Abstract

Facial beauty depends on the form, proportion and position of its various units. The chin is the most prominent element of the lower third of the face, both in the frontal view and in profile. The surgical approach to chin deformities did not start until the second half of the twentieth century. The development of silicone prostheses and the emergence of sliding genioplasty offered surgeons a whole new range of options to modify the size and position of the chin. We have performed a historical review of chin surgery, the multiple aesthetic analyses available and the advantages and disadvantages of the different alloplastic materials and osteotomies. To do so, a comprehensive search through current scientific literature on the topic has been carried out, focusing on large series, long-term follow-up studies, research in animal models and medical evidence. As happens in almost any topic in facial plastic surgery, no strong evidence useful in ENT practice for handling chin deformities can be found in today's scientific literature. Ethnicity influences the aesthetic analysis; the type and degree of deformity to be corrected will determine the allo-plastic augmentation of the chin or the suitability of osteotomy. Porous polyethylene (Medpor, Porex Surgical, Newman, Ca, USA) and solid silicone (Silastic, Michigan Medical Corporation, Santa Barbara, Ca, USA) show a clear advantage over other alloplastic materials. Moderate-to-severe retrogenia benefits from sliding genioplasty strategies rather than prosthetic enlargement.