Importance of the chin in achieving a feminine lower face: narrowing the chin by the "mini V-line" surgery

Abstract

Surgery to narrow the chin is usually combined with mandible reduction, both of which may greatly improve the aesthetics of the lower face. However, some patients have a disproportionately wide chin without an excessive mandible angle. In these cases, it is possible to achieve a harmonic and well-balanced lower face by simply narrowing the anterior portion of the mandible, including the chin, and leaving the posterior part of the mandible untouched. Patients with a wide chin not willing to undergo mandible angle reduction or those with no indications for mandible reduction were considered primary candidates for the surgery. Patients with unsatisfactory results after previous mandible contouring surgeries were also considered eligible for this procedure. Narrowing genioplasty was performed by the T-osteotomy technique followed by further reduction of the bony steps at the chin-mandible junction. Among the 248 patients, 64.9% were primary cases that had a wide lower face mainly because of prominence in the chin region. The other 35.1% of the cases were patients with a prior surgical history of mandible reduction with dissatisfactory results, especially from the frontal view. All patients showed improved lower face contours after surgery, and patients were satisfied with their surgical outcomes. Balance between the chin and the lower face is essential to obtain an aesthetically pleasing face. Surgeons planning lower face contouring surgery should consider their options carefully, as chin narrowing surgery alone without mandible angle reduction can be used to achieve aesthetically pleasing results in selected cases.