Q: I need a chin augmentation because my chin is definitely short. I know there are two ways to do it, either with an implant or an osteotomy. I would ultimately prefer the implant over an osteotomy. Is it possible to get some vertical lengthening with an implant, maybe in the range of 2 or 3 mms? Is it possible to get an implant without making the labiomental indentation deeper?
A: When significant vertical lengthening of the chin is needed, an osteotomy is really needed. But when the vertical height increase needed is small, a chin implant can achieve that dimensional change. It is necessary to place the implant as low as possible on the chin bone, almost as if it was on the edge of the bone. To maintain that position, I prefer to place a single metal screw into the bone to secure it. That way there is no risk that it can move upward even a single millimeter.
The labiomental sulcus or groove is located below the lip and really represents the location of the mandibular vestibule inside the mouth where the mentalis muscle attaches to the bone. Because of its superior fixed location, it will usually become a little deeper after chin implant augmentation. This is because it doesn’t change but the soft tissue of the chin moves forward, making it look a little deeper. When the amount of chin advancement is significant (8 to 10mms), the labiomental fold will get deeper in most patients. That effect will be lessened when the implant is placed on the lower end of the chin bone with vertical lengthening as the push underneath the labiomenal fold is less due to the lower position of the implant.
Dr. Barry Eppley