Fat grafting labiomental fold- WE NEED TO DISCUSS THIS

[Optimistic]

Let's be real, deep labiomental folds are a symptom of not just boney deficiency (underbite) but also of soft-tissue deficiency. I'm starting to think that when people like us are advancing our chins forward 1cm+ we are only causing the little soft-tissue we have there to become stretched. This means that even when we achieve a normal boney profile the fold may remain deeper than we like.

I believe the solution must be a combination of surgery + fat grafting.

http://exploreplasticsurgery.com/tag/labiomental-fold/

Has anyone tried this before? Once my swelling from this operation goes down I'll likely be seeing a surgeon for this.

[Optimistic]

Bump.

[needadvancement]

What a great idea, I didn't think of that before. I'd recommend it if a skilled surgeon offers it.

[Schrödingers Jaw]

Fat grafting has the advantage of being permanent, however I've heard it is difficult to get right and carries some unpredictability with it.

[Optimistic]

Interesting and relevant article regarding facial types and soft-tissue thickness of the chin: http://www.angle.org/doi/pdf/10.2319/062613-474.1

Fat grafting has the advantage of being permanent, however I've heard it is difficult to get right and carries some unpredictability with it.

Yes. Apparently the best choice would be a temporary filler to trial things out, then fat grafting. My understanding is fat grafting has some reabsorption, what's more is nothing is worse than over-filling. So multiple procedures are probably required to get it right. I think too that so-called micro fat grafting is best as it causes a lot more scar tissue to form which itself adds permanent volume to the area.

[Schrödingers Jaw]

Interesting and relevant article regarding facial types and soft-tissue thickness of the chin: http://www.angle.org/doi/pdf/10.2319/062613-474.1

Yes. Apparently the best choice would be a temporary filler to trial things out, then fat grafting. My understanding is fat grafting has some reabsorption, what's more is nothing is worse than over-filling. So multiple procedures are probably required to get it right. I think too that so-called micro fat grafting is best as it causes a lot more scar tissue to form which itself adds permanent volume to the area.

As I understand it's not a fully mastered or understood technique so there is a challenge in finding a skilled (enough) surgeon as well. If you do please let us know, my folds are beginning to show.

[Optimistic]

As I understand it's not a fully mastered or understood technique so there is a challenge in finding a skilled (enough) surgeon as well. If you do please let us know, my folds are beginning to show.

How long post-op are you?

[Schrödingers Jaw]

How long post-op are you?

I've had nothing done to my folds yet, they're only visible in certain lighting. This thread is for future reference as far as I am concerned.

Besides I want to see how my soft tissue changes after I get work done on my cheekbones before I transplant any fat to my face. Without good bone support one cannot properly spot soft tissue deficiencies anyway.

[Purist]

Don't chin shield/visor oesteotomies reduce the labiomental depth too? Not sure if it is a common procedure though?

[kjohnt]

I personally do not believe that a deep fold can be attributed to soft tissue deficiency.  I believe it is a bone deficiency issue in all cases and can be resolved via sliding genioplasty to add height and projection, and perhaps along with mandibular advancement when needed.  This is just my opinion and I could very well be incorrect.

[sean89]

I think fillers are the best option for this. Seems to be such a simple correction that can avoid the risks of an osteotomy.

[Optimistic]

I think fillers are the best option for this. Seems to be such a simple correction that can avoid the risks of an osteotomy.

No way to properly re-contour the entire chin with filler though. At least as far as I'm aware.

I've thought about this some more and I think in reality bone-grafting is the solution. Re-contour the chin to be as it should and the groove will disappear. This is the rule. There seem to be some legitimate exceptions whereby a chin is full in profile yet still has a deep groove. Then I can see some filler helping.