Sliding Genioplasty and Labiomental Fold

Q: Dr. Eppley, I would really value your opinion on the following; I am a 46 year old female. Over the last 15 months I have undergone orthodontic treatment to reduce my considerable over jet by bringing my lower incisors forward. Orthognathic surgery was not offered to me after assessment. I am very happy with the result. I have recently visited a maxillofacial surgeon with regard to surgery for my retrognathia. He suggests an advancement sliding genioplasty but with no vertical lengthening as my lower third is not deficient. My question to you is do you think this procedure would deepen my labiomental fold, resulting in an unharmonious appearance? I could send a lateral x ray photo if that helps. Many thanks for your time.

A: The answer to your question is very straightforward…yes it would. Every sliding genioplasty by definition will deepen the labiomental fold as the moveable chin point comes forward and the labiomental sulcus point stays fixed where it is. So the question is not really whether a sliding genioplasty will depend a labiodental fold but by how much and whether it will be aesthetically disadvantageous. That would depend on how deep the fold is now and how far forward the chin would be advanced. X-rays don’t help answer the question, actual pictures of your face would.

Dr. Barry Eppley
Indianapolis, Indiana