A correct projection of the chin is an important element in the beauty of the profile and in the harmony of the face. Alterations can be in defect or in excess determining respectively a small and receding chin or a prominent chin and the facial plastic surgeon must be ready to analyze the profile and be able to detect the presence of these imperfections. Sometimes an alteration of the occlusion of the dental arches coexists, which may also involve orthodontic treatment or orthognathic maxillofacial surgery. Often the alteration of the chin is associated with a nasal deformity and, in these cases, rhinoplasty without mentoplasty alone is not able to restore the right harmony and beauty to the face.
Additive mentoplasty can be easily carried out by inserting a silicone prosthesis of suitable size in a pocket in front of the chin bone. A small incision of the mucosa of the lower gingival fornix, below the incisors, is sufficient for the introduction of the prosthesis without any visible external scar.
Reductive mentoplasty involves the progressive removal of bone tissue until the desired chin projection is achieved. In severe cases, chin sectioning, removal of a bone plug internally, and subsequent osteosynthesis of the chin to the mandibular region behind with titanium plates may be indicated.

PROPHILOPLASTY
This patient came to observation complaining of an overall aesthetic alteration of her profile.

The clinical analysis showed a prominence of the nasal dorsum, a particularly droopy tip and little projected into space, a small and receding chin. The surgical intervention realized a harmonization of the profile by removal of the small hump, remodeling and upward rotation of the tip, mentoplasty. The result shows apleasant harmonization of the profile.

RHINOPLASTY, MAXILLARY ADVANCEMENT, REDUCTION MENTOPLASTY
This patient complained of an altered profile due to the presence of a prominent nasal hump, prominence of the chin and altered occlusion of the dental arches.

The clinical analysis showed: hump of the nasal dorsum, dental malocclusion with inversion of the bite, hyperplasia of the chin. The surgical intervention, conducted in a single time, involved: rhinoplasty with removal of the nasal hump and remodeling of the tip; orthognathic surgery with advancement of the upper jaw; reductive mentoplasty with removal of a mandibular bone plug. A preparatory orthodontic therapy was also performed to adapt the dental arches to their new position after surgery.