What the research shows
Every method gives good results with high satisfaction, and reviews name no single best one (Oranges 2023, Alwathnani 2026). Temporary numbness of the lower lip and chin followed about 1 in 6 bone operations and about 1 in 40 implants (Oranges 2023).
Silicone and the porous implant materials all had low complication rates, and how the implant was placed mattered more than the material: an implant placed under the bone's lining shifted and was removed less often than one placed partly above it, at the cost of more numbness, and an incision inside the mouth led to more removals but less asymmetry (Liao 2023). Infection is the main implant risk (Kauke-Navarro 2025). Implants also wear into the bone beneath them; this is common, usually shallow, and deeper the longer patients are followed (Yeung 2022). Patients who strain to close their lips are at risk of deeper erosion, which can reach the tooth roots; the authors advise another method for them, or regular X-ray checks for those who already have an implant (Matarasso 1996).
Genioplasty moves the chin bone itself, and the soft tissue follows the bone closely when it is moved forward (San Miguel Moragas 2015), making the result more predictable than with an implant (Kauke-Navarro 2025). Its main risk is the nerve that gives feeling to the lower lip: temporary change in sensation is common, and it persisted in up to about 1 in 8 in the studies reviewed (Kauke-Navarro 2025). Keeping the bone cut at least 6 mm below the nerve canal prevented permanent injuries in one surgeon's series (Ousterhout 1996). In a ten-year series, every patient who had genioplasty alone recovered full feeling in the lip and chin (Hoenig 2007).
Hyaluronic acid filler improved the chin in a randomized trial, and the result held through 48 weeks (Marcus 2022). Serious complications are rare and a review found no blood vessel blockages (Ou 2023), though case reports describe skin loss on the chin and loss of blood flow to the tongue after filler entered an artery (Wang 2018).
Where surgeons disagree
- Implant or bone. One review holds that implants cause more serious problems, such as infection, extrusion and bone erosion, and that genioplasty lasts longer and should be used more (Baus 2018). A larger review counted slightly more complications overall after bone surgery, most of them temporary numbness (Oranges 2023).
- The patient's own tissue. Bone and cartilage grafts give structure, while fat and skin grafts suit smaller corrections and partly shrink; none has been shown better than an implant or genioplasty (Nelke 2026).
What is new
- A 2026 review comparing surgery with filler found surgery lasts longer and filler works faster with mostly temporary side effects, and advised choosing by patient (Alwathnani 2026).
- Relaxing the chin muscle with botulinum toxin before filler gave the same result with less filler (Guo 2024).
- Filler reviews report high satisfaction in the short term, from studies that mostly lack a comparison group (Shome 2026).
What is still unknown
- How much bone wear implants cause after many years. Most studies follow patients for less than five (Yeung 2022).
- How to measure a genioplasty result in a standard way, and how filler results hold beyond a year (Dalmeijer 2025, Shome 2026).
Key papers
- Ousterhout 1996: set the safe distance between the bone cut and the lip nerve.
- Matarasso 1996: linked lip strain to progressive bone erosion under silicone implants.
- Hoenig 2007: ten years of sliding genioplasty with full return of feeling after genioplasty alone.
- San Miguel Moragas 2015: measured how closely the chin's soft tissue follows the bone.
- Marcus 2022: randomized trial of chin filler with results through 48 weeks.
- Oranges 2023: compared every chin method; all satisfying, each with its own risks.
- Liao 2023: showed implant placement matters more than implant material.
- Kauke-Navarro 2025: set implants and genioplasty side by side.
- Alwathnani 2026: compared surgery with filler; no single best method.