Osseous surgery of the chin is discussed and reviewed. Emphasis is placed on functional and aesthetic facial harmony. This requires concurrent evaluation of skeletal maxillary and mandibular disharmony, including the occlusion. Both reduction and advancement procedures are outlined and examples are presented. Complications, including chin ptosis and lack of cervicomandibular definition, are reviewed. Optimal results dictate that the timing of adjunctive facial cosmetic procedures be coordinated.