Q: Dr. Eppley, I have a very deep labiomental fold that I seek improved. That is what I am seeking your opinion about. What labiomental fold reduction procedure do you recommend? If so do you believe this procedure would bring long term improvement for me. Also, have you successfully performed this procedure in the past? Your credentials speak for themselves and I value and will follow your lead.
A: Even though it is a small area, labiomental fold reduction is challenging. Having tried synthetic fillers, injectable fat and Gore-tex, silicone and allogeneic dermal implants for the severely inverted V shaped labiomental fold, they simply can not lift the retracted skin edges. Internally the labiomental fold sits over the lower lip vestibule so it is not a bone influenced soft tissue structure of the upper chin. It requires release by making an incision along the depth of the crease (there is a skin fold there anyway), undermining and lifting up the skin edges, placing a dermal-fat graft and then closing the skin edges over it. A dermal-fat graft will completely survive and provide a permanent solution to the inverted labiomental fold.
Dr. Barry Eppley