Hello Dr. Mason, I have a question about philtrum growth and measurement. 15 mm is what we look for, but does this change with age and as the face grows?
Thank you for your wisdom!!
Thanks for your question. First, a few facts as background information: the maxilla has almost completed its growth by age seven, with just a little more growth between ages 8 and 12. By contrast, the mandible has a pre-pubertal and pubertal growth spurt and mandibular growth can continue well into the twenties. In addition, the face increases in vertical length that can continue up to and beyond age 16. The face can be separated into thirds, with the upper face extending from the hairline down to the eyebrows, while the midface is between the eyebrows and the base of the nose, and the lower third of the face can be further divided into thirds, with the lips positioned at the upper third of the face. In women, the lips often are located more at the upper half of the lower face due to the fact that the chin does not grow as much vertically.
Having said all of that, and knowing that individuals past age 16 tend to not change much in facial features, especially in the midface and maxilla, one would not expect much if any additional vertical growth of the maxilla with age. Generally, as the maxilla grows, the upper lip follows along. We know that since we see a stable relationship between the amount of upper teeth showing when a person purses their lips. The amounts to about 3 mm. With lips together, the lower lip will then cover 3 mm of upper teeth in a well balanced face.
To specifically respond to your question, your 15 mm philtrum measurement will be expected to remain stable over time since the midface will essentially stop growing after age 12. The additional vertical growth of the lower face that will result in the lips appearing to “rise” on the face as a product of mandibular growth at the chin, does not influence the upper lip or the maxilla to continue to grow as well. Data from a study by Vig and Cohen showed, in their 1979 article, that lip growth may continue up to age 17, but usually, not beyond.