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Facial beauty depends on the form, proportion and position of its various units. The chin is the most prominent element of the lower third of the face, both in the frontal view and in profile. Whether it is advisable to perform rhinoplasty first, followed by genioplasty, or the reverse depends on the type and severity of the deformities of the nose and chin. The selection of material is a matter of the plastic surgeon's preference. Fat is an ideal tissue filler substance because it is living tissue and from the patient’'s own body. So it is nonallergenic. The procedure can be performed alone as a chin augmentation with fat grafting or in combination with rhinoplasty or other facial surgery. The technique requires minimally traumatic fat harvesting, fat preparation, and multi-level facial infiltration. Remnant fat in the initial procedure is frozen and stored at -18C and can be used successfully for minor touch-up procedures. We have performed a review of chin surgery, the multiple aesthetic analyses available and the advantages and disadvantages of the various materials. Autologous fat transfer to the chin is safe, cost effective, and can produce long term aesthetic improvement. Although there are many synthetic fillers available, autologous fat is perhaps the best option for genioplasty. This simple, fast procedure is a very good alternative for patients with some form of microgenia or when patients and surgeons are not likely to use alloplastic implants. (Archives of Aesthetic Plastic Surgery 17: 69, 2011)