Q: Dr. Eppley, I am soon going to undergo maxillomandibular advancement. I currently have an optimal amount of tooth show. In the post-op simulation, my philtrum lengthens a bit. I suspect this is due to the advancement vector being a little downward relative to my natural head position (which is about 6.5 degrees downward from the frankfurt plane). I am not yet certain this will look bad, but I have always had a strong dislike for long as well as convex philtrums. I am wondering:
1. Is it possible to shorten the philtrum without increasing tooth show? I find mixed answers when it comes to this.
2. Is it possible to turn a concave philtrum convex again, also without altering tooth show?
Depending on the effect of my maxillomandibular advancement on the philtrum, I may be interested in one or both of these.
I look forward to hearing your response.
A: In my experience 1) No and 2) No.
Dr. Barry Eppley
World-Renowned Plastic Surgeon
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