Chin Augmentation Surgery (Correction of a Receding Chin)

 

675. <Chin Augmentation Surgery (Correction of a Receding Chin)>

Chin augmentation surgery is a procedure to improve the shape of the chin, especially in cases where the chin is short or retruded. But what causes a receding chin?

One of the main reasons is nasal issues such as chronic rhinitis. When nasal passages are blocked—especially during sleep—mouth breathing becomes habitual. This leads to sleeping with the mouth open, which affects facial development. Specifically, the upper jaw grows vertically downward due to the lack of occlusion with the lower jaw. As a result, the mandible rotates in a clockwise direction, causing the chin to appear retruded.

Additionally, habitual mouth opening leads to efforts to keep the mouth closed, causing the mentalis muscle to overwork. This results in a puckered chin and the formation of “pebble chin” or “orange peel” dimpling. In this way, an issue that starts in the respiratory system can lead to structural changes in the chin.

So how do we correct a receding chin?

The surgical method varies greatly depending on the chin's shape. Many clinics use artificial implants such as silicone, but there are important reasons to avoid this approach. First, there’s always a risk of infection. Second, even without infection, long-term pressure from a silicone implant can cause resorption of the cortical bone of the chin, which may lead to functional problems such as compression of the mental nerve or resorption around the canine teeth.

Instead, we use the patient’s own bone for natural and safe correction. If the chin is simply retruded, we perform a horizontal osteotomy and advance the chin segment forward (horizontal advancement osteotomy). When the chin is also vertically long, a portion of the bone is removed (horizontal reduction osteotomy) before advancing it. If the chin appears broad or "double-chinned," a vertical reduction of bone is done in addition to the advancement, in a procedure known as T-osteotomy.

In cases where the gap between the two sides of the chin is too wide, a T-osteotomy may not be feasible. Instead, the chin is narrowed by shaving the bone, and advancement is postponed to a second-stage surgery performed about six months later.

It’s also important to assess for sleep apnea in patients with a retruded chin. If severe snoring is observed during sleep and a polysomnography confirms sleep apnea, we must consider not only aesthetic improvement but also functional correction. In such cases, we perform a "D-shaped osteotomy" to advance both the chin and the genioglossus muscle (which is connected to the tongue), thereby enlarging the airway behind the tongue and improving airflow in the pharynx and larynx.

Other techniques include:

• Elevator osteotomy: to vertically elongate a short chin.

• "S"-shaped osteotomy: to avoid the mental nerve more safely during cutting.

Ultimately, the appropriate surgical plan is developed through both functional and aesthetic analysis of the chin.

Chin augmentation surgery corrects an underdeveloped chin by surgically enhancing its shape.

— 675 mm Growing Pine Tree 🌲