Will A Vertically Lengthening Bony Genioplasty Help My Lower Lip Problem?
Q: Dr. Eppley, I thought it might be possible to have some form of genioplasty, sliding the chin down slightly to lessen the angle of the chin from the side. I thought moving the chin down slightly might reduce the amount of compression of the lower lip. As for the alignment of the lips I thought I might use a fat transfer or filler to align the lips. (at a later date)
A: Your concept of moving the bony chin downward (vertical lengthening bony genioplasty) to try and drop the lower lip down with it is one that on the surface makes anatomic sense. In theory one would think there would be some relationship between the bottom position of the chin and the position of the lower lip. However in dong many vertical lengthening chin osteotomies with interpositional grafts, some up to almost 20mms, I have yet to see the lower lip pull down. (which is actually a theoretical concern about vertical chin lengthening) What that is good news for those patients with normally positioned lips, it may not be good news for someone who has your lip positional issues and is trying to change them. However I am quick to add have I ever done this operation in someone with your specific lower lip issues with that being goal.
Such an operation only makes sense for you if there is an aesthetic reason to vertically lengthen the chin. Then even if the lower lip position is not improved there would still be benefit from the surgery. In your face that is already long and narrow, such an aesthetic change would not seem beneficial.
Dr. Barry Eppley