Before surgery: what to prepare
Stop aspirin, ibuprofen, naproxen, and blood thinners 10–14 days before. Stop fish oil, vitamin E, ginseng, ginkgo. Smoking and vaping must stop 4 weeks before and through 6 weeks after, nicotine specifically risks bone non-union, not just slow healing. Dental cleaning 2 weeks pre-op. Stock liquid and soft foods. Buy straws and a soft toothbrush. Arrange home help for the first week.
The day of surgery
Chin genioplasty is performed under general anaesthesia, runs 1.5–2.5 hours, and usually requires one night in hospital. The incision is inside the mouth below the lower front teeth. The chin bone is cut and repositioned, then fixed with small titanium plates and screws. You wake up with a compression bandage around the lower face, a small drain, and the lower face already swelling.
Days 1–3: peak swelling
Swelling peaks day 3–5 and is concentrated in the lower face and neck. Pain is moderate, well-controlled. Drain usually out before discharge. Liquid diet only. Head elevation 45 degrees. Cold compresses outside the bandage. Mouth rinses after every intake. Numbness across the lower lip and chin is immediate and universal, the mental nerve was directly in the surgical field.
Week 1: stitches out, bruising fades
Bandage off around day 5–7. Swelling dropping but still visible. Mouth opening restricted. Liquid diet continues. Lower lip droop is common and temporary, the muscles attaching to the chin (mentalis muscle) have been disturbed and need time to recover. Numbness remains significant.
Weeks 2–4: back to public
Office work from week 2–3 for most patients. Soft diet starts week 2 and expands. Lower lip droop continues to recover. Numbness slowly improves. No tough food until cleared, usually week 6.
Months 2–3: swelling resolves
Swelling resolves and the new chin contour is clearly visible. Lower lip function continues to recover. Numbness continues to improve. Mouth opening near normal.
Months 6–12: the final result
Bone consolidation complete by 6 months. Final result by month 6 with minor refinement through month 12. Numbness in the lower lip and chin is largely resolved for most patients by month 6; partial residual numbness past 12 months in a minority and occasionally permanent. The osteotomy line is structurally healed by month 12.
Red flags: when to call the clinic
Call the clinic the same day for: fever over 38.5°C after day 3, sudden firm painful one-sided swelling (haematoma), pus or foul taste from the incision, sudden numbness worsening, lower lip and chin becoming completely numb past day 7 with no improvement, visible plate or screw through the gum line, or late-onset palpable hardware (screw loosening or plate irritation occurs in roughly 1–5% of cases and may need office-based removal months to years later). Go to an emergency room for difficulty breathing or sudden severe airway swelling in the first 72 hours. Routine numbness, lower lip droop, and asymmetric swelling in the first 4 weeks are not red flags.