What Type Of Implant Is Best For Labiomental Crease Augmentation?

Q: Dr. Eppley, my labiomental crease is very deep and I don’t like it. When you look at me you would first think that I have a big chin. But then when you look at the rest of my face you see that compared to everything else my chin is fine. My labiomental crease is so deep probably because my teeth are located far back in my head. And it looks like I have an overbite, but I really do not have one. I would be very interested to hear what you could do to improve this. I know that fat transfers do not last in this area, so I am looking for some kind of implant for a permanent result.

A: Based on your side profile, one reason your labiomental crease is deep is because of your prominent chin. The more chin projection one has, the deeper the crease will be. Otherwise, a Class II malocclusion can be a cause due to the overprojecting front teeth and the recessed lower teeth…but this does not seem to the case in you.

Short of a chin reduction, reduction of the depth of the labiomental fold can only be done by some type of implant. But the implant can not be primarily bone-based because the labiomental fold is not influenced much by bone augmentation as it is a soft tissue structure situated just in front of the anterior mandibular vestibule. Over the years, I haved used many types of implants from fat injections, intraoral dermal-fat grafts, mersilene mesh bone augmentation, and Advanta (Gore-ex) tubular implants. Of all of these, I have found that Advanta implants work best because they are placed directly under the skin and have permanent volume.

Dr. Barry Eppley

Indianapolis, Indiana