This study was designed to examine changes in soft tissue in six patients treated by advancement genioplasty combined with mandibular setback. The genioplasty technique was modified to keep a maximum amount of soft tissue attached to the repositioned genial segment. The group of patients was characterized by mandibular prognathism, a flattened labiomental sulcus, a prominent lower lip, and an apparent lack of chin prominence. The genioplasty consistently produced a 1:1 ratio of soft tissue change to advancement of the chin.