What Is The Correct Procedure When A Receded Chin, Deep Labiomental Fold and Lower Lip Eversion Exists?
Q: Dr. Eppley, I have what I consider a receded chin, and I don’t care about anyone else’s opinion on it to be blunt. I want a more forward appearing lower jaw, and would like to get reconstructive jaw surgery, but if sliding genioplasty can create the profile I’m looking, then I would be willing to a less invasive surgery. My main concern with just genioplasty is the labiomental groove. Mine already bothers me a lot, and I need it to be much, much flatter. I’m also interested in Rhinoplasty but my main concern is my chin. I’ve attached a few pictures or my profile, as well as two edited photos to give you an idea of what I’m looking for.
A: When you a short chin, deep labiomental fold and lower lip eversion this is all a reflection of an overall short lower. What really improves the depth of the labiomental fold and the lower lip eversion is having the whole lower jaw come forward. As the lower teeth move forward this pushes the labiomental fold and the lower lip forward. Thus you ideally need a BSSO mandibular advancement…but it will not create by itself the chi projection you are showing. It would need to be combined with a sliding genioplasty also moving the lower jaw forward will not create that degree of chin projection.
The alternative to total lower jaw advancement is a sliding genioplasty combined with grafting of the bony stepoff with fat injections to the labiomental fold. This will not produce as good as a result of the labiomental fold correction as the combined lower jaw advancement and sliding genioplasty.
Dr. Barry Eppley