Rhinoplasty and genioplasty in Switzerland: a balanced profile from nose to chin

A nose is often judged "too big" by looking at it in profile. Yet what gives this impression is not always the nose itself: a receding chin, even by a few millimetres, makes the nose look longer and more prominent, and the lower face weaker. Conversely, a nose reduced without taking a receding chin into account can leave an unbalanced profile, in which the mouth seems to jut forward and the neck merges with the jaw. Combining rhinoplasty and genioplasty, that is, chin surgery, treats both ends of the profile together. It rests on a simple idea: the profile reads as a line, from the forehead to the chin, and harmony depends on the balance between its projecting points. This page explains how the surgeon analyses a profile, how they divide the correction between the nose and chin, which techniques are used for each procedure, how a recovery affecting both the nose and mouth unfolds, which risks to know about, and how provision and prices are distributed in Switzerland.

Under general anaesthesia, the surgeon reshapes the nose through incisions inside the nostrils, sometimes supplemented by a small incision under the tip, then advances or reshapes the chin. The chin can be treated by a bony genioplasty, in which the chin bone is cut, advanced and fixed with a small plate, or by placing an implant, both usually through an incision inside the lower lip, with no visible scar. The procedure generally takes two and a half to four hours, often with a night in hospital. The nose is protected by a splint for about a week; the mouth requires care and an adapted diet for one to two weeks. The profile takes shape within a few weeks; the nasal tip refines over a year. Only a functional correction, such as of the nasal septum or a bite disorder treated by jaw surgery, may be covered. Budget guidelines are detailed on the page on rhinoplasty with genioplasty prices in Switzerland.

Rhinoplasty changes the shape and size of the nose. Genioplasty changes the position or shape of the chin: it can advance it, move it back, shorten it, lengthen it or correct an asymmetry. Together, they act on the two features that frame the mouth in profile. Our page on genioplasty in Switzerland describes chin surgery in detail, and the one on rhinoplasty covers the nose techniques; this page focuses on combining them and on the balance of the profile.

The idea that the nose and chin should be analysed together is not new. From the mid-twentieth century, surgeons described the value of advancing the chin in patients seeking rhinoplasty, noting that a large proportion of them had a receding chin. Since then, profile analysis has become a routine step in every rhinoplasty consultation. Techniques have evolved, with better-tolerated implants, more precise bony genioplasties and rhinoplasties that better respect the structure of the nose.

A notable proportion of people who consult about their nose have a slightly receding chin. Many are unaware of it, as the chin attracts less attention than the nose. That is why profile analysis is part of every serious rhinoplasty consultation, even when the request concerns only the nose.

A patient often asks only for rhinoplasty, and the surgeon mentions the chin. This can be surprising, even unsettling. The surgeon imposes nothing: they simply explain the role of the chin in the profile, perhaps show a simulation, and leave the patient to decide. Some choose the combination; others prefer to have only the nose done, fully informed.

The perceived size of a nose depends on what surrounds it. A receding chin creates a void below the mouth; the eye, deprived of this counterweight, attributes all the relief of the face to the nose. That is why many people who consult to reduce their nose discover, when their profile is analysed, that their chin plays a major role. Advancing the chin by a few millimetres can make a large reduction of the nose unnecessary, and give a more natural result than a heavily reduced nose.

In profile, the face presents a succession of features: the forehead, the root of the nose, the bridge and tip of the nose, the lips, the chin, then the neck angle. Harmony depends on how these features follow one another. A prominent nose combined with a receding chin creates a so-called convex, arched profile; a very prominent chin combined with a small nose creates a concave profile. Combining rhinoplasty and genioplasty aims for a straighter or slightly convex profile, depending on sex, background and build.

The lips lie between the nose and the chin. When the chin is set back and the nose prominent, the lips may look pushed forward or, on the contrary, lost. After the combination, they regain a more harmonious position, behind a line drawn between the tip of the nose and the chin. The surgeon also assesses the thickness and orientation of the lips, which influence the final result.

A better-projected chin supports the lower lip and may slightly change its shape. In some people, the lower lip then looks less droopy. If lip injections are being considered, it is better to wait until the profile has stabilised, to judge the volume really needed.

A receding chin visually shortens the line from the chin to the neck and erases the angle between them. The neck seems to extend up to the chin, sometimes with an apparent double chin even in slim people. Advancing the chin lengthens this line and redefines the angle, giving the lower face a more defined appearance. This is often one of the most visible changes in profile.

A receding chin shortens the line between the chin and the neck, sometimes giving the appearance of a double chin even in slim people. Advancing the chin lengthens this line and tightens the tissues under the chin, which often improves the appearance of the neck. When the double chin is due to excess fat, liposuction can complete the result.

The chin is judged not only from front to back, but also in height. A chin that is too short gives a compressed lower face; a chin that is too long, an elongated face. Bony genioplasty allows this height to be adjusted, which an implant does only to a small extent. The proportion between the nose level and the chin level matters a great deal in facial harmony.

A narrow, pointed chin gives a finer face, often sought by women; a wide, square chin gives a stronger face, often sought by men. The shape of the implant or the bone cut allows this width to be adjusted. The surgeon discusses it with you, taking the rest of the face into account.

Although the profile is the most transformed view, the frontal view also changes: a better-projected chin gives a more structured face and a more visible jawline, and a refined nose looks better integrated. The surgeon analyses both views, as a chin that is too wide or a nose that is too narrow can unbalance the frontal view even if the profile is successful.

Beyond reference points and measurements, the goal is a harmonious profile suited to the face and the person. An experienced surgeon uses reference points as guides, but also relies on their aesthetic sense and your expectations. The ideal result is one that looks like you, only more balanced.

There is no single ideal profile. The reference points used by surgeons describe trends observed in faces considered harmonious, but each face has its own proportions, linked to background, sex, age and personality. A slightly hooked nose can be perfectly harmonious in a face with strong features; a discreet chin can suit a fine face. The aim is not to force a face into a norm, but to correct what unbalances it while respecting what makes it unique. That is why simulations and discussion with the surgeon are so important: they allow you to find together the profile that suits you.

A chin advancement of a few millimetres, a hump slightly lowered, a tip lifted by a few degrees: taken individually, these changes seem modest. Together, they can transform the perception of a profile. This is one of the lessons of the combination: harmony depends more on the balance between the elements than on the extent of each correction.

A nose that is too reduced, too upturned or too pinched, or a chin that is too advanced or too wide, gives an artificial profile that is sometimes difficult to correct. Caution means correcting just what is needed, even if that means considering a small touch-up rather than an excessive correction. Experienced surgeons favour this measured approach.

A nose reduced too much in a wide face or with a strong chin looks out of proportion. This is a risk when rhinoplasty is performed without analysing the profile. Combining it with genioplasty makes it possible to reduce the nose less, so that it remains in proportion with the rest of the face.

A chin that is too advanced or too wide can masculinise a female face or harden a male face. The choice of advancement and shape is therefore essential. Simulation and, if needed, a test injection help avoid this excess.

Surgeons use reference points to analyse a profile. One of the best known is a line drawn from the tip of the nose to the most prominent point of the chin: in a balanced profile, the lips lie slightly behind this line. Other reference points assess the angle between the forehead and the nose, between the nose and the lip, or the position of the chin relative to a vertical line passing through the lower lip. These reference points are not absolute norms, but tools for understanding what unbalances a profile and what needs to be corrected.

Surgeons like to divide the face into three heights: forehead, nose level, and mouth and chin level. In a balanced face, these thirds are of similar height. The lower third is itself divided into two: from the base of the nose to where the lips meet, and from the lips to the bottom of the chin, the second segment being about twice as long as the first. A chin that is too short or too long changes these ratios. Bony genioplasty allows them to be corrected, while rhinoplasty acts on the middle third. These reference points help the surgeon understand why a face looks unbalanced.

In people with a long face, a high chin, a long nose and lips that struggle to close, the correction often combines shortening the chin by bony genioplasty and shortening the nose. The aim is to reduce the perceived height of the face. When the excess height comes from the upper jaw, jaw surgery is more suitable.

In people with a short face and a chin that is underdeveloped in height, bony genioplasty can lengthen the chin by leaving a small gap between the bone segments. The nose can then be shortened less, or even slightly lengthened, to balance it. These corrections require a fine analysis of proportions.

In a round face, a well-defined, slightly projected and somewhat narrow chin slims the oval. In a square face, already marked by a wide jaw, the chin must remain proportionate so as not to accentuate the width. The nose is adapted to each shape. The surgeon takes the overall shape of the face into account before choosing the shape of the chin.

The central question of this combination is how much to correct on each side. Heavily reducing a nose and leaving a receding chin often gives a small nose in a face that still lacks structure. Advancing a chin without touching a genuinely prominent nose leaves a hump or a drooping tip in the middle of the profile. The surgeon therefore looks for the combination that balances the profile with the least possible change to each element: often a moderate reduction of the nose and a measured advancement of the chin.

The decision combines several analyses: the proportion between the nose and the rest of the face, the position of the chin relative to the lips, the angle between the neck and the jaw, the dental bite, the thickness of the nasal skin and, of course, your expectations. The surgeon explains why they favour one procedure over another, and sometimes proposes several scenarios. The simulation helps visualise these options. The final decision is yours, once you have understood the advantages and limits of each.

Treating both areas in the same procedure allows the balance of the profile to be judged in real time and each procedure to be adjusted to the other. Only one anaesthetic and one recovery are needed, which reduces the total time away from social life. For many patients, it is also the assurance of a coherent result, rather than two separate procedures performed without an overall view.

In some cases, it is better to perform the two procedures separately: when one of them is complex and long, such as revision rhinoplasty with multiple grafts, when health suggests limiting the length of anaesthesia, or when the patient wants to judge the effect of a single procedure first. The surgeon discusses these options at the consultation.

Some people prefer to start with rhinoplasty and decide about the chin later, once the nose has healed. This is possible, but the overall analysis is then less precise, and a second anaesthetic is needed. Conversely, starting with the chin can sometimes make rhinoplasty less necessary. The surgeon discusses these options.

Some people received a chin implant years ago and are dissatisfied with it: an implant that is too large, displaced, palpable or that has worn away the bone. During rhinoplasty, it can be removed, replaced with a better-suited model or converted to a bony genioplasty. These revisions require precise planning, with prior imaging.

When a nose has already been operated on and the result is insufficient, revision rhinoplasty can be combined with genioplasty. Often, the first rhinoplasty reduced the nose too much without taking the chin into account. Adding chin projection sometimes allows procedures on a weakened nose to be limited. These procedures are a matter for experienced surgeons.

A receding chin can have two origins. Either the chin bone itself is underdeveloped while the jaws and teeth are well positioned: genioplasty is enough. Or the whole lower jaw is set back, which is often accompanied by a misalignment between the upper and lower teeth: this is called mandibular retrognathia. In this second case, genioplasty alone does not correct the underlying problem, and jaw surgery, combined with orthodontic treatment, may be more suitable. Examining the dental bite is therefore an essential step.

Before proposing genioplasty, the surgeon observes how the upper and lower teeth fit together. If the lower teeth are clearly set back, if the lower jaw looks small or if there is difficulty chewing or sleep-related breathing problems, they may refer you to an orthodontist or a maxillofacial surgeon. Correcting only the chin in this context would improve appearance without treating the cause.

When a receding chin is accompanied by a major misalignment of the jaws, orthognathic surgery, which moves the lower jaw and sometimes the upper jaw, corrects both the bite and the profile. It is often preceded and followed by orthodontic treatment and may, in certain functional situations, be covered. Rhinoplasty can be performed at the same time or later. This pathway is longer, but it treats the cause.

Chin asymmetry, with a chin deviated to one side, is common and often associated with jaw asymmetry. Bony genioplasty allows the chin to be recentred; an implant corrects this type of asymmetry less well. If the jaw itself is asymmetrical, jaw surgery may be discussed. The nose may also be deviated; the surgeon analyses the whole to propose a coherent correction.

Some people show a lot of gum when they smile, which may be linked to the position of the upper jaw, a short upper lip or an overactive muscle. This problem calls for other treatments, sometimes orthodontic or surgical, and is not corrected by rhinoplasty or genioplasty. It is useful to mention it at the consultation.

A very receding chin combined with a small jaw can be accompanied by snoring or pauses in breathing during sleep. Genioplasty alone does not significantly improve these disorders. If they are present, a sleep study and a maxillofacial consultation may be useful, as jaw surgery can improve them in some cases.

The combination suits adults whose profile is unbalanced by both the nose and the chin, with a satisfactory or already corrected dental bite. The nose must have finished growing, which is the case towards the end of adolescence, slightly later in boys than in girls. The candidate has precise, realistic expectations, does not smoke or agrees to stop, and wants a more harmonious profile rather than a radical change.

In young adults, facial growth must be complete before genioplasty, and the nose must have reached its adult shape. Current or recent orthodontic treatment must be taken into account. The motivation must be personal and well considered. Many surgeons advise first testing the effect of a chin advancement with an injection, to make sure the change meets expectations.

Genioplasty is generally not performed before facial growth is complete. In adolescents, a receding chin may still change, particularly with orthodontic treatment. Cosmetic rhinoplasty is also in principle postponed until the nose has finished growing, except in particular situations such as significant breathing difficulty. Parents and adolescents can consult for an opinion, but the surgical decision is often postponed.

After orthodontic treatment, the bite is often corrected, but the chin may remain set back. This is a common situation in which genioplasty has its place, complementing the orthodontic work. You must wait until the end of treatment and for the teeth to stabilise before operating.

After forty, the combination remains just as valuable: a more projected chin better supports the neck skin and redefines the jawline, which begins to slacken. The nose, whose tip tends to droop with age, can be lifted. In some people, neck liposuction or a lift can complete the result.

Over the years, the chin bone resorbs slightly and the soft tissues descend. The chin seems to recede, the jawline blurs and the neck slackens. A genioplasty or implant, by restoring projection, partly compensates for these changes. It is one way of preserving a clear lower-face line.

With age, the nasal tip drops, the chin bone resorbs a little and the neck slackens. The profile becomes more convex, the nose looks longer and the chin weaker. A rhinoplasty that lifts the tip and a genioplasty that restores projection can rejuvenate the profile, sometimes combined with a neck lift. Our page on facelift with fat transfer presents the overall approach to the ageing face.

In older people, a chin that has receded over time contributes to laxity of the lower face and neck. Restoring chin projection, with an implant or bony genioplasty, tightens the tissues under the jaw and redefines the neck angle. Combined with a rhinoplasty that lifts a drooping tip, this approach rejuvenates the profile without changing the identity of the face. In some cases, it can delay or complement a lift.

Over the years, the nasal tip tends to drop and lengthen, the cartilages soften and the skin thickens or thins depending on the person. The nose looks longer and more prominent in the profile. A rejuvenating rhinoplasty lifts and supports the tip, often without touching the bridge. Combined with chin projection, it gives the profile a younger, more balanced appearance.

After fifty, healing is often a little slower, swelling may last longer and the skin retracts less quickly. Recovery should be planned with a little more leeway. General health is assessed carefully before the procedure.

After fifty, an implant is often preferred for its simplicity and lighter recovery, especially as the chin bone may be thinner. Bony genioplasty remains possible when the correction justifies it. The surgeon adapts the choice to the anatomy and state of health.

• A major misalignment of the jaws, which calls for orthognathic surgery.
• Facial growth that is not complete.
• An untreated dental or gum infection.
• Expectations of a radical transformation of the face.
• An overwhelming preoccupation with a minimal flaw.
• Active smoking that has not been stopped.

The procedure, under general anaesthesia, requires good general health. The anaesthetist assesses the heart, breathing, blood pressure, any diabetes and current treatments. A well-controlled chronic disease is not necessarily an obstacle. A cold or sinus infection means the procedure must be postponed, as they hinder healing of the nose and increase the risk of complications.

Make a complete list of what you take, including supplements: aspirin, anti-inflammatories, high doses of omega-3, vitamin E or ginkgo encourage bleeding and must be stopped before the procedure, on medical advice. Anti-acne treatments derived from vitamin A affect healing: discuss them before setting the date.

Bony genioplasty involves cutting the lower part of the chin bone horizontally, below the tooth roots, moving it forwards, sometimes upwards or downwards, then fixing it with a small titanium plate and screws. Genioplasty with an implant involves placing a silicone or porous polyethylene prosthesis of chosen shape and size in front of the bone. Both techniques generally use an incision inside the lower lip; the implant can also be placed through a small incision under the chin.

Through an incision in the groove between the lower lip and the gum, the surgeon exposes the chin bone, preserving the nerves that emerge on each side. They mark the cutting line below the tooth roots, then separate the lower part of the chin with a fine saw or an ultrasonic instrument. This bone segment, which remains attached to the muscles and soft tissues, is then moved forwards, sometimes slightly upwards or downwards, or recentred in the case of asymmetry. It is fixed with a small titanium plate and screws. The surgeon checks the symmetry and position, then closes the lining of the mouth in two layers. A dressing supports the chin for the first few days.

Through an incision in the mouth or a small incision under the chin, the surgeon creates a fitted pocket in front of the bone, staying under the periosteum, a thin membrane that covers the bone. They place the implant, chosen in advance or after trying different sizes, check its symmetry and position, then fix it with a screw or sutures. They then close the incision. The procedure is shorter than a bony genioplasty.

The implant can be placed through the mouth, with no visible scar, or through a small two-centimetre incision under the chin, hidden in a natural crease. The external approach is less exposed to bacteria from the mouth and sometimes makes positioning easier; it leaves a small scar. The oral approach avoids any external scar. The surgeon explains the advantages of each.

A dose of antibiotic is generally given at the start of the procedure, particularly when an implant is placed. A short course may be continued after the procedure, according to the surgeon's practice. Mouthwashes and careful dental hygiene complete infection prevention.

When the chin bone is advanced, the soft tissues covering it — skin, muscle and fat — largely follow the movement, but not entirely. The visible advancement is therefore slightly less than the bony advancement. With an implant, the skin must stretch over added volume, which limits the possible advancement in people with firm skin. The surgeon takes this relationship between bone and soft tissue into account to predict the result. They also explain that the lower lip, attached to the chin, may be slightly better supported after the procedure.

In people with a receding chin, the chin muscle often has to contract to close the mouth. This tension gives the chin an orange-peel appearance and visible strain. By advancing the chin, genioplasty often reduces this effort: the lips close more naturally and the strained appearance softens. It is a discreet but appreciated benefit.

The choice depends on the amount of advancement needed, the height of the chin, any asymmetries, age and the preferences of the patient and surgeon. For a moderate advancement with no other correction, an implant may be enough. For a large advancement, a chin that is too long or too short, or an asymmetry, bony genioplasty is generally more suitable. It also has the advantage of moving the soft tissues attached to the bone, which can improve the line under the chin.

Some surgeons and patients prefer bony genioplasty, particularly in young people, because it uses the patient's own tissues, without an implant, with a result integrated into the bone, and because it allows corrections in several directions. It is a little more demanding than placing an implant, with swelling and lip numbness often more marked, but the result is very stable.

An implant is often chosen for its simplicity, a shorter procedure and lighter recovery, particularly when the advancement needed is moderate and there is no asymmetry or height problem. It can also be removed or changed if necessary. The choice therefore depends on the chin, expectations and discussion with the surgeon.

Implants come in different shapes and sizes: more or less projected, more or less wide, with lateral extensions to follow the jawline. The surgeon chooses the model according to the desired advancement, the shape of the face and the person's sex. A well-chosen implant should blend into the natural contour, with no visible step at the sides.

Silicone chin implants are smooth, flexible and easy to remove if necessary; they are surrounded by a thin membrane formed by the body. Porous polyethylene implants are more rigid and allow tissue to grow into them, which stabilises them but makes them harder to remove. Each material has its advantages; the surgeon explains their choice. In all cases, the implant is designed to stay in place long term.

For a bony genioplasty, the surgeon plans the cut from X-rays, sometimes a CT scan, locating the tooth roots and nerves. Some use digital planning and cutting guides. This preparation allows a precise correction and reduces the risks to the teeth and sensation.

On each side of the chin, a small nerve emerges from the bone and provides sensation to the lower lip and the skin of the chin. During genioplasty, it is identified and protected. It is nevertheless common for the lower lip and chin to be numb for a few weeks to a few months after the procedure, especially after bony genioplasty. Sensation usually returns; persistent reduced sensation is rare but possible. This is an important point to know before deciding.

In the context of a combination with the chin, requests often concern a hump on the bridge, a drooping tip, a long nose or a wide base. The correction is deliberately measured, as advancing the chin already helps rebalance the profile. The surgeon chooses between an approach through the inside of the nostrils only and an approach with a small incision under the tip, depending on complexity. The bone can be worked with conventional or ultrasonic instruments; our page on ultrasonic rhinoplasty describes this technique.

Depending on the nose, the surgeon may lower a hump by removing a little bone and cartilage, then close the vault by bringing the bones together; reshape the tip cartilages with sutures to refine or lift it; shorten a long nose by reducing the lower part of the septum; reduce the base of the nostrils with small excisions in the crease of the alae; and straighten a deviated septum. Cartilage grafts, usually taken from the septum, support the tip or correct an asymmetry. In the combination with the chin, these procedures are measured, as the chin already contributes to the balance.

Rhinoplasty can be performed entirely through the inside of the nostrils, with no visible scar, or with a small additional incision on the columella, the strip of skin between the nostrils. This second approach gives a better view of the structures and makes complex tip corrections or grafts easier. The resulting scar generally becomes very discreet. The surgeon chooses according to the complexity of the nose.

So-called preservation approaches aim to lower a hump while keeping the natural structure of the bridge, rather than removing it and then rebuilding it. They give a very natural bridge and can shorten recovery, but they do not suit every nose. They fit well with the logic of the combination with the chin, which aims to reduce the nose as little as possible.

Ultrasonic instruments allow the nasal bone to be sculpted precisely, limiting trauma to neighbouring tissues. They can reduce bruising and swelling. They are used by some surgeons for rhinoplasty and, more rarely, for bony genioplasty.

To support a tip, correct an asymmetry or strengthen a weakened septum, the surgeon sometimes uses cartilage taken from the nasal septum itself, more rarely from the ear or a rib. These grafts stabilise the result over time. They are more common in revision rhinoplasties.

After a hump has been lowered, or in the case of a wide upper nose, the two nasal bones are brought together to close the vault. This step causes most of the bruising around the eyes. Ultrasonic devices make it finer and less aggressive for the tissues.

The root of the nose, at eye level, influences the perception of its length. A deep root makes the nose look shorter and the hump more marked; a high root makes the nose look longer. The surgeon can modify it slightly, lowering it or filling it with a graft, to balance the profile. This detail, often overlooked, matters for harmony with the forehead and chin.

Tip projection is the distance between the tip of the nose and the face. An over-projected tip accentuates the presence of the nose in profile; an under-projected tip gives a drooping nose. Advancing the chin changes the perception of this projection: a stronger chin makes a slightly more projected tip acceptable. The surgeon adjusts the tip according to the chin.

The angle between the columella and the upper lip indicates the orientation of the tip. A closed angle gives a drooping nose, an overly open angle an upturned nose. In men, an angle close to a right angle is often sought; in women, a slightly more open angle. The surgeon adjusts the tip to obtain a suitable angle, without exaggeration.

The bridge of the nose, from the root to the tip, may have a hump, be straight or slightly scooped. With an advanced chin, a perfectly straight bridge, or even a very slightly convex one in men, often blends in better than a scooped bridge. Lowering the hump is therefore measured, taking the new chin into account.

The forehead also contributes to the profile. A very rounded or, on the contrary, sloping forehead influences the perception of the nose and chin. It is rarely changed in this combination, but the surgeon takes it into account in the analysis: a sloping forehead may, for example, call for a more modest reduction of the nose.

A long nose in a face whose lower part is short looks even longer. By slightly lengthening the chin with bony genioplasty and shortening the nose a little, the surgeon rebalances the thirds of the face. This type of combined correction illustrates the value of reasoning in proportions rather than isolated elements.

Thick skin masks the details of the structure and takes a long time for swelling to go down, especially at the tip. Thin skin shows every detail, including small irregularities. The surgeon adapts their technique and warns you how long the swelling will take to go down. In this combination, thick nasal skin may suggest relying more on the chin, which is more predictable.

One of the main advantages of the combination is being able to reduce the nose less. A heavily reduced nose can lose its character, look artificial and sometimes hinder breathing. By advancing the chin, the same balance of profile is often achieved with a lighter rhinoplasty that preserves the structure and identity of the nose. Many surgeons consider this one of the keys to a natural result.

A rhinoplasty, even a cosmetic one, must preserve or improve breathing. If a deviated septum or breathing difficulty exists, it can be corrected at the same time. Our page on septoplasty presents this correction, which may be the subject of a request for coverage when documented.

The septum separates the two nostrils. When deviated, it can hinder breathing on one or both sides. Its correction, septoplasty, is performed from inside the nose and can be done at the same time as rhinoplasty. Cartilage removed from the septum is sometimes used as a graft to support the tip. When the breathing difficulty is documented, this part may be the subject of a request for coverage.

At the entrance to the nose, two natural narrowings, the valves, regulate airflow. A rhinoplasty that narrows the nose too much can constrict them and hinder breathing. The surgeon takes care to preserve them, or even reinforce them with grafts. This is one of the reasons why a measured reduction of the nose, made possible by advancing the chin, is also good for function.

A nose blocked by a crooked septum or overly large internal structures can encourage snoring and mouth breathing at night. Correcting the septum during rhinoplasty often improves nasal breathing, sometimes with improved sleep. Snoring nevertheless often has other causes, and tests may be useful if it is significant.

Most surgeons start with the genioplasty, performed through the mouth, then change the sterile drapes and gloves before performing the rhinoplasty. Others start with the nose. What matters is that the two areas are prepared separately and that the surgeon can judge the balance of the profile before finalising each procedure.

Performing two separate procedures, in two areas with different sterility requirements, with a change of drapes in between, takes time. Rhinoplasty, especially when the tip is reshaped, is meticulous. Bony genioplasty requires a precise cut and fixation. A duration of three to four hours is nothing unusual.

This first appointment is above all an analysis of the profile. The surgeon asks what bothers you: the size of the nose, a hump, a missing chin, a face that seems to run "endlessly" into the neck. They examine the nose from every angle, its interior and breathing, then the chin, lower lip, jawline and dental bite. They observe the profile at rest and when smiling, as the lower lip and chin move together. Standardised profile photographs are taken, often with a simulation.

A first consultation for this combination often lasts forty-five minutes to an hour: listening, profile analysis, examination of the nose and teeth, photos, simulation and explanation of the options. It is useful to bring your questions in writing.

A second consultation allows you to review the simulation, confirm the chin technique and the extent of the nose correction, and ask the questions that have come up since. For a procedure that changes the profile, this extra time is invaluable.

The information document given by the surgeon describes the procedures on the nose and chin, the chosen techniques, recovery and risks — particularly lip numbness and complications linked to an implant — as well as the alternatives. Read it carefully and ask your questions before signing it, after a period of reflection.

For a procedure that changes the profile, a few weeks of reflection are recommended. They allow you to review the simulation, possibly test a chin advancement with an injection, ask for a second opinion and choose the right time.

Photo simulation is particularly telling for this combination: you can see the effect of reducing the nose alone, advancing the chin alone, and then both together. Many patients are surprised to see how much a small chin advancement changes their profile. The simulation remains a tool for discussion; the actual result depends on the skin, healing and anatomy.

We almost always see ourselves from the front, in the mirror. We discover our profile in a photo taken by someone else, often with surprise, sometimes with embarrassment. That is why many people who consult about their nose have an incomplete perception of their face. During the analysis, the surgeon shows the profile from different angles and explains what creates the impression that bothers you. This awareness is often a key step in understanding the value of also acting on the chin.

For a first opinion, photographs taken by another person, from about two metres away, against a neutral background, with a relaxed expression and hair off the face, are the most useful: from the front, in profile on both sides and at three-quarters. Avoid selfies, which distort the nose and chin, and filters. These images give the surgeon a first impression, to be confirmed at the consultation.

To track your progress, take or have taken profile photos under identical conditions: same distance, about two metres; same camera height, at face level; same light, preferably natural and diffuse; head straight, eyes looking horizontally, relaxed expression. Hair should be off the face and neck. These photos, taken before the procedure and then at one, three and twelve months, allow a reliable comparison.

The three-quarter view shows the profile of the nose, the shape of the chin and the jawline at the same time. It is often the view in which those around you see your face day to day. The surgeon examines it carefully, as a well-defined chin and a balanced nose produce a very visible effect from this angle.

Photos taken at arm's length with a phone enlarge the nose and shrink the chin, because of the short distance. They therefore accentuate precisely the imbalance that prompts the consultation. It is better not to base your judgement on these images, before or after the procedure.

In the mirror, we see ourselves almost exclusively from the front, and reversed. The profile, which is the view most changed by the combination, does not appear. A three-way mirror or photos taken by someone else are needed to appreciate the result.

A panoramic dental X-ray, sometimes a lateral X-ray or a CT scan, may be requested before a bony genioplasty to check the position of the tooth roots and the nerve of the lower lip, and to plan the cut precisely. For the nose, a clinical examination is usually enough, supplemented if necessary by an examination of the inside of the nasal passages.

Before genioplasty, a dental check-up is recommended: a dental or gum infection must be treated, as the incision is made inside the mouth. If orthodontic treatment is ongoing or planned, discuss it with the surgeon, as it can change the position of the teeth and therefore the indication for genioplasty.

It is useful to bring photographs of profiles you like, of people of the same sex and similar build. Also say what you do not want: a nose that is too upturned, a chin that is too strong or too square. A male profile and a female profile are not constructed in the same way.

A long-standing concern, felt since adolescence, linked to a prominent nose or a missing chin, is often associated with good satisfaction after the procedure. A recent request, prompted by a remark, a photo or a trend, deserves more reflection. It is useful to discuss it frankly with the surgeon.

Those around you may have varied opinions. They can help you think things through, but the decision must remain personal. Sharing the information received at the consultation often helps you get the support you need during recovery.

A harmonious profile is not a standard profile. A slightly hooked nose can be part of a face's identity and be kept, simply softened. A well-defined chin may be enough to rebalance the whole. The surgeon seeks to improve without erasing what makes the face unique.

Some people are very preoccupied by a flaw of the nose or chin that others do not notice, to the point of thinking about it constantly, hiding or seeking consultation after consultation. In this case, surgery rarely brings the hoped-for relief. An attentive practitioner will then suggest talking to a psychologist before deciding, to avoid a procedure that would not help.

Very sculpted profiles, with a thin, upturned nose and a very strong chin, are common on social media, often retouched with filters. They do not suit every face and sometimes age badly. The surgeon helps define a goal that suits your face, rather than a fashionable model.

Reading reliable information about rhinoplasty, genioplasty and profile analysis helps you prepare for the consultation and ask the right questions. Be wary, however, of forums and social media, where testimonials are often isolated and photos retouched. Your surgeon's explanations, based on examining your face, remain the reference.

In men, a well-projected and fairly wide chin, a clear jawline and a straight nose are often sought; the nose should not be too refined or upturned. In women, the chin is often narrower and slightly less projected, the nose finer, with a straight or slightly softened bridge. The surgeon adapts the shape of the implant or the bone cut, as well as the nose procedure, to these goals.

In men, a strong profile often rests on a well-projected and sufficiently wide chin, a clear jawline and a straight nose, without a tip that is too fine or too upturned. A receding chin can give a face that lacks a solid base, and a beard is sometimes used to hide it. Advancing the chin, with a wider implant or bony genioplasty, and a rhinoplasty that respects a strong nose, give the face back a masculine structure. A nose that is too refined, which would feminise the face, should be avoided.

In women, the desired chin is often narrower and slightly projected, with a softly V-shaped lower face. The nose is generally finer, with a straight or slightly softened bridge and a slightly upturned tip. A chin that is too wide or too projected would masculinise the face. The surgeon chooses narrow implants or a suitable bone cut, and a measured rhinoplasty.

Many men with a receding chin grow a beard to hide it. After genioplasty, some choose to shave it off, others keep it while enjoying a better-defined chin. As the incision is inside the mouth, a beard does not hinder healing. It can hide residual swelling in the first few weeks.

Profiles vary between backgrounds: nose shape, skin thickness, lip position, natural chin projection. A respectful analysis aims for the harmony specific to each face, not a single model. In some face types, naturally forward lips call for a greater chin advancement and an adapted rhinoplasty. Our page on ethnic rhinoplasty develops these aspects for the nose.

You must stop smoking completely at least a month beforehand, as it compromises healing of the mouth and nasal skin and increases the risk of implant infection. Blood-thinning medicines are suspended on medical advice. Dental care is carried out. Plan for easy-to-eat foods, mouthwash, saline solution for the nose, and one to two weeks away from social life.

Smoking slows healing of the mouth, bone and nasal skin, and increases the risk of chin implant infection. Stopping completely, including e-cigarettes and nicotine substitutes, at least a month beforehand and during healing is strongly recommended.

Alcohol encourages bleeding and swelling, interacts with medicines and irritates the healing mouth. It is advisable to avoid it in the days before and the two weeks after the procedure.

Allergic or chronic rhinitis must be treated before and after the procedure, otherwise nasal breathing may remain obstructed despite the rhinoplasty. Suitable treatment, prescribed by your doctor or an ENT specialist, is therefore essential.

A dental check-up a few weeks before the procedure allows tooth decay, infection or gum inflammation to be treated. Scaling may be advised. A healthy mouth reduces the risk of infection of the chin incision and the implant.

Before the procedure, prepare your home for one or two quiet weeks. Plan pillows to sleep with your upper body raised, cold compresses, a supply of soft foods such as soups, purées, stewed fruit and yoghurts, saline solution and mouthwash, straws if the surgeon allows them, a lip balm, and things to keep you occupied without effort. With a numb mouth and a blocked nose, the first few days go better in an environment organised in advance.

Someone close to you present in the first few days helps with soft meals, shopping, watching for a nosebleed or unusual chin swelling, and with morale. Explaining to them in advance what to expect avoids worry.

A child who throws their arms around your neck can knock your nose or chin. For a few weeks, it is wise to arrange help, favour cuddles sitting down and protect your face.

• Pillows or an inclined cushion.
• Cold compresses wrapped in a cloth.
• Saline solution for the nose.
• Mouthwash and a soft toothbrush.
• Soft foods and lukewarm drinks.
• A lip balm.
• The prescribed medicines and the team's number.

The combination is performed under general anaesthesia, with intubation that protects the airway while the surgeon works in the mouth and nose. The anaesthetist plans treatment for nausea and pain, and additional local anaesthesia for the nose and chin.

• How will I be put to sleep, and how will my airway be protected?
• What do you plan to prevent nausea?
• How will pain be treated when I wake up?
• Do I need to adjust my usual treatments?

The nose is protected by an external splint, sometimes by soft internal splints. The incision in the mouth is closed with absorbable stitches. An adhesive dressing or an elastic band is often placed on the chin for a few days to support the tissues and limit swelling.

The combination leaves few visible scars. Rhinoplasty is performed through the inside of the nostrils, sometimes with a small scar under the tip that becomes very discreet, and sometimes small scars in the crease of the nostrils if their base is reduced. Genioplasty is performed through the inside of the lower lip, with no visible scar, unless the implant is placed through a small incision under the chin, hidden in a natural crease. Protecting any visible scars from the sun in the first year helps them mature.

When the approach with an incision on the columella is used, the scar, shaped like a small zigzag or inverted V, is pink at first, then fades within a few months. It generally becomes hard to spot, even close up. Gentle care and sun protection are enough.

If the implant is placed externally, a scar of about two centimetres is hidden in the crease under the chin. It is barely visible except when the head is tilted back. It fades within a few months.

You wake up with a blocked nose, a numb and swollen lower lip and chin, and a feeling of tightness in the lower face. You breathe through your mouth, which dries it out. Pain is generally moderate. The team helps you settle with your head raised and gives you something to moisten your mouth.

You go home accompanied, the same day or the next day. At home, alternate rest and short walks, keep your head raised, apply cold to the permitted areas and follow the instructions for the mouth and nose. Having someone present on the first night is reassuring.

Clothes pulled on over the head risk knocking the nose and splint. During the first week, prefer shirts, cardigans and jackets that open at the front.

Fatigue is common for a few days, linked to the anaesthesia, sleep disturbed by mouth breathing and a limited diet. It fades quickly. Naps, good hydration and short walks help.

Seeing yourself with a swollen chin, a nose in a splint and a numb lip can be unsettling, especially as the profile has not yet appeared. A moment of doubt is common towards the end of the first week. It eases as the swelling goes down and the new profile begins to take shape.

For about three days, the face swells more, particularly the chin and lower lip, and bruising may appear around the eyes and under the chin. Keep your head raised, apply cool compresses, stay calm and avoid tilting your head down. The chin dressing is kept on for a few days according to the instructions.

Cold limits swelling in the first two or three days. Apply it in short sessions to the cheeks and around the chin, never directly on the skin or pressing on the nose. Numb areas do not feel cold well: a compress that is too cold can irritate the skin without you noticing.

In the first few days, the numb lower lip and chin swelling make some sounds less clear. The smile may look asymmetrical or stiff. This is temporary: mobility returns as the swelling goes down and sensation comes back. It is worth warning those around you, especially for work calls.

In the first few days, numbness of the lower lip, chin swelling and a blocked nose slightly change the voice and articulation. Sounds that use the lower lip, such as "b", "p" or "f", may be less clear. This disappears as the swelling goes down and sensation returns, generally within one to two weeks. For people whose job relies on speaking, such as teachers, lawyers or salespeople, it is useful to plan one to two weeks without major speaking engagements. Singers and wind instrument players must wait longer, until the mouth has fully healed and good lip sensation has returned.

With a numb lip, it is hard to control the temperature and flow of liquids. It is wise to drink lukewarm drinks in small sips, in front of a mirror in the first few days if necessary, and avoid very hot drinks that could burn the lip without you realising.

The chin swells more than the nose in the first few days, especially after bony genioplasty. The swelling can move down to the neck and give the impression of a temporary double chin. It decreases markedly within two to three weeks, but slight swelling persists for a few months, making the chin a little larger than it will be. The compression dressing in the first few days helps limit it.

Bruising may appear around the eyes after rhinoplasty, especially if the bone has been worked on, and under the chin or on the neck after genioplasty. It turns from blue to yellowish before fading within about two weeks. Light make-up can hide it after a few days.

The incision inside the lower lip must stay clean. Rinse your mouth with the prescribed mouthwash after each meal, brush your teeth with a soft brush avoiding the incision, and avoid pulling the lip to look at the scar, which could open it. The stitches dissolve within one to two weeks.

The genioplasty incision lies in the groove between the lower lip and the gum. It heals quickly, thanks to the rich blood supply of the mouth, but it is exposed to food and bacteria. Rinsing after each meal, a soft diet and not pulling the lip to look at the wound promote good healing. The stitches dissolve on their own. After two weeks, the scar has generally closed and becomes invisible.

In the first few days, opening the mouth may be limited by swelling and tightness of the chin. Do not force it. Biting into a large food item, such as an apple or a thick sandwich, waits one to two weeks. Food cut into small pieces is easier to eat.

Brushing remains essential, with a soft brush, avoiding the incision in the first few days. Floss can be used carefully on the upper teeth; on the lower teeth, it is better to wait for the surgeon's agreement. Water flossers must not be used on the operated area during healing.

In the first few days, opening the mouth and chewing are somewhat limited, and the lower lip is numb, making it harder to control liquids. Soft, lukewarm, easy-to-swallow foods are preferable: soups, purées, stewed fruit, eggs, fish, yoghurts. A straw can help if the surgeon allows it. Avoid hard, crunchy, very spicy or very hot foods for about a week.

During the first two weeks, eating in restaurants can be tricky: the numb lip makes movements less precise, and some hard or crunchy foods should be avoided. Choosing tender dishes, cutting food into small pieces and using a spoon make meals easier. Many patients prefer to wait until the end of the second week before eating out again.

Breathing through the mouth dries the mucous membranes, and a soft diet can reduce water intake. Drinking regularly, in small sips, aids healing, limits dryness of the mouth and helps recovery. Very sugary or acidic drinks can irritate the incision; water remains the best choice.

Keep a mirror within reach to check your mouth is clean after meals. Use a spoon rather than a fork in the first few days, to avoid knocking the numb lip. Use straws only if the surgeon allows them. Warn those close to you that your speech may be slightly altered for a few days. Write down your questions for the first check-up.

Numbness of the lower lip and chin is common after genioplasty, especially bony genioplasty. It can make drinking, speaking or kissing awkward, and you may bite your lip without realising. Be careful with hot drinks. Sensation returns gradually, often over several weeks to a few months, sometimes with tingling, a sign that the nerves are recovering.

Sensation in the lower lip and chin generally returns gradually, often starting with tingling, pins and needles or electric sensations, signs of nerve recovery. This can take a few weeks after an implant, and several months after bony genioplasty. A small area of reduced sensation may persist in some people, without significant functional impairment.

After bony genioplasty, the lower front teeth may feel numb or more sensitive for a few weeks. This phenomenon, linked to the proximity of the cut and the nerves, generally disappears spontaneously. Mention it to your dentist at subsequent check-ups.

Saline rinses several times a day help clear the nose and promote healing inside. Avoid blowing your nose hard, wearing glasses that rest on the nose and any knock. The splint is removed at around the seventh day.

The nose may feel stiff, numb at the tip and slightly tender to the touch for several weeks. Do not massage or handle it without the surgeon's instruction. These sensations gradually disappear as the tissues heal.

In the first few days, the blocked nose forces you to breathe through your mouth, even though it has been operated on. The mouth and lips dry out. Drinking regularly in small sips, humidifying the bedroom air and applying lip balm make this period more comfortable. Nasal rinses help you regain nasal breathing more quickly.

At around the seventh day, the surgeon removes the splint and any internal splints, takes off the chin dressing, checks healing inside the lip and answers your questions about sensation and swelling.

Sleep on your back, with your head raised, for at least one to two weeks, to contain swelling and avoid pressing on the nose or chin. An extra pillow or a U-shaped cushion helps you keep the position.

The first nights are sometimes difficult: blocked nose, dry mouth, having to sleep on your back, a tight chin. A humidifier in the bedroom, a glass of water within reach, a U-shaped cushion to support the head and taking painkillers before bed improve comfort. Avoiding screens late at night and keeping the bedroom cool also help you get to sleep. Nights become easier after a few days, as nasal breathing returns and the swelling goes down. If insomnia persists, it is worth mentioning it to the team, who can suggest suitable solutions.

A pleasant temperature, soft lighting and calm activities promote recovery. Avoid bending down, carrying loads and receiving too many visitors in the first few days. Give yourself time to recover: a calm recovery contributes to a better result.

As for pain, painkillers are usually enough: a blocked-nose feeling, chin tightness, discomfort when opening the mouth. Bony genioplasty is a little more uncomfortable than an implant. Pain that increases instead of decreasing must be reported.

The nose and chin consolidate over several weeks. A knock can displace the nasal bone or a chin implant. Avoid contact sports, rough play with children and risky situations for two to three months. If you suffer a knock, consult the surgeon.

Heat and sun increase swelling. For a few weeks, avoid saunas, steam rooms, very hot baths and prolonged sun exposure. A hat and sunscreen protect the face, including any small scar under the nasal tip.

In the first few weeks, the skin of the nose may be oilier and have a few spots, linked to the splint and swelling. Gentle cleansing is enough. Facial beauty treatments, scrubs and massages are postponed for a few weeks, avoiding the nose and chin.

Make-up can hide bruising after a few days, without pressing on the nose. Avoid products on the incision areas until they have fully healed. Make-up removal must be gentle.

The sun can permanently pigment a recent scar and increase swelling. For several months, protect any scars with sunscreen and avoid prolonged exposure.

While the nasal bone is consolidating, frames must not rest on the bridge. Contact lenses can be worn if you are used to them. The surgeon can suggest a way to hold glasses without resting them on the nose.

A self-employed person is in principle not compensated for time off after cosmetic surgery. Working from home is often possible after a few days; contact with clients waits about ten days.

For a wedding, photo shoot or professional event, it is better to schedule the procedure at least three months beforehand. The profile will then be clearly visible, even if the nasal tip continues to refine.

Short trips are possible after a few days. It is better to avoid travelling far before the splint has been removed and the first check-up has taken place, and to ask the surgeon's advice for a longer trip, as the nose remains congested for a few weeks.

Most people resume social activities after ten to fifteen days. Chin swelling remains noticeable for a few weeks, especially from the front, but those around you often attribute it to a simple change in appearance. Light make-up can soften the last bruises.

You can drive again when the medicines no longer cause drowsiness and the swelling does not impair your vision, often after about a week.

It is better to avoid surgery during a cold or a dental infection, and to schedule the procedure well away from important events. Periods of strong sunshine are less comfortable, as the sun encourages swelling.

In the first week, the face is very swollen, the nose in a splint and the lip numb; you eat soft food, rinse your mouth and sleep with your head raised. In the second week, the splint is removed, bruising turns yellow, the mouth heals and a discreet social life can resume. In the third week, chin swelling decreases markedly and eating becomes almost normal. In the fourth week, the new profile begins to appear, even though the nose remains a little thick at the tip and the lip partly numb. Most people have then resumed their usual activities, except sports with a risk of knocks.

Swelling affects both the nose and the chin, and the two areas do not go down at the same rate. The chin tends to go down faster than the nasal tip, which may, for a few weeks, give a profile in which the nose still looks a little thick. The profile must therefore be judged gradually: the general shape is visible after one month, the balance between nose and chin at around three months, and the refinement of the nasal tip at around one year.

The first month is dominated by swelling, numbness of the lip and the gradual discovery of the new profile. In the second and third months, the chin takes its final shape, the lip often regains some of its sensation and the nose refines. Between three and six months, the profile is established and the nasal tip continues to become more defined. After a year, the result is stable.

At one year, the nose has reached its near-final shape, the chin is stable and lip sensation has generally returned. The surgeon compares before-and-after profile photographs and discusses a touch-up if necessary.

After a year, the result is established. The nose may still change very slightly for a few months in people with thick skin, but the essentials are in place. The chin, whether treated with an implant or bony genioplasty, is stable. There are no more routine check-ups, but it remains useful to consult if you have a question, discomfort or an unexpected change. Many patients then forget about the procedure and keep only the pleasure of a more balanced profile, in keeping with their face and personality. The photographs taken before the procedure then become the best record of how far you have come, often more telling than any comment from those around you. Patients frequently realise, when looking at them again, the true extent of the change for the first time, having forgotten it day to day. Keeping these images, along with those taken at three months and one year, also helps the surgeon answer any future questions and keep a precise record of the journey, useful if another facial procedure is considered years later. Finally, they are a precious reminder of a step that was chosen and carefully considered, which many like to look back on with some pleasure, and sometimes an understandable touch of emotion, years later.

Profile photographs taken regularly, at the same distance and in the same light, are the best way to track progress, far more reliable than the mirror. Comparing the first, third and twelfth months shows how the swelling has gone down.

Profile photographs taken before the procedure are invaluable for judging the result. Memory quickly forgets the initial appearance, and many patients are surprised, when they look at them again, by the extent of the change. Keep them and compare them with those taken at three months and one year.

After the procedure, many people catch themselves looking at their profile, in a three-way mirror or in photos, which they used to avoid. This new way of seeing themselves is often part of the perceived benefit.

The combination adds together the risks of nose surgery and chin surgery. Most are rare and treatable.

As the implant is a foreign body placed close to the mouth, there is a small risk of infection, particularly when it is placed through the mouth. Redness, increasing swelling, pain or discharge require medical attention. Antibiotic treatment may be enough; in some cases, the implant must be removed, then possibly replaced a few months later. Sterile precautions and the antibiotic given in theatre reduce this risk.

A poorly fixed implant or one placed in a pocket that is too large can move up, down or to one side, creating asymmetry. Surgeons often fix it with a screw or sutures and create a fitted pocket. If displacement occurs, a short procedure allows it to be repositioned.

Over time, an implant can cause slight wear of the bone on which it rests. It is usually minimal and has no visible consequence. It is one of the factors that lead some surgeons to prefer bony genioplasty in young patients, for a result integrated into the bone in the long term.

The small titanium plate that fixes the chin is generally left in place for life, without discomfort. It is not detected by security scanners. In some people with very thin skin, it can be felt under the lip; it can then be removed with a small procedure once the bone has consolidated, after several months.

Once healing is complete, a chin implant requires no particular care. It is generally neither palpable nor visible. It should nevertheless be mentioned before major dental treatment or certain procedures, and you should consult if there is swelling, pain or redness, even years later. It does not interfere with sport, once consolidated, or with imaging tests.

After bony genioplasty, the titanium plate and screws usually stay in place for life. Titanium is well tolerated, MRI-compatible and rarely detected by security scanners. If the plate can be felt under the lip or is bothersome, it can be removed with a small procedure once the bone has consolidated.

After bony genioplasty, the repositioned chin segment fuses with the bone in about six to eight weeks, then continues to remodel for several months. During this period, knocks to the chin must be avoided. The plate holds the position during consolidation.

During bony genioplasty, the cut is made below the tooth roots. Unusual sensitivity of the lower front teeth may appear for a few weeks. Damage to the roots is very rare thanks to prior planning on X-rays.

The face is rarely symmetrical, and the chin is no exception. A small asymmetry may persist after the procedure, sometimes already present beforehand. Swelling in the first few weeks can also create a false asymmetry. A troublesome, persistent asymmetry can be touched up.

• A heavy nosebleed that does not stop.
• Chin swelling that increases suddenly, with pain.
• Fever, redness or discharge inside the lip.
• Difficulty breathing or swallowing.
• Pain that worsens after the first few days.

In the event of a persistent nosebleed, sudden chin swelling, fever or discharge in the mouth, call without delay. For routine questions, note them for the next check-up or call at the designated times.

A nose touch-up is generally discussed after one year. For the chin, a touch-up may be considered after a few months in the case of asymmetry, implant displacement or an insufficient result. Knowing the surgeon's touch-up policy from the outset avoids surprises.

A nose touch-up is discussed after one year, once the swelling has completely resolved. For the chin, a touch-up may be considered earlier, after a few months, if an implant is poorly positioned or the advancement seems insufficient. These touch-ups are generally simpler than the initial procedure.

When the combination is successful, the profile looks more balanced: a proportionate nose, a better-framed mouth, a chin that completes the face and often a more defined neckline. From the front, the face looks more structured. Patients often describe a stronger, more "finished" face, without those around them knowing exactly what has changed.

A good result is often one that those around you cannot identify. The face looks more balanced and stronger, but it remains the same. This is the fruit of a measured correction of the nose, a well-proportioned chin and an overall analysis of the profile.

The most satisfied patients are often those who had understood, before the procedure, the role of the chin in their profile and who accepted a measured correction of the nose. They appreciate a more balanced, stronger face that remains their own. Disappointments come more often from expectations focused on a single element, or from judging too early, while swelling is still present.

Patients often describe the blocked nose and numb lip as the main constraints of the first few days. They are surprised by the chin swelling, then by the change in profile when it emerges, generally between the first and third months. Many say they feel more at ease in profile photos, which they used to avoid.

Those around you often notice a more balanced, more "finished" face, without identifying exactly what has changed. Some think of a new hairstyle or weight loss. Whether or not to talk about the procedure remains a personal choice.

For many, an unbalanced profile was a long-standing source of embarrassment: avoiding being photographed from the side, positioning themselves facing the person they are talking to, hiding behind their hair or a beard. After the procedure, these avoidance strategies often disappear. This benefit, difficult to measure, often counts for more than the number of millimetres gained.

For many people, the profile is linked to how they see themselves and how they think others see them: a strong chin is often associated with determination, a harmonious nose with gentleness or elegance. These associations are cultural and subjective, but they influence self-image. A procedure that rebalances the profile can therefore have a significant effect on confidence, beyond the physical change itself. It is nevertheless essential that the decision remains personal, based on your own expectations rather than on stereotypes or how others see you. The surgeon can help distinguish between a real imbalance and a passing worry.

Rhinoplasty and bony genioplasty give lasting results. A chin implant stays in place long term, with simple monitoring. The face continues to age naturally, but a well-projected chin often helps keep a clear jawline and neckline over the years.

The nose and chin continue to change slightly with age, like the whole face. A well-projected chin often helps keep a clearer jawline and neckline with age. A bony genioplasty ages with the bone; an implant remains stable, with simple monitoring.

Little is needed to preserve the result: protecting the face from knocks in the first few months and from the sun in the first few weeks, maintaining good dental hygiene and mentioning the presence of an implant or plate before major dental treatment or imaging tests.

Even once follow-up has ended, do not hesitate to see your surgeon again about any question concerning the implant, lip sensation, breathing or a wish for a touch-up.

Before deciding, some people test the effect of a chin advancement with a hyaluronic acid injection. It gives an idea of the change, with an effect lasting a few months. It does not replace genioplasty when the desired advancement is large, but it can help you picture the result.

For a small advancement, fat transfer can be an option, without an implant or bone cut. Some of the fat is reabsorbed, and the effect is more moderate. It can suit people who refuse an implant and whose chin recession is limited. Our page on facial fat transfer presents this technique.

When the neck is also involved, with a double chin or an erased angle, the combination can be completed by neck liposuction. This is then called profileplasty. Our page on profileplasty with rhinoplasty, genioplasty and double chin treatment presents this overall approach.

To compare the options without amounts, we express them relative to a base of 100 corresponding to cosmetic rhinoplasty combined with genioplasty using an implant, performed in Geneva.

Details of the differences appear on the page on rhinoplasty with genioplasty prices.

The choice between an implant and bony genioplasty, the complexity of the nose, the use of ultrasound, a septum correction, the length of the procedure, the stay and the facility explain most of the differences. The implant model or type of plate also have an influence.

The cosmetic part of the rhinoplasty and cosmetic genioplasty remain at the patient's expense. Correction of the nasal septum for documented breathing difficulty may be covered on request. When chin recession is part of a bite disorder treated by jaw surgery and orthodontics, coverage may be considered under precise criteria, after prior approval.

The cosmetic part of the rhinoplasty and cosmetic genioplasty are entirely at your expense. If the insurer agrees to fund the septum, you pay only the deductible (franchise) and co-payment (quote-part) on that part. It is useful to know these amounts before the procedure.

Some clinics offer staggered payment for the cosmetic part. Check the total cost and make sure the instalments remain compatible with your budget.

It specifies the procedures on the nose, the genioplasty technique and the materials used, any functional correction, the anaesthesia, the stay, splints and dressings, check-ups and the conditions for a touch-up.

The quote is sometimes supplemented by imaging tests, medicines, saline, mouthwash, any test injection and, for self-employed people, loss of income. A covered functional part reduces what remains to be paid.

Beyond cost, the combination takes time: one or two consultations, sometimes a test injection, dental check-ups, then one to two weeks of recovery before returning to social life, and several check-ups over a year. Contact sports wait two to three months. Planning this timetable from the outset allows you to choose a suitable period, with no work deadlines or important events in the following weeks. Many patients choose a holiday or quieter period to get through recovery calmly, away from colleagues. It is also worth bearing in mind that the final result for the nose will only be visible after a year: an important occasion, such as a wedding, should therefore be planned well in advance, ideally at least six months after the procedure.

Compare the technique planned for the chin, the implant model or type of plate, the procedures on the nose, the surgical approach, any septum correction, the anaesthesia, the stay, the splints, the check-ups and the touch-up policy. A price difference may reflect a difference in technique.

Rhinoplasty is performed by plastic surgeons and ENT surgeons specialising in the face; genioplasty, particularly bony genioplasty, also by maxillofacial surgeons. The table shows, for twenty-two cities, the availability of bony genioplasty, the presence of facial specialists and the price level.

University and cantonal hospitals have maxillofacial surgery departments, useful when the problem calls for jaw surgery.

In French-speaking Switzerland, Geneva and Lausanne bring together most facial surgeons who regularly combine rhinoplasty and genioplasty, with support from university departments for cases that call for jaw surgery. Further north and east, Zurich offers the widest choice, followed by Bern, Basel, Lucerne and St. Gallen. In Ticino, Lugano hosts most of the provision. Patients from small cantons usually travel to one of these cities.

For a simple cosmetic combination, a plastic surgeon or a facial surgeon with an ENT background who is used to both procedures is suitable. When the dental bite is involved, a maxillofacial surgeon is the key contact. Some centres bring these skills together, which makes complex cases easier.

The three specialties that perform this combination have complementary perspectives. The plastic surgeon has an overall aesthetic approach to the face. The ENT surgeon specialising in the face brings in-depth expertise in breathing and the internal structure of the nose. The maxillofacial surgeon is expert in the facial bones, the jaws and the dental bite. For a simple combination, any of them may be suitable if they regularly perform both procedures. For a complex case, with a significant breathing problem or misaligned jaws, it is a good idea to consult the most suitable specialist, or a centre that brings these skills together.

Some clinics and hospitals bring together plastic, ENT and maxillofacial surgeons, sometimes with orthodontists. This organisation makes overall facial analysis easier, as well as the management of cases that combine aesthetics, breathing and dental bite. It is particularly useful for people whose receding chin is accompanied by an occlusion problem.

The specialist title, whether in plastic surgery, ENT or maxillofacial surgery, can be checked in the public register of medical professions. It is useful to make sure the surgeon is trained in facial cosmetic surgery and regularly performs the combination.

The cosmetic combination is most often performed in private clinics. University and cantonal hospitals are mainly involved when the problem calls for jaw surgery, a malformation or reconstruction, with possible coverage in certain situations. For a receding chin linked to misaligned jaws, these departments are often best placed.

Profile analysis, the choice between an implant and bony genioplasty, and the risks to lip sensation are concepts that must be fully understood. In French-speaking Switzerland, everything takes place in French; in the major German-speaking centres and in Ticino, many practitioners see patients in French.

A chin implant combined with rhinoplasty is often performed as day surgery or with a single night, which makes travelling to a distant centre easier. A return visit is nevertheless needed after a week to remove the splint, then for a few spaced-out visits. Bony genioplasty often requires a night in hospital.

If you have surgery far from home, plan to return for splint removal at around one week. Subsequent check-ups, more widely spaced, can be organised during a single trip. A local doctor can take over if you have questions, in liaison with the surgeon.

A second opinion is particularly useful to confirm the choice between an implant and bony genioplasty, to check that no bite problem calls for a different approach, and to compare the proposed division between the nose and chin.

Choose a surgeon who regularly performs both procedures and thinks in terms of the overall profile. Ask how they divide the correction between the nose and chin, when they prefer an implant or bony genioplasty, and what complications they see. Look at before-and-after profile photographs, at more than a year for the nose, of people of the same sex and similar build.

The combination requires mastering two different techniques, in two separate areas, and above all knowing how to balance them against each other. A surgeon experienced in both procedures will know how to analyse your profile, choose the right division, avoid an over-reduced nose or an overly strong chin, and manage any complications. Ask how many combinations they perform and look at comparable results.

A good result also depends on good dialogue. The surgeon must listen to your expectations, explain what they see and what they propose, and welcome your questions. You should feel free to express your doubts and preferences. This dialogue continues throughout recovery, with clear answers to your concerns.

The procedure involves the surgeon, the anaesthetist, the theatre team and the nursing team. Depending on the case, an orthodontist or dentist takes part in the preparation. Ask who your contact is after discharge.

They will explain what unbalances your profile, why they propose acting on the nose, the chin or both, which technique they prefer for the chin and why, what the risks are, particularly for lip sensation, and what the result will not be able to achieve. They will not hesitate to refer you to another approach if a bite problem is involved.

Ask for before-and-after profile photographs, at more than a year for the nose, of people of the same sex and similar build. Look at the balance between nose and chin, the neckline and how natural the result looks.

• Is my chin really set back, and why?
• Is my dental bite normal?
• Implant or bony genioplasty: what do you propose and why?
• By how many millimetres will you advance the chin?
• How much will you reduce my nose, given the chin advancement?
• How long might my lip be numb?
• How do you manage an implant infection or displacement?

• Heavily reducing the nose without looking at the chin.
• Treating a receding chin linked to misaligned jaws with a simple implant.
• Neglecting a dental infection before the procedure.
• Judging the profile in the first few weeks.
• Resuming sports with a risk of knocks too early.
• Choosing a chin that is too strong for your face.

The hump and the discreet chin

A twenty-six-year-old woman finds her nose too big in profile. The analysis shows a moderate hump and a slightly receding chin. The surgeon proposes measured lowering of the hump and a small chin implant. The profile becomes balanced without heavily reducing the nose.

The very receding chin

A thirty-one-year-old man has a normal-sized nose and a very receding chin, with a correct bite. The surgeon proposes an advancement bony genioplasty and a light rhinoplasty to refine the tip.

Misaligned jaws

A twenty-four-year-old woman wants a chin implant. The examination reveals a significant dental misalignment. The surgeon refers her to an orthodontist and a maxillofacial surgeon for jaw surgery, with rhinoplasty to be considered afterwards.

The chin that is too long

A thirty-five-year-old woman has a long chin and a nose with a drooping tip. The surgeon proposes a shortening bony genioplasty and lifting of the nasal tip.

The nose and the neck

A forty-two-year-old man has a hooked nose, a receding chin and a double chin. The surgeon proposes rhinoplasty, a chin implant and neck liposuction.

A twenty-nine-year-old woman consults to reduce her nose, which she finds too big in profile. The analysis shows a moderate hump, a slightly drooping tip and a chin set back by a few millimetres, with a normal dental bite. The surgeon shows her a simulation: heavily reducing the nose alone, or moderately reducing the nose and advancing the chin with a small implant. She chooses the second option. The procedure takes three hours, with a night in hospital. A week later, the splint is removed; ten days after the operation, she returns to the office. Her lip remains slightly numb for a few weeks. At three months, her profile is balanced; at one year, the nasal tip is refined. She says she is surprised by how much the chin contributed to the result.

The sportsman with a broken nose

A thirty-four-year-old man, a former rugby player, has a nose deviated by several fractures and a receding chin. He breathes poorly on one side. The surgeon proposes rhinoplasty with septum straightening, whose functional part is submitted to the insurer, and an advancement bony genioplasty. He advises waiting three months before resuming a contact sport, with protection.

The woman with a fine nose but a receding profile

A twenty-seven-year-old woman has a normal-sized nose, but finds her profile has "no chin". The surgeon proposes only a chin implant, without rhinoplasty, and shows her in a simulation that her nose will look finer once the chin is advanced. She chooses this option.

The man who wanted to need his beard less

A thirty-eight-year-old man has always worn a beard to hide a receding chin. He wants to be able to shave it off. The surgeon proposes a bony genioplasty with slight widening and a small rhinoplasty of the tip. Six months later, he keeps a short beard by choice, no longer out of necessity.

These situations share one thing: the result depends less on the extent of each procedure than on the accuracy of the analysis. In some cases, the chin alone is enough; in others, the nose remains the priority; sometimes a completely different approach, such as jaw surgery, is needed. A consultation that takes time to analyse the whole profile is the best guarantee of a suitable plan.

• I have understood what unbalances my profile.
• My dental bite has been checked.
• I know the technique planned for the chin and its risks.
• I know what correction is planned for the nose.
• I have had my dental care done and stopped smoking.
• I accept several weeks of swelling and possible numbness of the lip.
• I have a detailed quote.

Just before deciding, check that you have properly understood what unbalances your profile, whether you accept a procedure on the chin as well as the nose, whether you are prepared to live for a few weeks with a numb lip and an adapted diet, and whether you have had your dental bite checked. If the answers are clear, the decision becomes calmer.

Before committing, several simple tests can help: looking at photos of your profile taken by someone else, examining the simulation proposed by the surgeon from several angles and, if you are hesitating about the chin, considering a temporary injection. Taking the time for these steps allows you to arrive in theatre with a clear, calm idea of the result you are aiming for, and reduces the risk of disappointment.

The nose and chin respond to each other in the profile: a receding chin makes the nose look bigger, and a nose reduced without looking at the chin can leave an unbalanced profile. Combining rhinoplasty and genioplasty often allows the nose to be reduced less, for a more natural result. The chin is treated with an implant or bony genioplasty, depending on the advancement needed and the desired shape. The dental bite must be checked, as misaligned jaws call for a different approach.

Recovery affects the nose and mouth: a splint, mouth care, a soft diet, a lip that is often numb for a while. The profile takes shape within a few weeks, the nasal tip within a year. Depending on the canton, fees can be up to fourteen per cent lower than in Geneva.

Have your whole profile analysed, not just your nose. Have your dental bite checked. Understand the difference between an implant and bony genioplasty. Accept a measured correction of the nose. Look after your teeth and stop smoking. Prepare a soft diet and mouth care. And give the profile time to reveal itself.

If your nose seems too big in profile or your chin seems to be missing, an analysis of your profile will show where the imbalance really lies and which combination of procedures would suit you. Medespoir Suisse can direct you, free of charge, to a facial surgeon experienced in this combination.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Rhinoplasty and genioplasty: prices in Switzerland.

Related procedures

• Rhinoplasty and buccal fat removal in Switzerland
• Facelift and facial fat transfer in Switzerland
• Profileplasty: nose, chin and double chin in Switzerland
• Breast implant exchange and breast lift in Switzerland
• Breast implant removal and breast lift in Switzerland
• Breast fat transfer and liposuction in Switzerland

The procedures that make up this combination

• Rhinoplasty in Switzerland
• Ultrasonic rhinoplasty in Switzerland
• Ethnic rhinoplasty in Switzerland
• Genioplasty in Switzerland

Our guides

• Combined procedures in Switzerland
• Cosmetic surgery in Switzerland

Profile, receding chin, implant or bone cut, numb lip, diet and result: the most frequent questions about this combination.

The principle

Why combine the nose and chin? Because they frame the mouth in profile: correcting one without the other often leaves an imbalance.

Does a receding chin make the nose look bigger? Yes, the lack of a counterweight below the mouth draws the eye to the nose.

Can the nose be reduced less thanks to the chin? Often yes, which preserves the character and function of the nose.

What is a convex profile? An arched profile, with a prominent nose and a receding chin.

What is genioplasty? Surgery that changes the position or shape of the chin.

Are the scars visible? The chin is generally operated on from inside the lip; the nose through the nostrils, sometimes with a small scar under the tip.

The chin

Implant or bony genioplasty? An implant suits moderate advancements; a bone cut allows larger or more varied corrections.

How far can the chin be advanced? It depends on the anatomy and the goal; the surgeon specifies this after analysing the profile.

What are implants made of? Silicone or porous polyethylene.

Does the titanium plate stay in? Generally yes, without discomfort; it can be removed if it can be felt.

Can a chin that is too long be shortened? Yes, with a bony genioplasty.

Can an asymmetrical chin be corrected? Yes, mainly with a bony genioplasty.

Can the implant move? This is rare if it is well fixed; displacement is corrected with a short procedure.

The jaws and teeth

Why check the teeth? Because a receding chin may reflect a misalignment of the jaws, which calls for different surgery.

What is retrognathia? A lower jaw that is set back, often with misaligned teeth.

Is an orthodontist needed? Only if the dental bite is disturbed.

Can the teeth be damaged? Damage to the roots is very rare thanks to planning with X-rays.

Can I have dental implants afterwards? Yes, but you must tell the dentist about the genioplasty.

The nose

Which nose problems are concerned? A hump, a tip that is too low or too wide, excessive length, flared nostrils, a crooked nose.

Can I breathe better? Yes, if a correction of the septum is added.

Does swelling of the tip go down quickly? No, it refines over several months, up to a year.

The procedure

How long does the procedure take? Between two and a half and four hours, depending on the technique for the chin.

Do I need to stay the night at the clinic? Often one night, especially after a bony genioplasty.

What type of anaesthesia? General anaesthesia with airway protection.

What does the surgeon start with? Often the chin, then the nose, after changing the sterile drapes.

Recovery

Will my lip be numb? Often, for a few weeks to a few months, especially after a bony genioplasty.

What should I eat in the first few days? Soft, lukewarm foods that are easy to swallow.

How should I clean my mouth? With the prescribed mouthwash after each meal and a soft toothbrush.

When is the nasal splint removed? At around the seventh day.

Is the chin bandaged? Often with an adhesive dressing or an elastic band for a few days.

When can I see people again? Generally after ten to fifteen days.

Is speech affected? A little in the first few days, because of swelling and numbness of the lip.

Risks

What is the most common side effect? Numbness of the lower lip and chin, usually temporary.

Can an implant become infected? Rarely; an infection may require antibiotics or removal of the implant.

Can the bone wear away under the implant? Slight wear is possible over time, generally with no visible consequence.

Can the nose bleed? A little in the first few days; heavy bleeding must be reported.

The result

When will I see the new profile? After one month for the general shape, three months for the chin, one year for the nasal tip.

Is the result lasting? Yes, bony genioplasty and rhinoplasty are lasting; the implant stays in place long term.

Will my neck look more defined? Often, as an advanced chin better defines the angle between the neck and jaw.

Price and insurance

Does insurance reimburse it? Not the cosmetic part; a breathing correction or a bite disorder may be reimbursed on request.

Is an implant cheaper? Yes, generally, than a bony genioplasty.

Do prices vary by canton? Yes, they can be up to fourteen per cent lower than in Geneva.

Choosing

Which surgeon should I consult? A plastic surgeon, a facial surgeon or a maxillofacial surgeon experienced in both procedures.

Is a second opinion needed? It is useful to confirm the chin technique and how the corrections are divided.

Particular situations

Can I have just the chin done? Yes, if the nose is in proportion; genioplasty is also performed on its own.

Can I have just the nose done? Yes, if the chin is well projected.

Can the chin advancement be tested? Yes, with a temporary hyaluronic acid injection.

Can fat transfer replace an implant? For a small advancement, sometimes; the effect is more moderate and some of the fat is reabsorbed.

Can neck liposuction be combined? Yes, if there is a double chin; this is then called profileplasty.

Can an old chin implant be changed? Yes, it can be removed, replaced or converted to a bony genioplasty.

Can a revision rhinoplasty be done at the same time? Yes, but secondary rhinoplasty is longer and more complex.

Can I wear a dental brace? Discuss it with the surgeon and orthodontist before the procedure.

Is a beard a problem? No, as the incision is usually inside the mouth; it can hide residual swelling.

Does the smile change? The lower lip may look slightly different for the first few weeks, then regains its mobility.

Can I kiss after the procedure? It is better to wait until the scar in the mouth has closed and the lip is less sensitive.

Should wind instrument players wait? Yes, until the lip has healed and regained its sensation.

Do security scanners detect the plate? Generally not.

Can I have an MRI with a titanium plate? Yes, titanium is MRI-compatible.

Can the chin look too square? This is a risk if the implant or advancement is poorly chosen; the shape is adapted to the face.

Can a woman end up with a chin that is too masculine? The surgeon chooses a narrow shape and a measured advancement to avoid this.

Can a man widen his chin? Yes, an implant or genioplasty can widen and project the chin.

Can I have surgery at eighteen? If facial growth is complete and the request well considered, it is possible.

And after fifty? Yes; an advanced chin can also improve the neckline.

Does genioplasty help breathing at night? Not directly; for sleep-related breathing disorders, jaw surgery may be discussed.

Is chin swelling significant? It is marked in the first few days, especially after a bony genioplasty, then decreases within a few weeks.

Can I do sport? Exercise resumes at around four to six weeks, contact sports after two to three months.

Is lymphatic drainage needed? It can reduce swelling, according to the surgeon's advice.

How long should I avoid the sun? Several weeks, to limit swelling and marks.

What about my glasses? Avoid letting them rest on your nose for the first few weeks.

When can I blow my nose? Gently, after one to two weeks, according to the instructions.

Is the scar under the nasal tip visible? It generally becomes very discreet within a few months.

Can the chin become infected after dental treatment? This is rare; it is advisable to mention the implant before major dental treatment.

What should I do if I can feel the implant? Talk to the surgeon, who will check its position.

What if my lip remains numb? Sensation usually returns over several months; the surgeon monitors its progress.

Can a chin that projects too far be corrected? Yes, a bony genioplasty can move it back, sometimes with jaw surgery.

Does the result look natural? With a measured correction suited to the face, yes.

Will those around me notice? They often notice a more balanced face without identifying the procedure.

Do I need to stop smoking? Yes, at least a month beforehand and during healing.

Are tests needed beforehand? Often a dental X-ray, sometimes a CT scan for a bony genioplasty.

How many check-ups should I plan for? One at around one week, then at one, three, six and twelve months.

Can it be done as day surgery? Often with an implant; a night is common with a bony genioplasty.

What should I prepare for the consultation? Your expectations, profile photos, your dental history and your questions.

Do I need someone to accompany me? Yes, for the journey home and the first few hours at home.

Should I tell my employer? A sick note is enough, without details of the procedure.

Which period should I choose? A period with no important event in the following three months.

Can the chin move over time? A bony genioplasty is stable; a well-fixed implant is too.

Can an implant be removed later? Yes, if necessary, with a small procedure.

Does genioplasty change the voice? No.

Can the procedure be done during orthodontic treatment? This is decided with the orthodontist depending on the stage of treatment.

Is the profile judged in photos? Yes, before-and-after profile photos are essential to assess the result.

How can Medespoir Suisse help me? By directing you, free of charge, to a facial surgeon experienced in this combination.

How long will visible swelling last? Most of it disappears within two to three weeks; slight swelling persists for several months.

Can the chin look asymmetrical at first? Yes, because of swelling; you need to wait several weeks before judging.

Can the surgeon refuse the procedure? Yes, if they consider it unsuitable or that another approach is preferable.

Can ethnic rhinoplasty be combined? Yes, the nose procedure is adapted to the person's background and facial features.

Can the chin change with age? The chin bone resorbs slightly over the years, like the rest of the face.

Can the shape of the lower lip change? It may look slightly different, generally better supported by an advanced chin.

Are chin wrinkles improved? A better-projected chin can reduce contraction of the chin muscle and the orange-peel appearance.

Do I need to follow a special diet for long? No, eating returns to normal after one to two weeks.

How long before seeing the surgeon again after one year? Only if you have a question or want a touch-up.

Describe what bothers you about your nose and chin, and the region where you would like to consult. An adviser will direct you, free of charge, to a facial surgeon who thinks in terms of the overall profile.