Q: Dr. Eppley, I am interrested in chin augmentation but I already have a deep labiomental fold and weak chin. If I move my chin forward with it would look very unusual. I can’t have my chin moved vertically downward because i already have a long face, and I cant afford to make it any longer. Is there a way to move the chin 1 cm forward while at the same time addressing the really deep lm fold? Fillers/Fat graft maybe before/after the chin surgery? Thank you for your guidance.
A: Two approaches to help lessen the depth of the labiomental fold in a chin augmentation procedure:
1) Graft the step-off in the sliding genioplasty during the initial procedure and
2) Place a dermal-fat graft between the muscle and the skin through an intraoral approach secondarily if needed.
The deep labiomental fold poses a challenge in chin augmentation. Grafting the step-off in a sliding genioplasty is helpful but not a complete solution. I have found that the best treatment long term is to perform a secondary intraoral release and place a dermal-fat graft. This pushes out the fold most effectively because it provides a direct approach to it as the level just under the skin.
Dr. Barry Eppley