Many noses that look prominent are not: what is happening is that the chin is set back — hypomentonism — and makes the nose look larger. Correcting the nose alone leaves an incomplete result.
That is why a rhinoplasty consultation includes an assessment of the whole profile — the jawline, the projection of the chin, the relationship between forehead, nose and chin — and not just the shape of the nose.
The analysis rests on the facial thirds: if the chin sits behind the lower lip and the plane of the nose, the symmetry of the profile is broken.
Where combining them is appropriate, they are operated on in the same procedure under general anaesthetic: the rhinoplasty reshapes the bridge and the tip; the mentoplasty augments the chin with an implant, advances it by osteotomy or reduces it.
At 7-10 days splints and stitches come out and normal life resumes; the profile settles and the final results of the harmonisation are apparent at 2-3 months.
Facial aesthetic surgery should not be approached as a set of independent procedures but as a piece of work on the whole, where each feature influences how the face is perceived overall. One of the clearest examples is the relationship between the nose and the chin. In many cases, a patient who comes about a rhinoplasty discovers that the origin of their facial imbalance lies not only in the nose but also in the position or projection of the chin.
At the Instituto de Cirugía Plástica del Mediterráneo, in Valencia, we approach these cases with an integrated view known as profiloplasty: the surgical combination of rhinoplasty with chin surgery to achieve a harmonious, natural and proportionate profile.
A profiloplasty is a surgical approach that sets out to correct the proportions of the facial profile as a whole, chiefly through the nose and the chin. Its aim is to achieve a balance between the middle third and the lower third of the face, improving the line that runs from the forehead to the chin.
The procedure can combine two main operations:
Rhinoplasty: reshapes the form and projection of the nose.
Mentoplasty: changes the projection of the chin, either increasing or reducing its size.
The final result improves not only the appearance of both elements but brings greater overall harmony to the patient’s face.
Why does the chin influence how the nose is perceived?
In many cases a nose that looks prominent or projecting is not really so. What is happening is that the chin is set back (hypomentonism), which makes the nose look larger or out of proportion. Correcting the nose alone, without assessing the position of the chin, can leave an incomplete result.
How facial balance is perceived rests on invisible axes and lines that organise the proportion between features. One of the analyses most used in aesthetic surgery is that of the facial thirds. If the chin sits behind the lower lip and the plane of the nose, the symmetry of the profile is broken.
For that reason, before any nose surgery with aesthetic aims, it is essential to assess the chin and its relationship with the nose, the neck and the jaw.
When the chin changes the nose, and when it does not
That the chin “makes” the nose is said often and almost never with figures. There are figures, and they are useful because they mark the exact point at which the profile stops being a matter of taste.
One study did the most direct thing possible: it took an ideal profile and moved the chin two millimetres at a time, from 24 mm set back to 12 mm advanced, and asked three groups — patients, clinicians and people with no connection to surgery — to score each version. The thresholds that emerged:
Up to 4 mm either way, nobody notices, professionals included. A chin that is slightly short or slightly forward simply does not alter how the profile reads.
From 6 mm of advancement, or 10 mm of setback, a wish to correct it appears consistently.
The reference for the ideal is a simple one: the most prominent point of the chin falls on a vertical drawn from the base of the nose, or just behind it.
The distance between those two thresholds says something worth remembering: the profile tolerates a short chin considerably better than an excessive one. So where there is doubt, restraint wins.
And how often do the two go together? In a series of 426 rhinoplasties, around 17% also needed work on the facial skeleton — the chin among it — for the profile to come together. It is neither the norm nor rare. The conclusion of that paper is the one that underpins this page: nose, middle third and chin are assessed together, even though only one of the three is then operated on.
Common indications for a profiloplasty
Patients who may benefit from a combined operation usually have one or more of the following:
A receding chin with a projecting nose
A prominent chin with a small or poorly defined nose
A deviated nose with jaw asymmetry
Disproportion between the middle third and the lower third of the face
A wish for greater definition of the facial profile
Combining the operations makes it possible to address the real cause of the facial imbalance, not only its most obvious manifestation.
Facial assessment beforehand: a complete approach
The first consultation for a rhinoplasty at our clinic includes an assessment of the whole profile. We do not confine ourselves to studying the shape of the nose but analyse the face as a whole, particularly the jawline, the projection of the chin and the relationship between forehead, nose and chin.
The analysis includes:
Clinical photographs in profile and from the front
Assessment of the occlusal plane and the projection of the chin
A study of the vertical and horizontal proportions
Digital simulations to visualise the combined changes
This assessment determines whether chin surgery is advisable alongside the rhinoplasty, or whether one operation on its own is enough.
How is the surgery carried out?
When the patient agrees to a profiloplasty, both operations are carried out in the same procedure, under general anaesthetic.
1. Cosmetic rhinoplasty
The nose is reshaped according to the patient’s goals: reducing a hump, refining the tip, correcting deviations, among others. The technique may be open or closed, according to the case.
2. Mentoplasty
Depending on the indication, one of the following techniques is used:
Chin augmentation with a silicone implant: inserted through a small incision under the chin or inside the mouth.
Bony advancement mentoplasty: a controlled cut is made in the jawbone (an osteotomy) to move the chin forward.
Chin reduction: where the chin is excessively prominent, the bone is reshaped or shortened.
The two procedures complement one another to improve the profile without producing an artificial or exaggerated change.
Recovery after surgery
Recovery after a profiloplasty is similar to that of a standard rhinoplasty, though with a few particulars because of the chin surgery.
During the first week:
There may be swelling of the nose, the chin and the lower part of the face
Slight bruising of the neck or chin is usual
Sleeping with the head raised and avoiding sudden jaw movements are advised
At 7-10 days:
Splints and stitches (where there are any) are removed
The swelling goes down
Normal social and working life can resume
At 2-3 months:
The profile settles
The final results of the harmonisation between nose and chin become apparent
Medical follow-up allows progress to be checked and any question answered during recovery.
Results: a harmonious, proportionate face
The success of a profiloplasty lies in how natural the result looks. It is not about transforming the face but about reordering its proportions to achieve a balanced profile. The change in how the face is perceived can be marked, even where the chin surgery is minimal.
Many patients find:
Greater definition of the facial contour
A sense of balance between their features
Increased confidence and self-assurance
Less self-consciousness about the nose, once the whole is in harmony
Addressing both together also avoids further operations later and offers a more complete and lasting solution.
At the Instituto de Cirugía Plástica del Mediterráneo we believe in individual, strategic surgery. We know that beauty lies in balance, not in the isolated perfection of one feature. That is why a complete facial assessment is the key to coherent, responsible surgical decisions aimed at real results.
Our specialists in rhinoplasty and chin surgery work together, using advanced techniques and diagnostic resources that allow a treatment tailored to each patient.
Is a profiloplasty right for you?
If you feel your nose does not sit well with your face, or you sense that your chin is not aligned with the rest of your features, a combined operation may be the best option. Request a medical assessment with our surgeons and receive a professional, honest analysis with no obligation.
Facial harmony does not lie in one feature but in the balance between them all. We will help you achieve it.
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Why are you talking about my chin when I came about my nose?
Because many noses that look prominent are not: what is happening is that the chin is set back (hypomentonism), which makes the nose look larger or out of proportion. Correcting only the nose without considering the position of the chin can leave an incomplete result.
What is a profiloplasty?
The approach that corrects the proportions of the facial profile through the nose and the chin together, seeking a balance between the middle and lower thirds of the face. It combines rhinoplasty — reshaping the form and projection of the nose — with genioplasty — augmenting, advancing or reducing the chin.
From how far back does a short chin start to show?
It has been measured. A study moved the chin of an ideal profile two millimetres at a time and asked patients, clinicians and people outside the field to score each version: up to 4 mm forwards or backwards nobody notices, not even the professionals. The wish to correct it appears consistently from 6 mm of advancement or 10 mm of retrusion.
What is the reference for an ideal profile?
A simple one: the most prominent point of the chin falls on a vertical line drawn from the base of the nose, or just behind it. And there is a nuance worth keeping: the profile tolerates a short chin considerably better than an excessive one, so when in doubt, restraint wins.
Is it common to have to operate on both?
Neither usual nor rare. In a series of 426 rhinoplasties, around 17% also needed work on the facial skeleton — the chin among it — for the profile to come together. Nose, middle third and chin are assessed together, even if only one of the three is then operated on.
Who is a candidate for a combined procedure?
Anyone with a receding chin and a projecting nose, a prominent chin with a small or poorly defined nose, a deviated nose with mandibular asymmetry, disproportion between the middle and lower thirds, or simply the wish for greater definition of the profile.
What is assessed at the consultation?
The whole profile, not just the shape of the nose: the jawline, the projection of the chin and the relationship between forehead, nose and chin. It includes clinical photographs in profile and front view, assessment of the occlusal plane and chin projection, study of the vertical and horizontal proportions, and digital simulations to visualise the combined changes.
Are they operated on at the same time?
Yes. When it is appropriate to combine them, both operations are carried out in the same session, under general anaesthetic.
How is the chin corrected?
In three ways, according to the indication: augmentation with a silicone implant, inserted through a small incision under the chin or inside the mouth; sliding genioplasty, with a controlled cut in the jawbone (osteotomy) that moves the chin forwards; or reduction, reshaping or shortening the chin bone where there is excessive prominence.
How long does recovery take?
In the first week there may be swelling of the nose, chin and lower face, and mild bruising on the neck or chin. At 7-10 days the splints and stitches are removed and normal social and working life resumes. At 2-3 months the profile settles and the final results of the harmonisation can be seen.
Will I end up with a different face?
It is not about transforming the face but about reordering its proportions. The change in how the face is perceived can be notable even if the chin surgery is minimal. What is more, the combined approach avoids future revisions and offers a more complete and lasting solution.
Sources
Naini FB, Donaldson ANA, McDonald F, Cobourne MT.Assessing the influence of chin prominence on perceived attractiveness in the orthognathic patient, clinician and layperson. Int J Oral Maxillofac Surg. 2012;41(7):839-846. PMID 22340990 — an ideal profile altered 2 mm at a time and scored by three groups: up to 4 mm the change goes unnoticed; the wish for surgery appears from 6 mm of advancement or 10 mm of setback.
Reategui A, Jazayeri H, Mier A, Peck CJ, Phillips S, Lopez J, Steinbacher D.Profileplasty: Comprehensive Facial Profile Management Algorithm Based on 426 Patients. J Craniofac Surg. 2025;36(2):523-525. PMID 39715529 — across 426 rhinoplasties, 17% required additional surgery on the facial skeleton; nose, middle third and chin should be assessed together.
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