Mentalis Muscle Resuspension

Q: Dr. Eppley, I have an interest in getting a mentalis muscle resuspension. I recently underwent a sliding genioplasty procedure and a few weeks later noticed that my lower lip began to be pulled down. I now have trouble keeping my mouth closed. I have been doing some research on mentalis resuspensions but it seems like most of the cases I’ve seen the lip position stays in place for a while but eventually falls back down. If permanent fixtures are placed and the mentalis is sutured to the fixtures, how can it fall back down? What causes this to happen? Also, what causes the sulcus to deepen and how can you bring it back to normal. Thanks and I hope to hear from you soon.

A: Mentalis muscle resuspension has a high incidence of ineffectiveness and lack of sustained long-term results. I would be particularly unenthusiastic about any success after a sliding geniopalsty where the tissues are already stretched. Deepening of the labiomental fold is an expected and natural sequelae of moving the chin bone forward.

The only surgical approach that I think has any merit is a dermal-fat graft to the labiomental sulcus placed intraorally and above the mentalis muscle.

Dr. Barry Eppley