What is Chin-Wing or Mini-Wing Genioplasty?

Chin-Wing genioplasty is a chin surgery method involving osteotomy (cutting, moving, and securing pieces of bone using titanium plates and screws). It is intended for people with a receding chin but no dental occlusion problems (no difficulty chewing food). This is referred to as a receding chin, a receding chin, or a weak chin.

Common related problems include:

a double chin,
the need to force the lips to close the mouth,
a half-open mouth at rest,
teeth that push the lower lip,
absence of a chin fold,
physical and psychological discomfort (loss of self-confidence, etc.).

The technique was popularized by Dr. TRIACA (in Zurich, Switzerland). It is performed by cosmetic surgeons, oral surgeons, and maxillofacial surgeons.

It differs from advancement genioplasty, where the surgeon only advances the tip of the chin horizontally. In chin-wing genioplasty, the surgeon cuts, moves, and rotates the front and lower part of the lower jaw. This results in vertical and horizontal movement of the lower face. This is why it is called extended genioplasty. The operation is slightly more complex and the recovery time longer than a traditional genioplasty. It sometimes requires a bone graft.

The operation leaves no visible scars (operation from the inside of the mouth).
The titanium plates and screws used to secure the cut piece of bone are not removed. They are invisible under the skin and are not detected at the airport or during checkout. The metal is biocompatible and does not cause allergies. The bone heals within a few weeks, and the mandible regains its initial strength within a few months.
What is the benefit of the operation?

This operation moves the chin forward and lowers the back of the mandible (ear side). This allows:

to better define the hollow between the lower lip and chin.
to recreate a clear line between the face and neck.
to reduce or eliminate a double chin.
to reduce muscle tension in the lips and chin.
to restore the natural balance of the face.
to correct very drooping chins.
a moderate improvement for sleep apnea.

This operation is considered moderate to minimally painful. It is performed from the age of 16/17 (sometimes earlier in certain specific cases). At this age, it is certain that the roots of the canines will not be affected during the cut. The surgeon will verify this using the X-ray taken before the operation. Some people prefer injections to avoid surgery, but the results will only be temporary. Surgery can be combined with rhinoplasty to further harmonize the facial profile.

What is the difference between Chin-Wing genioplasty and Skeletal Class II malocclusion?

In the case of skeletal Class II malocclusion surgery, the surgeon cuts the lower jaw to move it forward completely (including the lower teeth). In Chin-Wing genioplasty, the surgeon cuts the lower jawbone horizontally (then vertically to include the entire chin) into two parts. The lower part, which is attached to the chin, will be moved and then reattached. This is called a drawer-like displacement because after being cut in half lengthwise, the two parts of the mandible slide back on themselves. The upper part, to which the lower teeth are attached, remains unchanged. The surgery therefore has no impact on the position of the teeth and therefore on the occlusion, chewing, etc., which could have been corrected with orthodontics.
Chin-wing genioplasty is sometimes performed in addition to a Class II skeletal surgery to improve the final aesthetics.

What are the stages of the surgery?

Before the surgery

The patient develops the project. They can order a simulation based on a photo on chirurgie-avant-apres.fr to get an idea of what the result could be. They can show the simulation to the surgeon to ask about its feasibility and discuss the options based on a concrete element.

First consultation with a cosmetic surgeon, oral surgeon, or maxillofacial surgeon to explain their wishes and concerns and to discuss the choice and feasibility of the surgery.
Second consultation at least 15 days later (legal deadline). The surgeon explains the procedures, schedule, and risks, and provides the patient with a quote. The patient undergoes the necessary tests (blood tests, allergies, anesthesiology), cephalometric assessment, mandibular cone beam, and possibly a 3D CT scan to ensure the surgery can proceed. The patient may be referred for another surgery following these tests.

Day of the surgery

D-DAY – The surgery is performed under general anesthesia in a clinic or hospital. The patient is treated as an outpatient (meaning they are admitted and discharged on the same day and do not stay overnight in the hospital, but this is rare) or with one or two nights in the hospital. The surgeon cuts the mandible, moves the loose piece, and secures it with titanium plates and screws (a biocompatible metal). The surgeon sutures the gum. The operation lasts 2 to 4 hours.

After surgery

D-DAY+1: Removal of the drains to limit the size of the hematoma. Performed the same day for outpatients.
D-DAY+7: End of warm liquid diet. Gradual transition to soft and then hard foods according to a schedule provided by your surgeon.
D-DAY+10: Removal of the sutures (absorbable, therefore optional) in the mouth. Day 15: Disappearance of swelling and bruising on the face.
1 month: Resume gentle sports
2 months: Resume sports (according to your surgeon’s instructions)
Between 3 and 6 months: The final results are visible and the bone begins to heal well.

What are the possible complications?

Common: Loss of sensation in the operated area (chin, gums, lips, lower face). This complication is almost always present but quickly improves. There are rare cases where patients do not regain their sensation.
Rare: Poor bone healing. The body does not create enough bone cells to repair the two pieces of bone. Rare: Bleeding with compressive hematoma requiring immediate reoperation.
Rare: Bleeding, allergies to anesthetics, infections, etc. (risks present with any surgical procedure).
Rare: Injury to the inferior alveolar nerve, which passes through the mandible (risk of permanent loss of sensation).

What is the difference between conventional and ultrasonic genioplasty?

The difference is when the surgeon cuts the jawbone.

The traditional method involves cutting the bone with a milling machine. This is faster, but it burns the bone and there is a greater risk of damaging soft tissue (nerves, blood vessels, and mucous membranes). Generally, the hematoma and postoperative swelling will be more significant and will take longer to resolve.

Ultrasonic method: The surgeon uses an ultrasonic cutting device. The piezoelectric device produces micro-vibrations that are transmitted to an insert. Thus, the insert will only attack the hard tissue, i.e., the bone. Therefore, it will cause less damage to the soft tissue but will take a little longer. The bone will be cut more precisely. Hematoma and postoperative swelling will be reduced.

Each surgeon chooses to use one or the other of these methods, or a combination of the two.

For further information: Consult Dr. Pauline POUZOULET’s thesis (2017)