What I The Best Way To Eliminate A Chin Cleft?

Q: Dr. Eppley, hello! Thank you for the opportunity to ask you a question. If the filler completely satisfied my aesthetic needs for smoothing the chin cleft, will fat grafting give a similar result as the filler, but for a longer term? In the foreseeable future, I am planning an orthognastic surgery with genioplasty and I am also considering the option of eliminating my cleft chin (namely cleft) using alloderm, so as not to carry out two procedures (genioplasty and then fat vaccination), however, I am concerned about the possible risks, both aesthetic and physiological (risks of infection; encapsulation; contouring through the skin; excessive volume or, conversely, lack of it.), is it also possible to simultaneously perform genioplasty using alloderm (as I understand it, supraperiostatically)? Or should I not take the risk and just have two procedures (genioplasty and fat grafting) to get a guaranteed result? I thought about having two possible solutions to the problem, since I have a bone cleft in my chin (but I have read your articles and am aware that this may not always be the root cause, and even with the presence of a bone fossa, some people do not have it on their face or it is very poorly expressed, so I cannot be I am sure that it is my deepening of the bone that is responsible for the cleft of the chin on my face) and I do not know the root cause of its presence on my chin. I attached photos from the Internet with the results of the insertion of a filler for dimple correction (because my filler has already been removed, and I don’t have any suitable photos for comparison, but I have almost identical initial external cleft chin data and had almost exactly the same result.

I would also like to know about the correction of the labiomental sulcus, as I have already said, in the foreseeable future I plan orthognastic surgery with genioplasty, most likely the tactics of chin augmentation will be in the mini chin wing using allogeneic bone blocks in diastases and increasing the vertical height of the chin by onlay bone graft, also using alogenous or autogenous bone plates and most likely, my labimental crease is likely to increase due to this correction, and what is the best way to correct it? I’m leaning towards alloderm, because it can be used to cover up the irregularities of the onlay bone graft (perhaps I’m wrong) and at the same time eliminate the labiomental fold, but I can also consider a dermal fat graft and fat injection. I would like to hear your opinion as a surgeon, who is probably the best at this and has the most extensive experience in eliminating this aesthetic problem. Could you tell me from your experience what is the best way in this situation to eliminate and prevent the occurrence of labiomental fold, given my case. Where is it better to place the alloderm to avoid contouring: above the periosteum (as injections with fat and skin-fat transparency (in your article from February 2026)) or above the muscle, or under the periosteum? Is it also possible to do this in a place with genioplasty, or is it better to do it after? I would like to learn more about the risks of contouring alloderms (and other risks, too, both aesthetic and physiological) to eliminate the labiomental fold. I know that you said that the best option to eliminate this aesthetic defect is a skin-fat graft, because it gives a larger volume, etc., however, I will probably consider it last, because I am not satisfied with the risk of scarring, etc. Therefore, I want to find out which is better than alloderms or fat injections or their possible combination? But if you do them together, what is the best way to place them in soft tissues and again during/after surgery?

Another question about Alloderms, but already in the field of the infra-orbital edge, you say that this is a worthy alternative to implants and it can be supplemented by injecting fat or moving fat from the eyes, I would like to know a few important points: again, about the risks of contouring and the layer of superposition of alloderms and whether the previously performed Ultherapy in this area is a contraindication to if not, how long should I wait between these two procedures to avoid complications and so on? Thank you again for the opportunity to ask you a question!!!

A: I believe you are asking much more than one question. In that regard, I can make the following comments.:

1)if filler has been successful for a chin cleft improvement, then one could anticipate fat grafting will also. The question with fat grafting is whether it will persist longer than that of the injectable fillers.

2) The only procedure you can combine with the genioplasty for a chin cleft or a deep labiomental fold is fat injections.

3) No form of bone manipulation is going to improve a chin cleft or a deep labiomental full. Those problems have to be addressed with soft tissue management.

4) Alloderm is one form of soft tissue augmentation for a chin cleft or deep labi omental fold. However, it does require small, external skin incisions for its placement.

Dr Barry Eppley

Plastic Surgeon