Physical examination findings included: a pointed forehead, bilateral ptosis, arched eyebrows, synophrys, a small upturned nose, long philtrum, and a thin upper lip. ( Table 1; Figure 2a ). The proband has a positive family history of metopic ridging, which affects her elder sister (IV2), father (III2), and paternal great grandfather (I1). The fimbriated fold hangs under the tongue, just like how skin tags hang off the skin. Some people develop more or less 1cm long flaps of skin, and they appear in pairs. They are located on each side of the frenulum, which is a tissue that connects the bottom of the tongue to the inside of the mouth. They may even appear up to 4 or more sets. Cancers of the lower lip have a better prognosis than those of the upper lip. Chronic sun exposure is the most common cause, but smoking can also be an etiology. ... Ankyloglossia or a persistent lingual frenulum is a congenital persistence of tissue which binds the tongue to the floor of the mouth. When severe, the frenulum should be cut to.