Q: Dr. Eppley, hello, I am 37 yrs old and I have a 100% overbite with a deep labiomental fold. I want to have that fixed and get a better jawline and chin and don’t know what procedure would work for me.
A: In looking at your pictures, I can see the external symptoms of the 100% overbite to which you have described. The jaw is overrotated upward causing a vertically short chin (albeit with a touch too much horizontal projection) and a deep labiomental fold. Thi is what happens when there is not an adequate occlusal stop on jaw closure. (overbite should usually be about 10 to 20%)
Correction can be done by one two approaches. One option is a vertically lengthening chin osteotomy with an interpositional hydroxyapatite block graft. This would need to be at least 1 cm (10mm) of vertical lengthening if not more. This would create more of a prominent chin and would help lessen the visible depth of the labiomental fold as it stretches down the chin tissues downward. I have attached some computer imaging of that potential result. The other option is a custom chin implant that would vertically lengthen the chin as well as back along the jawline. In either case, a labiomental implant could also be used to shallow the depth of the fold although this may not be needed with the chin osteotomy as the fold naturally becomes a little less deep as the soft tissues are moved downward with the bony movement.
Dr. Barry Eppley