Q: Dr. Eppley, I was interested in the perioral and buccal lipectomies as well as a revision sliding genioplasty to add just a tiny bit more projection (3mm or so), as well as a platysmaplasty to refine the jawline. I was wondering if the chin were to be advanced more, could we fill in part of the labiomental fold with HA paste to prevent a deep crease there? Thanks!
A:Typically I would fill in the step of a sliding genioplasty with allogeneic bone particles which will ultimately become ingrown with bone. HA paste, an older form of bony augmentation which is synthetic, has largely been relegated to historical significance given the lack of manufacturers who make the particles. HA bone cements are also an option but due their high cost and lack of bony ingrowth would be inferior in my opinion to allogeneic (tissue bank) bone particles.
Dr. Barry Eppley