Autologous Tissue Grafts for Chin Augmentation with or Without Genioplasty: A Systematic Review

Objective: This systematic review evaluated the clinical application of autologous tissue grafts for chin augmentation performed with or without genioplasty. The primary outcomes included clinical and aesthetic improvement, graft stability and integration, resorption, complications, patient satisfaction, and the need for secondary procedures. Methods: The review was prospectively registered in OSF and conducted in accordance with the PRISMA 2020 statement. PubMed, Scopus, Embase, Web of Science, and WorldCat were searched using terms related to genioplasty, chin advancement, and autologous grafting materials, including bone, adipose tissue, cartilage, dermal tissue, and tooth-derived grafts. Eligible studies included original clinical publications involving human patients and reporting outcomes following chin augmentation with an autologous tissue graft, with or without genioplasty. Study selection and data extraction were conducted independently according to predefined eligibility criteria. Methodological quality was assessed using the appropriate Joanna Briggs Institute critical appraisal tools. Because of substantial clinical and methodological heterogeneity across the included studies, no meta-analysis was performed, and the findings were instead synthesized qualitatively. Results: Seventeen publications were included, comprising predominantly retrospective studies, case series, case reports, and technique-oriented clinical reports, with only one prospective randomized comparative trial; the overall level of evidence was therefore low, and comparative data across graft types remained limited. The evaluated materials comprised autologous adipose tissue, dermal grafts, iliac crest bone, costal cartilage and costochondral grafts, coronoid process bone, external oblique line corticocancellous bone, mandibular bone harvested during orthognathic surgery, a third-molar tooth graft, and an osteocartilaginous nasal hump graft. Most studies reported improvements in chin projection, facial profile, symmetry, or lower facial proportions. The available evidence suggests that autologous bone and cartilage grafts may provide integration and structural support, with limited clinically evident resorption reported; however, these observations derive from limited and heterogeneous evidence. Soft-tissue grafts improved chin contour but showed less predictable volume maintenance. Dermal graft resorption reached approximately 35% after 12 months, while fat grafting was associated with soft-tissue relapse and occasional secondary lipofilling. Serious graft-related complications were not frequently reported; however, adverse-event reporting was inconsistent, preventing reliable estimation of their incidence. Reported events included infections, temporary sensory disturbances, contour irregularities, and isolated graft removals. The certainty of the findings was limited by heterogeneous study designs, predominantly small or uncontrolled samples, variable outcome measures, and inconsistent follow-up. Conclusions: Autologous tissue grafts represent potentially effective options for chin augmentation when the graft source and surgical technique are selected according to the type and extent of the deformity. The available evidence suggests that bone and cartilage grafts may provide structural support, whereas adipose and dermal tissues may be considered for moderate soft-tissue augmentation; however, these conclusions are based on limited and heterogeneous evidence. However, the available evidence does not establish the superiority of autologous grafts over sliding genioplasty or alloplastic implants. Registration: Open Science Framework.