

Sliding genioplasty and other options

A sliding (osseous) genioplasty reshapes the chin with the patient’s own bone. Through an incision inside the lower lip, the lower chin bone is cut horizontally below the tooth roots and mental nerves, moved to the planned position, and fixed with a small titanium plate or screws. Because the bone itself moves, a genioplasty can advance or set back the chin, lengthen or shorten it, and correct asymmetry [4]. Advancing the bone also carries forward the floor-of-mouth muscles, which can sharpen the chin-neck angle [6].

The result is predictable. In a 3-year study of 21 patients with an average advancement of 8.4 mm, the soft-tissue chin moved about 0.9 mm per 1 mm of bone, and relapse averaged 8% [23]. A systematic review estimated that about 85% of bony movement shows in the soft tissue after genioplasty, compared with about 66% of implant thickness [17].

Risks of genioplasty

Numbness of the lower lip and chin is the main trade-off, because the mental nerves are retracted during surgery. In a 10-year series, almost all patients had transient changes lasting a few weeks, 93.1% had normal sensation at one year or later, and results were rated excellent or good in about 97% [24]. Pooled complication rates were 19.7% for osteotomy versus 15.7% for implants, including nerve disturbance in 16.4% versus 2.4% [12], and persistent altered sensation has been reported in roughly 7% to 13% of genioplasty patients in some series [17]. Other risks include bleeding, infection, tooth root injury, a palpable step at the bone cut, plate irritation, and soft-tissue sagging if the mentalis muscle is not carefully reattached (see chin reduction below) [25, 26].

Genioplasty compared with an implant

No randomized trial has compared the two, so comparisons rely on cohort studies and systematic reviews:

  • Implants: shorter, simpler and reversible; less nerve disturbance; more infection, shifting and removal; limited mainly to forward projection [12, 14, 16].

  • Genioplasty: no foreign body; corrects length, asymmetry and larger deficiencies; more predictable soft-tissue change; more temporary numbness; usually general anesthesia [17, 4].

  • Satisfaction is high with both. In an 80-patient comparison it was significantly higher after genioplasty [16], and a review of 1,126 patients found a trend in the same direction [17]; the most recent review concluded that no technique is clearly superior and the choice should be individualized [18].

Injectable fillers for the chin

For a smaller change without surgery, or to preview a surgical result, a firm hyaluronic acid (HA) filler can be placed at the point of the chin. Juvéderm Voluma carries U.S. FDA approval for chin augmentation, and several products have been tested in randomized trials against untreated controls:

  • Juvéderm Voluma (VYC-20L): 56.3% of 144 treated patients improved on a chin retrusion scale at 6 months versus 27.5% of controls, with benefit still evident at 12 months [27].

  • Restylane Defyne: 81% of treated patients improved at least one grade at 12 weeks versus 6% of controls, and 74% at 48 weeks [28].

  • Juvéderm Volux (VYC-25L), approved in the U.S. for jawline definition and studied for the chin outside the U.S.: in 119 treated patients, the profile angle improved significantly more than in controls, with benefit still evident at 12 months [29]; about half were still rated improved at 18 months, and one repeat treatment restored the result in more than 95% [30].

Filler adds volume over the bone rather than moving it, so the change is modest, and it lasts roughly one to two years. Swelling, tenderness and firmness are common and temporary. The serious risk is injection into an artery: the arteries of the chin run near the injection points and connect with vessels in the floor of the mouth [31], and rare cases of chin skin necrosis and tongue injury have been reported [32]. HA filler can be dissolved with hyaluronidase. More detail is in the Learning Center page on injectables.

chin reduction surgery

A chin can also be too large: too projecting, too long, too wide, or a combination (macrogenia). Chin reduction is requested and offered less often than augmentation but can substantially improve facial balance [33]. The first step is to separate a large chin bone from an underbite, where orthognathic surgery may be the better answer, and from a chin that only looks large because of excess or sagging soft tissue [1].

Reduction genioplasty and mentoplasty

  • Burring the front and lower border of the chin to reduce projection or width.

  • Setback or shortening genioplasty: moving the cut bone segment backward, or removing a horizontal wedge to shorten a long chin [4].

  • Lower border resection: removing a strip of bone along the lower edge of the chin and jaw [34, 35].

  • Narrowing genioplasty for a broad or square chin [36].

Outcome data come from case series. In 49 chin reductions over 25 years, 78% of patients followed for an average of 2.5 years rated the result very good or good; transient nerve changes were common, and five patients needed a minor procedure for skin indentations along the jawline [33]. In 24 patients with 5 to 10 mm of lower-border resection plus resuspension of the neck soft tissues, there were no major complications [35], and a narrowing technique in 117 patients had 6.0% minor and no major complications [36].

The soft tissue and the “witch’s chin”

When bone is removed, the overlying skin, fat and mentalis muscle do not shrink to match. The excess can sag below the jawline, producing a witch’s chin (chin ptosis): a drooping soft-tissue pad with a deep crease beneath it. The same deformity develops with aging and after earlier chin surgery, and it can be mistaken for a large chin [1, 6].

After surgery, chin ptosis is attributed mainly to stripping the soft tissue off the bone and failing to reattach the mentalis muscle, which also controls lower lip position. Precise reattachment of the mentalis preserved lower lip length in a comparative study [25], and a genioplasty technique that avoided stripping the soft tissue produced no witch’s chin deformities versus six of 25 with the traditional technique [26]. During reduction, surgeons therefore resuspend the soft tissue and may remove or tighten the excess [37, 35].

Risks of chin reduction

  • Numbness of the lower lip and chin, usually temporary [33, 34].

  • Soft-tissue sagging under the chin, contour irregularities and jawline indentations [34, 33].

  • Asymmetry, under- or over-correction, revision, bleeding, infection and tooth root injury.

Because a sharp jaw-neck angle depends on soft tissue as much as bone, reduction is sometimes combined with neck liposuction or a neck lift; see aging neck treatments.

Summary

The chin is evaluated as part of the whole profile, with the nose, lips, bite and neck. A small chin with a normal bite can be treated with an implant or a sliding genioplasty; both have high satisfaction, implants with more infection and shifting, genioplasty with more temporary numbness. When the bite itself is off, orthodontic and jaw surgery is usually the better answer. Hyaluronic acid filler gives a modest, temporary change with a small but serious risk of vascular injury. A chin that is too large can be reduced, and careful handling of the soft tissue is the key to avoiding a witch’s chin. To prepare for a consultation, see making the most of your aesthetic visit.

Last reviewed: October 4, 2026

References

  1. Guyuron B, Michelow BJ, Willis L. Practical classification of chin deformities. Aesthetic Plast Surg. 1995;19(3):257-64. doi:10.1007/BF00451101 PubMed 7668174

  2. Naini FB, Donaldson AN, McDonald F, et al. Assessing the influence of chin prominence on perceived attractiveness in the orthognathic patient, clinician and layperson. Int J Oral Maxillofac Surg. 2012;41(7):839-46. doi:10.1016/j.ijom.2012.01.012 PubMed 22340990

  3. Küçük E, Yıldırım M, Erdur EA. Evaluation of the impact of mandibular symphysis region alterations on profile aesthetics. Sci Rep. 2025;15(1):14832. doi:10.1038/s41598-025-99352-7 PubMed 40295733

  4. Sykes JM, Suárez GA. Chin Advancement, Augmentation, and Reduction as Adjuncts to Rhinoplasty. Clin Plast Surg. 2016;43(1):295-306. doi:10.1016/j.cps.2015.09.021 PubMed 26616715

  5. Reategui A, Jazayeri H, Mier A, et al. Profileplasty: Comprehensive Facial Profile Management Algorithm Based on 426 Patients. J Craniofac Surg. 2025;36(2):523-525. doi:10.1097/SCS.0000000000010999 PubMed 39715529

  6. Danahey DG, Dayan SH, Benson AG, et al. Importance of chin evaluation and treatment to optimizing neck rejuvenation surgery. Facial Plast Surg. 2001;17(2):91-7. doi:10.1055/s-2001-17757 PubMed 11598814

  7. Jones DH, Carruthers J, Joseph JH, et al. REFINE-1, a Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase 3 Trial With ATX-101, an Injectable Drug for Submental Fat Reduction. Dermatol Surg. 2016;42(1):38-49. doi:10.1097/DSS.0000000000000578 PubMed 26673433

  8. Posnick JC, Egolum N, Tremont TJ. Primary Mandibular Deficiency Dentofacial Deformities: Occlusion and Facial Aesthetic Surgical Outcomes. J Oral Maxillofac Surg. 2018;76(10):2209.e1-2209.e15. doi:10.1016/j.joms.2018.06.009 PubMed 30269767

  9. Borzabadi-Farahani A, Olkun HK, Eslamian L, et al. Functional needs in orthognathic patients with different sagittal skeletal discrepancies. Oral Surg Oral Med Oral Pathol Oral Radiol. 2024;138(2):255-260. doi:10.1016/j.oooo.2024.04.006 PubMed 38749877

  10. Ramanathan M, Panneerselvam E, Parameswaran A, et al. Genioplasty in Contemporary Orthognathic Surgery. Oral Maxillofac Surg Clin North Am. 2023;35(1):97-114. doi:10.1016/j.coms.2022.06.009 PubMed 36336599

  11. Meger MN, Fatturi AL, Gerber JT, et al. Impact of orthognathic surgery on quality of life of patients with dentofacial deformity: a systematic review and meta-analysis. Br J Oral Maxillofac Surg. 2021;59(3):265-271. doi:10.1016/j.bjoms.2020.08.014 PubMed 33546846

  12. Oranges CM, Grufman V, di Summa PG, et al. Chin Augmentation Techniques: A Systematic Review. Plast Reconstr Surg. 2023;151(5):758e-771e. doi:10.1097/PRS.0000000000010079 PubMed 36729154

  13. Yaremchuk MJ. Improving aesthetic outcomes after alloplastic chin augmentation. Plast Reconstr Surg. 2003;112(5):1422-32; discussion 1433-4. doi:10.1097/01.PRS.0000081067.90827.C2 PubMed 14504528

  14. Liao CD, Rodriguez E, Zhao K, et al. Complications Following Alloplastic Chin Augmentation: A Systematic Review of Implant Materials and Surgical Techniques. Ann Plast Surg. 2023;90(6S Suppl 5):S515-S520. doi:10.1097/SAP.0000000000003423 PubMed 36880789

  15. Aynehchi BB, Burstein DH, Parhiscar A, et al. Vertical incision intraoral silicone chin augmentation. Otolaryngol Head Neck Surg. 2012;146(4):553-9. doi:10.1177/0194599811434889 PubMed 22241784

  16. Tabrizi R, Behnia P, Kavianipour M, et al. Osseous genioplasty versus chin implants: early complications and patient satisfaction. Int J Oral Maxillofac Surg. 2024;53(2):141-145. doi:10.1016/j.ijom.2023.03.017 PubMed 37059630

  17. Kauke-Navarro M, Knoedler L, Allam O, et al. Implant-Based Chin Augmentation Vs Osseous Genioplasty: A Systematic Review of Indications and Outcomes. Aesthet Surg J Open Forum. 2025;7:ojaf048. doi:10.1093/asjof/ojaf048 PubMed 40666078

  18. Alwathnani YK, Alkhwildi LA, Almathami AA, et al. Surgical vs Non-surgical Chin Augmentation: A Systematic Review of Techniques Satisfaction, and Complications. Aesthetic Plast Surg. 2026;50(11):4292-4314. doi:10.1007/s00266-026-05611-x PubMed 41714371

  19. Yeung AWK, Wong NSM. Mandibular Bone Resorption Following Chin Augmentation: A Systematic Review. Front Surg. 2022;9:815106. doi:10.3389/fsurg.2022.815106 PubMed 35402503

  20. Sciaraffia CE, Ahumada MF, Parada FJ, et al. Bone Resorption after Use of Silicone Chin Implants, Long-term Follow-up Study with Lateral Chin Radiography. Plast Reconstr Surg Glob Open. 2018;6(7):e1850. doi:10.1097/GOX.0000000000001850 PubMed 30175015

  21. Cao J, Zhuang J, Wang C, et al. Factors Influencing Bone Resorption after Augmentation Mentoplasty with Implants: A Retrospective Study Using Three-Dimensional Imaging. Aesthetic Plast Surg. 2024;48(21):4280-4290. doi:10.1007/s00266-024-04356-9 PubMed 39271547

  22. Madorsky SJ, Meltzer OA. Bone Changes With Silicone Chin Implants: Clinical Case, Review, and Considerations for Technique Modification. Plast Reconstr Surg Glob Open. 2025;13(2):e6521. doi:10.1097/GOX.0000000000006521 PubMed 39925480

  23. Shaughnessy S, Mobarak KA, Høgevold HE, et al. Long-term skeletal and soft-tissue responses after advancement genioplasty. Am J Orthod Dentofacial Orthop. 2006;130(1):8-17. doi:10.1016/j.ajodo.2004.11.035 PubMed 16849066

  24. Hoenig JF. Sliding osteotomy genioplasty for facial aesthetic balance: 10 years of experience. Aesthetic Plast Surg. 2007;31(4):384-91. doi:10.1007/s00266-006-0177-6 PubMed 17549558

  25. Chaushu G, Blinder D, Taicher S, et al. The effect of precise reattachment of the mentalis muscle on the soft tissue response to genioplasty. J Oral Maxillofac Surg. 2001;59(5):510-6; discussion 517. doi:10.1053/joms.2001.22678 PubMed 11326372

  26. Zhang BH, Byrd R, Bradley C, et al. Osseous Genioplasty: Prevention of Witch's Chin Deformity with No-Degloving Technique. Plast Reconstr Surg. 2021;148(5):720e-726e. doi:10.1097/PRS.0000000000008478 PubMed 34529592

  27. Beer K, Kaufman-Janette J, Bank D, et al. Safe and Effective Chin Augmentation With the Hyaluronic Acid Injectable Filler, VYC-20L. Dermatol Surg. 2021;47(1):80-85. doi:10.1097/DSS.0000000000002795 PubMed 33347003

  28. Marcus K, Moradi A, Kaufman-Janette J, et al. A Randomized Trial to Assess Effectiveness and Safety of a Hyaluronic Acid Filler for Chin Augmentation and Correction of Chin Retrusion. Plast Reconstr Surg. 2022;150(6):1240e-1248e. doi:10.1097/PRS.0000000000009733 PubMed 36126213

  29. Ogilvie P, Sattler G, Gaymans F, et al. Safe, Effective Chin and Jaw Restoration With VYC-25L Hyaluronic Acid Injectable Gel. Dermatol Surg. 2019;45(10):1294-1303. doi:10.1097/DSS.0000000000001960 PubMed 31135570

  30. Ogilvie P, Benouaiche L, Philipp-Dormston WG, et al. VYC-25L Hyaluronic Acid Injectable Gel Is Safe and Effective for Long-Term Restoration and Creation of Volume of the Lower Face. Aesthet Surg J. 2020;40(9):NP499-NP510. doi:10.1093/asj/sjaa013 PubMed 31960896

  31. Tansatit T, Phumyoo T, Sawatwong W, et al. Implication of Location of the Ascending Mental Artery at the Chin Injection Point. Plast Reconstr Surg. 2020;145(1):51e-57e. doi:10.1097/PRS.0000000000006394 PubMed 31881605

  32. Wang Q, Zhao Y, Li H, et al. Vascular Complications After Chin Augmentation Using Hyaluronic Acid. Aesthetic Plast Surg. 2018;42(2):553-559. doi:10.1007/s00266-017-1036-3 PubMed 29260270

  33. Niechajev I. Reduction genioplasty for mandibular prognathism and long chin. Oral Maxillofac Surg. 2020;24(3):333-341. doi:10.1007/s10006-020-00853-8 PubMed 32533407

  34. Wang S, Lv C, Gui L, et al. Treatment protocol and surgical techniques for macrogenia. J Craniofac Surg. 2013;24(4):1353-6. doi:10.1097/SCS.0b013e31828dcbe1 PubMed 23851806

  35. Lobos CT, Ruiz CC, Pose MF, et al. Symphysis Resection and Soft Tissue Suspension for the Long and Prominent Chin: An Alternative to Conventional Genioplasty. Aesthetic Plast Surg. 2026;50(1):71-80. doi:10.1007/s00266-025-05389-4 PubMed 41136694

  36. Hirohi T. A New Concept of Narrowing Genioplasty: Home Plate-Shaped Sliding Osteotomy. Plast Reconstr Surg. 2021;148(2):309-319. doi:10.1097/PRS.0000000000008187 PubMed 34133407

  37. Torrealba R, Fariña R, Valladares S, et al. Correction of chin ptosis. Int J Oral Maxillofac Surg. 2017;46(8):1026-1029. doi:10.1016/j.ijom.2017.03.037 PubMed 28495393

Learning Center Main Index:

 

This page