Isolated horizontal osteotomy of the anterior mandible (genioplasty) to move the chin posteriorly can be used to improve facial profile. There has been an increasing tendency in practice to carry out this procedure in combination with maxillary and/or mandibular surgery. This is most appropriately undertaken when pre-operative prediction techniques indicate that chin prominence will remain excessive following maxillary and/or mandibular advancement surgery. This paper reviews surgical techniques applicable to posterior movement of the chin ("the setback genioplasty') and illustrates the clinical results achieved with its use.