Q: Dr. Eppley, I would like to see if it is possible to improve 3 areas around my chin. The areas I want to improve are my jawline. I would like it better defined. I would also like to create a better angle on neck underneath the chin for better profile. I would also like to create better balance and harmony on my chin. Maybe lengthen it to try and release some of the mental crease. I’m not quite sure what will work. It’s a pretty deep crease. I was born with it. Feels like a huge step below my lower lip. I have attached a front and side view of me for you to see what I mean.
A: What you have is a classic issue of an overall short lower jaw. Your lower jaw is short in both horizontal and vertical dimensions which is most manifest in the chin area. While I can not see your occlusion (bite), I suspect it is a Class II malocclusion where your lower teeth are somewhat behind your upper teeth and do not meet in an edge-to-edge fashion. That is also why you have a deep labiomental crease. The lower lip is not well supported by the retropositioned lower teeth so the crease deepens while the lower lip rolls forward. What you need for correction is a vertical lengthening chin osteotomy that also brings the entire chin bone forward. I would estimate that it must be vertically lengthened by 8mm and brought forward 10mms. A hydroxyapatite block needs to be added to the step-off in the osteotomy to help build out the labiomental crease or at least prevent it from becoming even deeper. Lengthening the chin will actually help soften the depth of the crease as it pulls the soft tissue of the lower chin down and forward.
Dr. Barry Eppley