What it means for a patient
- Surgery and fillers both improved chin shape, with high satisfaction in the included studies.
- Surgical results lasted longer but carried risks including infection, implant problems, bone loss and lasting numbness or altered feeling.
- Fillers worked quickly, with mostly short-lived swelling, bruising and pain. Serious blood vessel complications were rare.
- The authors found no single technique clearly superior and state that treatment should be chosen for each patient.
- Most included studies were retrospective and small.
Why this paper matters
It compared surgical and filler chin augmentation across studies published from 1975 to 2024 and set out the trade-off between durability and risk. The authors call for prospective studies with standard aesthetic and patient-reported measures.
Overview
Chin augmentation is done with surgery (osseous genioplasty or alloplastic implants) or with injectable fillers. Long-term results, complications and satisfaction across these approaches were not well described. The authors searched MEDLINE, PubMed, Web of Science and the Cochrane Library for English-language studies from January 1975 to December 2024, under a PROSPERO-registered protocol (CRD420251135340). Randomized trials, cohort studies and case series with at least 10 patients were included. The studies differed too much to pool, so results were described by treatment type.
Findings
- 56 studies with 4,844 patients were included.
- Surgery (osseous genioplasty and alloplastic implants) generally gave lasting improvement in chin projection and lower-face balance, with high satisfaction.
- Surgical complications included infection, hardware or implant problems, bone resorption and persistent neurosensory deficits.
- Fillers (mainly hyaluronic acid and calcium hydroxylapatite) gave rapid contour improvement and high short-term satisfaction.
- Filler side effects were mostly transient (swelling, bruising, pain), with rare serious vascular complications.
- Evidence quality was limited by retrospective designs, small samples, non-standardized outcome measures and inconsistent complication reporting.
- The authors assigned level of evidence III.
Terms
- Chin augmentation: making the chin project further forward.
- Osseous genioplasty: surgery that cuts and moves the chin bone.
- Alloplastic implant: an implant made of synthetic material.
- Hyaluronic acid filler: an injectable gel made of a sugar found naturally in skin.
- Calcium hydroxylapatite: an injectable filler made of mineral particles in a gel.
- Bone resorption: loss of bone, here under or around an implant.
- Neurosensory deficit: numbness or altered feeling caused by nerve injury.
- Vascular complication: a problem caused by filler entering or pressing on a blood vessel.
- Retrospective study: a study that looks back at records of patients already treated.