What Surgery Is Best for Correcting a Short Chin or Recessed Chin? The Limits of Chin Surgery and the Actual Results

Hello, I’m Dr. Jo Hyun-woo of 입체성형외과.

These days, I’ve mentioned in several columns that the trend in facial contouring surgery is a small, slender chin.

However, there are many patients whose chins are smaller than average and who need forward advancement of the chin.

Today, I’ll talk about which surgery is effective for improving a recessed chin.

The line of an ideal side profile is based on the Ricketts line, as shown in the figure above.

When the line from the tip of the nose is extended to the chin, it is about 4 mm from the upper lip and about 2 mm from the lower lip.

In fact, I don’t think this is the ideal side profile currently desired in Korea.

Looking at the side profile of Jennie, who is said to have the face shape desired by today’s young MZ generation, it does not fit the classic ideal proportions at all.

A smaller and shorter chin seems to be the trend these days, but if the chin is even smaller than this or set further back, forward advancement of the chin may be needed.

There are broadly three ways to advance the chin.

1. Bone-based advancement surgery 2) Implant-based advancement surgery 3) Fat grafting or filler-based advancement

These are the three methods, and I’ll explain the pros and cons of each.

Bone-based advancement surgery

Bone-based chin advancement surgery is a little different from the T-osteotomy procedure that people generally know. It is better to perform it in a way that does not reduce the volume of the chin.

If a T-osteotomy is performed, the cut bone reduces the volume of the chin even more, and even if the chin is advanced forward, the small, underdeveloped look of the chin may not disappear.

Opinions may differ depending on the surgeon, but in my case, for a small, underdeveloped chin, I perform chin advancement without bone removal rather than a T-osteotomy.

In the case of a small, underdeveloped chin: bone-based advancement surgery

When surgery is done this way, because it uses the patient’s own bone, there is no foreign-body sensation and fewer other side effects.

However, bone-based advancement has limitations, which I’ll explain later.

Implant-based advancement surgery

An implant can be used to move the chin forward.

There are various types of implants, and different implants can be selected depending on the patient.

However, there seem to be a lot of preconceptions about implants.

People say, ‘Implants erode the bone.’ To be honest, that statement is half right and half not right.

Implants placed precisely on the thicker part of the bone do not easily cause erosion, but implants positioned slightly higher can cause erosion.

As shown in the CT image above, you can see bone erosion in the side view.

However, when an implant is placed exactly on thick bone, erosion occurs very little, if at all.

The limitation of the chin advancement surgery I mentioned earlier lies in the amount of bone that can be advanced.

I tell patients that the maximum amount for chin advancement surgery is about 5 to 6 mm.

The reason is that, in the side view of the bone, the thickness of the chin bone is at most about 12 mm.

In my opinion, about half of the chin bone thickness, or around 5 to 6 mm, should remain engaged so that the bone will heal well and be securely fixed later.

However, depending on the case, there are quite a few patients who need advancement of about 1 cm.

For these patients, bone-based advancement may feel insufficient.

There are not many women like this, but in men, the lack of volume is often quite pronounced.

Chin advancement surgery using an implant

In such cases, inserting an implant of about 1 cm can produce very good results.

Chin advancement surgery using an implant

If you want an ideal side profile, better results can be achieved than with bone-based surgery.

There may be various cases, but in my opinion, it is not necessary to consider bone surgery at all costs for better results.

Fat grafting, filler-based advancement

If surgery feels too frightening or burdensome, another option is fat grafting or filler-based treatment.

Advancement using fat grafting

As you can see in the photo, the chin has advanced well after surgery.

However, what is disappointing here is the shape. Unlike firm bone or implants, fat or filler has limitations in creating a natural appearance, and in some cases, firm fillers may be effective for creating a pointed chin tip, but they seem far from natural.

Today, I talked about methods for correcting a recessed chin, as well as the limits and results of chin surgery.

Since each surgery has its own pros and cons, choosing the method that best suits you as a patient may lead to more satisfying results.

Thank you.