Categorized | Wrinkles

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Improving That Deep Groove (Labiomental Crease) Below Your Lip

The labiomental crease is that horizontal indentation or groove below your lower lip. For some it is quite deep, for others it is barely noticeable at all. While there are anatomic reasons as to why it is there (It represents the junction between the horizontal orbicularis muscle and the vertical mentalis muscle), most people only notice it if they think it is too deep or prominent. A deeper labiomental crease may may an undesirable deep indentation or may make the chin look more prominent than it really is. For some, it merely makes them look older.

Softening of the deep labiomental crease can be easily done with any of the commercially-available injectable fillers. The more visous and longer lasting injectable fillers work best in this area. Treatment volumes are less than the nasolabial fold area, for example, usually about 0.5ccs or half a syringe worth. Injectable fillers such as Perlane, Radiesse, or Sculptra produce good long-term but not permanent results.

The deep labiomental crease cam also be treated with other types of materials, from natural to synthetic. These include off-the-shelf dermis (eg, Alloderm or NeoForm), dermal-fat grafts (strip fat grafts), fat injections, and synthetic implants. They all produce a lessening of the crease and some are more effective than others at it. I do not find dermal-fat grafts or fat injections as effective as I would have hoped. It is not possible to thread in as large a dermal-fat graft as is needed through very small incisions at the side of the creases. Fat injections do not seem to last very long in this area. Processed dermis or tubed synthetic implants (eg, Advanta) work the best for long-term results. Whatever material is used, it must be stiff enough to provide a good 'push' of the deep crease outward to seek visible results.

Because of the location of the labiomental crease, there is no bone-based approaches that will work. In fact, chin augmentations in some patients with a deep labiomental crease will worsen its appearance by actually making it 'deeper' as the chin tissues come forward.

Treatment of the labiomental fold is best with injectable fillers for a temporary effect or a synthetic implant for a more permanent solution.

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