In short. Plates and screws in a genioplasty hold the cut segment while the bone join unites, and in most patients they stay in place permanently. Removal is a second operation reserved for a plate that can be felt and is uncomfortable, an infection around the hardware, or metal exposed inside the mouth.
Key points
- The plates hold two pieces of bone together while the join unites.
- Most people cannot feel them through the soft tissue of the chin.
- Once the bone is solid, whether the metal stays does not change the shape.
- Removal is a second operation under anaesthesia, deferred until the join is solid.
- An infection around hardware is treated by removing the plates as well.
What the plates are doing
The segment is held in its new position by small plates and screws fixed to the bone. They are placed through the same incision inside the mouth, they are made of an alloy the body tolerates, and in the great majority of patients they stay there for good. Removing them is a second operation, and it is done for a reason rather than as a routine.
How the plates sit under the skin
Most people cannot feel them. The plates sit on the surface of the jaw under the soft tissue, and in a chin of ordinary thickness they are not perceptible from the outside. Someone who is very thin, or who has had the same area operated on before, may be able to feel an edge with a fingertip. That is a finding rather than a problem, and it usually needs nothing done about it.
Why the plates are not shaping the chin
They are holding two pieces of bone together while the join unites. Once the bone has healed, that job is finished, and whether the metal stays is a matter of convenience rather than of the result. Nothing about the shape of the chin changes if a plate comes out after the bone is solid.
What makes removal the right answer?
The reasons to consider removal are limited. Occasionally a plate becomes noticeable enough to be uncomfortable when the chin is pressed. Occasionally an infection settles around the hardware, which shows as swelling, redness or discharge weeks or months after the operation, and the plates come out as part of treating it. Occasionally a patient does not want metal in the body and asks for removal once the bone has healed. A plate that has become exposed inside the mouth is also removed.
Why removal waits for the bone to heal
Timing matters if removal is planned. The plates are doing structural work until the bone has healed, which takes months rather than weeks, so removal is normally deferred until the join is solid. Taking them out earlier risks the segment moving. Done after that point, removal is a smaller operation than the original, but it is still an operation under anaesthesia.
| Situation | What it means | What is usually done | What you should know |
|---|---|---|---|
| No symptoms, bone healed | The plates have finished their job | They usually stay for good | The shape does not depend on them |
| An edge felt with a fingertip | A finding, not a problem | Usually nothing | More likely in thin tissue or after previous surgery |
| A plate uncomfortable when the chin is pressed | Noticeable enough to consider removal | Removal is discussed | It is a second operation |
| Swelling, redness or discharge weeks or months after surgery | Infection around the hardware | The infection is treated and the plates removed | Metal in place makes an infection hard to clear |
| Metal exposed inside the mouth | The gum over a plate has broken down | The plate is removed | It is one of the reasons removal is done |
| A radiograph or scan taken years later | The plates and screws are visible | Tell your dentist | Any clinician reading it will know the chin was operated on |
What will imaging show years later?
Hardware is also visible on imaging. A radiograph or scan of the jaw taken years later will show the plates and screws, and any clinician reading it will know the chin bone has been operated on. That is worth telling a dentist about, particularly before any treatment that involves the lower jaw or the roots of the front teeth.
What to ask before the operation
The question worth asking before the operation is not whether the plates will be removed but what would make removal the right answer, and who would decide. A surgeon who answers that specifically has thought about the years after the operation rather than only about the day of it.
Sources
- American Society of Plastic Surgeons: guidance on facial bone fixation and genioplasty
- NICE: interventional procedures guidance relevant to facial bone surgery
- Cochrane Library: systematic reviews relevant to orthognathic fixation
Source links open each organisation's search results for the topic. Document-level confirmation is pending the reviewer's sign-off.
Internal links
Frequently asked questions
Can the plates be felt through the skin of the chin?
In most people they cannot. The plates sit against the bone under the soft tissue, and an ordinary thickness of tissue hides them. Someone who is very thin, or who has had the area operated on before so the tissue is scarred, may be able to feel an edge with a fingertip. That alone is not a reason to remove anything.
What happens if a plate becomes infected?
An infection around hardware usually shows as swelling, redness or discharge weeks or months after the operation rather than immediately. Treating it normally means removing the plates as well as treating the infection, because metal in place makes an infection hard to clear. By that stage the bone has usually healed enough to hold the segment without them.
Will the plates set off a metal detector at an airport?
They are small and in most cases do not trigger the alarms used at airports, though the sensitivity of the equipment varies. If a detector does react, saying that you have had jaw surgery is enough, and no documentation is ordinarily needed. The plates are visible on imaging, which is the record that matters clinically.
Risks & Limitations
- Numbness of the lower lip and chin is expected after a cut in the jaw; it usually improves over months and may not return completely.
- A second operation in the same bone carries a higher chance of numbness that does not recover fully.
- The change is fixed once the bone heals, and reversing it means cutting again rather than removing something.
- Final results are judged at three months or later, and more fairly at a year, not in the first weeks.
When to Seek Care
- Difficulty breathing or chest pain — seek emergency care immediately.
- Fever with swelling, redness or discharge over the jaw, which may mean infection around the plates.
- A numb area of the lip or chin that is getting larger rather than smaller after the first weeks.
- Loss of movement in the lower lip, or an incision inside the mouth that opens.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews
- Chinese Medical Association Plastic Surgery Branch — clinical guidance
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.