Composite graft for the prevention and correction of a deep labiomental fold after advancement genioplasty

Abstract

When an advancement genioplasty exceeds 3-4 mm an unpleasant fold may arise between lower lip and chin, especially in patients with thin skin. To flatten the labiomental fold, a solid graft can be inserted into the concavity between alveolar process and chin prominence. An original technique is proposed that uses a composite graft made of a bone block fixed directly to the mandibular basal bone and covered with a layer of cartilage, to overcome the flaws associated with previously described techniques. This technique was used over a 7-year period to treat 38 patients, either to prevent or to correct an excessively deep labiomental fold after advancement genioplasty, or simply to fill an existing deep fold even though a genioplasty was not performed. Only two cases of failure occurred: one due to suture dehiscence, the other due to infection of the graft. The graft also provides support to the lower lip and corrects the sagittal discrepancy between the basal bone (i.e. chin) and alveolar bone (i.e. teeth and lower lip) that often coexists in these patients. The procedure takes only a few minutes and presents a minimal risk of complications; therefore, it can be considered a simple and effective technique.