Relative maxillary retrusion as a natural consequence of aging: Combining skeletal and soft-tissue changes into an integrated model of midfacial aging

Joel E. Pessa, Vikram P. Zadoo, Keith L. Mutimer, Christy Haffner, Cheng Yuan, Adriane I. DeWitt, Jaime R. Garza

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

The contribution of maxillary retrusion to the formation of the nasolabial fold is evaluated in the present study. Clinical observation of patients from the craniofacial trait with concomitant maxillary retrusion revealed prominent signs of midfacial aging: specifically these individuals displayed a prominent nasolabial fold at an early age. This observation led to the hypothesis that relative maxillary retrusion occurs as a normal feature of the aging process. Retrusion of the lower facial skeleton below the soft tissue of the nasolabial fold causes the nasolabial fold to appear more prominent. To test this hypothesis, computed tomographic data were assembled retrospectively and included both males and females, young and old. The age range of the males (n = 14) was 18 to 24 years (young) and 43 to 57 years (old); the age range of the females (n = 14) was 15 to 30 years (young) and 43 to 57 years (old). All individuals had complete upper dentition and had no bony facial injury. Computed tomographic data were reconstructed into three-dimensional images, and a technique was developed to create a standardized lateral view which eliminated rotational variance. Analysis of anterior-posterior changes showed that there is a tendency for the lower maxillary skeleton at pyriform to become retrusive with age relative to the upper face in individuals with complete dentition. Findings were very significant for both males and females (p = 0.0001 and p = 0.002, respectively). In both groups, a slight increase in vertical maxillary dimension was noted, consistent with previous studies. It is suggested that relative maxillary dimension is a factor in the development of the nasolabial fold. The skeletal features of normal midfacial aging can be combined with the soft-tissue features such as ptosis and atrophy into an integrated model of midfacial aging. A model such as this has significance regarding both the timing and choice of procedure used to restore the aging midface.

Original languageEnglish (US)
Pages (from-to)205-212
Number of pages8
JournalPlastic and Reconstructive Surgery
Volume102
Issue number1
DOIs
StatePublished - Jul 1998

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Nasolabial Fold
Retrognathia
Dentition
Skeleton
Facial Injuries
Vertical Dimension
Three-Dimensional Imaging
Atrophy
Observation

ASJC Scopus subject areas

  • Surgery

Cite this

Relative maxillary retrusion as a natural consequence of aging : Combining skeletal and soft-tissue changes into an integrated model of midfacial aging. / Pessa, Joel E.; Zadoo, Vikram P.; Mutimer, Keith L.; Haffner, Christy; Yuan, Cheng; DeWitt, Adriane I.; Garza, Jaime R.

In: Plastic and Reconstructive Surgery, Vol. 102, No. 1, 07.1998, p. 205-212.

Research output: Contribution to journalArticle

Pessa, Joel E. ; Zadoo, Vikram P. ; Mutimer, Keith L. ; Haffner, Christy ; Yuan, Cheng ; DeWitt, Adriane I. ; Garza, Jaime R. / Relative maxillary retrusion as a natural consequence of aging : Combining skeletal and soft-tissue changes into an integrated model of midfacial aging. In: Plastic and Reconstructive Surgery. 1998 ; Vol. 102, No. 1. pp. 205-212.
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