The senior author (B.M.Z.) has performed 512 chin reoperations over the last 30 years. This paper will describe the usual errors in surgical planning regarding what seems to be a relatively straightforward operation. We will focus on: (1) assessment of the chin; (2) pitfalls with surgical approaches; and (3) problem cases. This paper will not focus on the large chin, but rather on the chin that needs augmentation. Some chins will do well with an implant, others will need an osteotomy or ostectomy, and even others need both. The surgeon is responsible for selecting the correct operation. Thus, it remains incumbent on the surgeon to become diligent in diagnosis and delivery.