In 1988, I performed 15 chin procedures, seven osteotomies, and eight implants. During that same period, 38 rhinoplasties were done, but only five patients (15 per cent) had a simultaneous genioplasty. While the chin is important in nasal surgery, correction is also indicated for other aesthetic problems. Genioplasty, whether by osteotomy or implant, continues to present a unique opportunity to improve facial aesthetics with minimal risk. The current challenge is to define patient selection better, refine the technique (for example, bone substitutes and fixation hardware), and, most important, establish genioplasty firmly in the practice of plastic surgeons who perform aesthetic procedures on the face.