How Can My Chin-Lip Groove (Labiomental Sulcus) Be Made Less Deep After A Genioplasty?
Q: Hi Dr Eppley, I read a article that you have used a long-lasting injectable filler to lessen the deepness of the chin lip fold? I had a sliding genioplasty and there is a mild stepoff and a bit of a deeper sulcus afetr surgery. I was wondering if you would be able to blend the chin into the jawline like the stepoffs and also lessen the labiomental chin lip sulcus? How long after genioplasty am I able to have the injectabale treatment? Also what complications have you seen with such injectable treatments? Thanks.
A: The first thing to appreciate is the anatomy of the labiomental sulcus (chin-lip groove) and how that has been changed from your bony genioplasty. The depth of the labiomental sulcus is a reflection of your anterior mandibular vestibule. If you put your thumb in the labiomental sulcus and your index finger inside your mouth, you will see the correlation between the two. The fold represents the level of the vestibule but, more pertinently, it is the upper or superior attachments of the mentalis muscle. Once the chin bone has been slide forward, the labiomental sulcus deepens because the chin point moves forward with the bulk of the mentalis muscle with it. That will deepen thue sulcus because the vestibule has not moved but the chin bone has.
How to treat the deep labiomental sulcus can be done several ways. If one is looking for a permanent solution to the depth of the fold, treat the exact anatomic problem and place a dermal graft and build it up from underneath in the bony step-off. That would be my preferred approach. The other option is to use injectable fillers but understand that they will onlu be temporary and are not long-term solutions.
Dr. Barry Eppley