WHO IS A GOOD CANDIDATE FOR MEDICAL GENIOPLASTY ?

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Hyaluronic acid for the chin in Geneva

Medical genioplasty, or injectable genioplasty, is now established as a reliable non-surgical alternative for correcting certain chin imperfections. Performed by an experienced physician, this minimally invasive procedure allows reshaping the lower face using injections of dense, structuring hyaluronic acid, without hospitalization or general anesthesia. However, this approach, effective as it may be, is not suitable for all profiles. Who can truly benefit from this solution? What are the objective criteria for determining whether a patient is a good candidate for medical genioplasty ?

Medical genioplasty : correcting a receding chin

The chin occupies a central place in facial harmony. Located at the junction between the gaze and the profile, it directly influences the perception of symmetry, overall balance, and jawline definition. When it is too small, receding, or asymmetrical, it can disrupt this harmony and accentuate certain contrasts, particularly if accompanied by a prominent nose or underdeveloped jaw.
Medical genioplasty is a targeted response to these imbalances. Through deep injection of volumizing hyaluronic acid, it is possible to project, redefine, or symmetrize the chin while preserving the natural proportions of the face.
However, this approach requires rigorous patient selection, an essential condition to ensure a result that is both aesthetic and harmonious.

Patient selection criteria for medical genioplasty

The success of medical genioplasty relies primarily on rigorous patient selection. Beyond aesthetic motivations, it involves identifying profiles for which this treatment offers a harmonious, natural, and long-lasting result, with the assurance of optimal safety and proven medical relevance.

Morphological criteria for medical genioplasty

Moderate retrognathia : the most common case in medical genioplasty is retrognathia, also called a “receding chin.” This configuration is characterized by a chin that is set back relative to the vertical line of the forehead and nose (Ricketts line). When this setback is moderate, it can be effectively corrected with injections. The goal is to restore balanced projection, often in combination with treatment of the jawline or nose.
Mild asymmetry or contour irregularity : some patients present a subtle chin asymmetry (slight lateral deviation, flattening on one side, or unilateral projection deficiency). As long as this asymmetry remains moderate, it can be corrected with injections.
Shortened lower third of the face : in some patients, the lower third of the face is shortened, without major bone abnormalities. By subtly increasing the vertical height or projection of the chin, medical genioplasty helps rebalance the facial proportions, particularly in profile.
Absence of mandibular hyperplasia or pathology : a suitable candidate must have a bone structure compatible with volume augmentation. Cases of prognathism, mandibular hyperplasia, or associated occlusion disorders are generally addressed through maxillofacial surgery. Clinical examination and, if necessary, radiological analysis help rule out these contraindications.

Skin and tissue criteria

Toned and well-vascularized skin : firm, well-vascularized skin without significant laxity is essential to ensure good retention of the filler and a natural result. In older patients, excessive skin laxity may compromise the outcome and require combined treatments (radiofrequency, focused ultrasound, collagen inducers).
Absence of submental fat excess : an excess of fat under the chin (double chin) can compromise the definition of the lower third of the face, even if the chin is projected. In these patients, prior or complementary management is recommended to optimize the overall aesthetic result.

Psychological criteria for chin injection

Psychological maturity and realistic expectations : the patient must understand that medical genioplasty is not a radical transformation, but a subtle correction. Unrealistic expectations or disproportionate requests are warning signs. A suitable candidate is able to envision a natural result that is consistent with their anatomy.
Willingness for reversibility and acceptance of maintenance : the result of medical genioplasty is temporary. Maintenance injections are required every 12 to 18 months, depending on the patient’s metabolism and the product used. Patients seeking a permanent solution are not suitable candidates for this medical approach.
Emotional stability : a brief psychological assessment is essential to rule out at-risk profiles such as body dysmorphic disorders, emotional instability, or strong social pressures.

Ideal profiles for medical genioplasty

In Geneva, as elsewhere, several categories of patients perfectly meet the criteria for injectable genioplasty.

Young adults with a moderately receding chin.
Women seeking a more harmonious and refined face.
Men seeking a more masculine face.
Patients with moderate volume loss in the lower third of the face, whether due to weight loss or the natural effects of aging.
People who have undergone medical or surgical rhinoplasty and wish to balance their profile.

These patients share common characteristics : compatible anatomy, reasonable expectations, and a thoughtful approach.

Cases not suitable for medical genioplasty

A number of profiles are not suitable for this technique. The physician must be able to identify them and redirect the patient if necessary.

Very receding or deformed chins — the indication is surgical.
Prognathism or joint disorders.
Significant skin laxity in the lower third of the face.
Body dysmorphia, external pressures, psychological instability.
Documented allergies to hyaluronic acid or a history of granuloma.

Facial aging and the relevance of medical genioplasty

With age, the chin area undergoes several structural transformations that can make some individuals eligible for late medical genioplasty.

Mandibular bone loss : the bone resorption process associated with aging can lead to chin recession, even in patients who previously showed no retrognathia. This loss of bone support affects the lower third of the face, altering proportions and mandibular definition.
Soft tissue laxity : over time, the skin and muscles lose tone, which can lead to jowls, disrupt the contour of the facial oval, and visually reduce chin projection. In patients with moderate skin laxity, medical genioplasty with hyaluronic acid can partially restore the profile axis and provide support to the lower third of the face. However, the ideal candidate remains one whose skin retains sufficient residual firmness to achieve a satisfactory result through a non-surgical approach. In other cases, especially when laxity is significant, it is essential to distinguish between indications suitable for medical treatment and those requiring a cervico-facial lift.

The role of profile harmonization in patient selection

The chin should never be assessed in isolation. Medical genioplasty takes on its full meaning when it is part of a global approach to the face, known as medical profiloplasty. This comprehensive analysis aims to study the relationships between the forehead, nose, lips, chin, and neckline, in order to restore overall profile balance.
In this context, Ricketts’ aesthetic line is used to evaluate the position of the chin in relation to the forehead and the tip of the nose. It helps reveal possible retrognathia — that is, a chin that is too far back.
Furthermore, harmony between the nose and chin is essential. After a rhinoplasty, whether medical or surgical, a lack of chin projection may become more noticeable. In such cases, medical genioplasty can be proposed to reestablish aesthetic balance between the different parts of the face.
It is also important to consider the lower lip and the cervico-mental angle. A prominent lower lip or a poorly defined junction between the neck and chin can falsely give the impression of a receding chin. The physician must therefore ensure that the issue truly originates from the chin itself.

Common mistakes patients make when self-assessing their eligibility

Patients, often influenced by social media or retouched images, may mistakenly self-diagnose as candidates for medical genioplasty. The physician’s role is then to refocus the indication.

Confusing a receding chin with fat accumulation : a double chin may be caused by fat deposits or skin laxity, not by a bone deficit. In this case, hyaluronic acid injections will provide no benefit and may even accentuate the sense of heaviness.
Wanting to “slim” the face with injections : some patients hope for a facial slimming effect through medical genioplasty. However, the very principle of this technique is based on adding volume. It therefore does not slim, but rather structures and reshapes the face.
Demanding a radical transformation : when a patient wishes to profoundly change the structure of their face, bone surgery may be necessary. In such cases, medical genioplasty with hyaluronic acid is not the appropriate indication. The physician’s role is to clearly explain this distinction, guide the patient carefully, and, when possible, propose suitable alternatives.

Aesthetic expectations of medical genioplasty according to gender

The perception of an “ideal” chin varies according to gender, aesthetic standards of each era, and the overall facial morphology. A suitable candidate for medical genioplasty is also defined by the visual identity goal they wish to achieve.
Most men considering medical genioplasty aim to enhance the masculinity of their profile. This typically involves a more pronounced forward projection of the chin, a sharper jawline contour, and better definition of the junction between the chin and the mandible. In this context, medical genioplasty can be combined with jawline injections, a technique known as jawline contouring. The ideal candidate has a slightly undefined face, without significant skin laxity or submental fat excess.
For women, expectations differ and focus more on elegance and balance. Correcting a receding chin or a poorly defined jawline is often central to the request. A chin that is too small can accentuate a prominent nose or disrupt facial harmony. Female patients generally seek a more defined oval, a smooth transition between the lips, chin, and neck, and a result that is subtle, natural, and delicate.
In all cases, the physician ensures that the aesthetic codes specific to each gender are respected, particularly avoiding overly angular or prominent contours in women.

Article written by Dr Romano Valeria

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