Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Genioplasty is typically performed under general anesthesia to ensure the patient’s airway is protected and they are entirely comfortable. In some cases of simple implant placement, IV sedation (twilight sleep) or local anesthesia may be used, but general anesthesia is standard for osseous procedures.
The most common incision is intraoral, placed inside the mouth between the gum and the lower lip. This approach leaves no visible scar on the face. The surgeon cuts through the mucosa and muscle to expose the chin bone (mandible).
For some implant procedures, a submental incision (under the chin) is used. This leaves a small, hidden scar under the chin but carries a lower risk of infection since it avoids oral bacteria. This approach is sometimes preferred for larger implants or revision surgeries.
In a sliding genioplasty, the surgeon uses a specialized oscillating saw to cut the bone. The cut is made well below the tooth roots and the mental nerves to avoid damage. This horizontal cut separates the chin button from the rest of the jaw.
The mobilized bone segment is then physically moved to its new position. It can be slid forward, backward, or sideways. If vertical changes are needed, a wedge of bone may be removed, or the bone may be stepped down.
Once in position, the bone is rigidly fixed using titanium plates and screws. These microplates are robust and hold the bone stable while it heals. They are low profile and typically cannot be felt under the skin.
For implant surgery, the surgeon creates a tight pocket directly over the bone and under the periosteum (the connective tissue covering the bone). This subperiosteal pocket is crucial; it must be large enough to accommodate the implant without allowing it to slide.
The sterile implant is inserted into the pocket. The surgeon ensures it sits symmetrically and that the “wings” of the implant lie flat against the jawline. Some implants are secured to the bone with a small screw to prevent them from shifting over time.
After the bone or implant is secured, the muscle layers are carefully reapproximated. Correctly reattaching the mentalis muscle is vital to prevent chin sagging (ptosis). The mucosa inside the mouth is closed with absorbable sutures.
A compression dressing made of tape is applied to the outside of the chin. This tape splint helps to minimize swelling and supports the soft tissue in its new position. It serves as a mold for the skin to readapt to the new chin shape.
Patients wake up in the recovery room. The chin will feel tight, numb, and heavy. This numbness is normal and is due to the stretching of the mental nerves and the local anesthetic used during surgery.
Pain is generally moderate and well-managed with prescribed oral medication. Ice packs are applied immediately to the face to control swelling. Most patients are discharged home the same day once they are alert and can drink fluids.
Swelling is the most significant aspect of recovery. It peaks around day 3 or 4. The chin may initially look alarmingly large and square. This is not the final result. Bruising may extend down the neck.
By the end of the first week, about 50% of the swelling subsides. By week 2 or 3, most patients look socially presentable, though residual swelling persists. The final definition of the chin takes months to reveal itself as the last bit of fluid resolves fully.
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A strict diet is necessary to protect the intraoral incision. For the first few days, a clear liquid diet is recommended. This progresses to a full liquid and then a soft-food diet (mashed potatoes, yogurt, smoothies) for about 2 weeks.
Patients must avoid hard, crunchy, or spicy foods that could irritate the incision or get stuck in the stitches. Chewing should be minimized to avoid pulling on the muscle repair. Straws are generally avoided to prevent suction pressure on the wound.
Keeping the mouth clean is critical to prevent infection. Patients are instructed to rinse their mouth gently with saltwater or a prescribed antiseptic mouthwash after every meal.
Teeth brushing should be done carefully with a soft-bristle brush, avoiding the incision line for the first week. Water picks and vigorous swishing should be avoided until the incision is fully healed.
Pain is typically managed with a combination of narcotics (for the first 2-3 days) and over-the-counter anti-inflammatories or acetaminophen. As the swelling subsides, the pain quickly turns into a dull ache.
Keeping the head elevated at all times, including during sleep (using two pillows), significantly reduces throbbing and pain. Constant icing for the first 48 hours is the most effective natural pain reliever.
Patients should rest for the first week. Walking is encouraged to prevent blood clots, but the heart rate should be kept low. Bending over, lifting heavy objects, or straining must be avoided as this increases blood pressure in the face and can cause bleeding.
Contact sports are strictly prohibited for 6 to 8 weeks. The bone needs time to heal (in sliding genioplasty), or the implant needs time to settle without trauma. A blow to the chin during this period could displace the result.
You will look swollen. The chin tape will be visible for the first 5-7 days. Once the tape is removed, you will look “puffy,” but most people will think you gained a little weight or had dental work, not necessarily plastic surgery.
Yes, you can talk immediately, but you will sound a bit funny due to the swelling and numbness in your lower lip (“mumbling”). It is best to rest your voice and limit excessive talking for the first few days to let the muscles heal.
If you had an intraoral incision, the stitches are absorbable and will dissolve and fall out on their own over 1-2 weeks. If you had an incision under the chin, the surgeon usually removes those stitches after 5-7 days.
You must sleep on your back with your head elevated on 2 or 3 pillows. This helps drain the fluid away from your face. Do not sleep on your stomach or side, as this can put pressure on the chin and cause asymmetry.
Hard lumps along the jawline are usually deep bruises or swollen knots. They typically resolve with time and gentle massage (once the surgeon clears you). If a lump is red, hot, or painful, call your surgeon immediately, as it could be an infection.
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