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Aesthetic Plastic Surgery

, Volume 38, Issue 1, pp 236–241 | Cite as

The Labial Aging Process: A Surface Analysis-Based Three-Dimensional Evaluation

  • Riccardo Rosati
  • Marina Codari
  • Francesco Maffessanti
  • Claudia Dolci
  • Virgilio F. Ferrario
  • Chiarella SforzaEmail author
Original Article Experimental/Special Topics

Abstract

Background

With increasing age, the smile becomes elongated and less appealing. Currently, several methods are proposed for analysis of lip morphology including lateral cephalograms, profile and frontal photographs, video images, and three-dimensional systems. Despite several descriptions of morphologic and histologic age-related changes in the literature, no scientific well-supported model of the labial aging process is reported.

Methods

For this study, 33 healthy volunteers were selected and divided into two groups according to age: a youthful group (ages 21–34 years) and an aged group (ages 45–65 years). Their dental and labial stone casts were obtained, digitized, and virtually reproduced using a computerized electromechanical digitizer and applying nonuniform rational B-spline geometry. To obtain a synthetic parameter describing local surface deformation, average curvature and curvature variability indexes were computed and compared.

Results

No significant age- or sex-related differences in the average curvature were detected. In contrast, the curvature variability was significantly greater in the young than in the aged subjects.

Conclusions

The labial arch surface remains macroscopically constant between the third and the sixth decades of life, but with local modifications that influence the standard deviation of its curvature. A high standard deviation described the protruding labial appearance of the young subjects, whereas a reduced one described the flat lips of the aged subjects.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords

3D Labial morphology NURBS Aging 

References

  1. 1.
    Abed Y, Har-Zion G, Redlich M (2009) Lip posture following debonding of labial appliances based on conventional profile photographs. Angle Orthod 79:235–239PubMedCrossRefGoogle Scholar
  2. 2.
    Bisson M, Grobbelaar A (2004) The esthetic properties of lips: a comparison of models and nonmodels. Angle Orthod 74:162–166PubMedGoogle Scholar
  3. 3.
    Caisey L, Gubanova E, Baras D, Lévêque JL (2008) Unexpected distribution of surface hydration level of the lip. J Eur Acad Dermatol Venereol 22:1159–1162PubMedCrossRefGoogle Scholar
  4. 4.
    Caisey L, Gubanova E, Camus C, Lapatina N, Smetnik V, Leveque JL (2008) Influence of age and hormone replacement therapy on the functional properties of the lips. Skin Res Technol 14:220–225PubMedCrossRefGoogle Scholar
  5. 5.
    De Menezes M, Rosati R, Baga I, Mapelli A, Sforza C (2011) Three-dimensional analysis of labial morphology: effect of sex and age. Int J Oral Maxillofac Surg 40:856–861PubMedCrossRefGoogle Scholar
  6. 6.
    Desai S, Upadhyay M, Nanda R (2009) Dynamic smile analysis: changes with age. Am J Orthod Dentofacial Orthop. doi: 10.1016/j.ajodo2009.01.021 PubMedGoogle Scholar
  7. 7.
    Edelsbrunner H (2001) Geometry and topology for mesh generation. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  8. 8.
    Faulkner JA, Larkin LM, Claflin DR, Brooks SV (2007) Age-related changes in the structure and function of skeletal muscles. Clin Exp Pharmacol Physiol 34:1091–1096PubMedCrossRefGoogle Scholar
  9. 9.
    Ferrario VF, Rosati R, Peretta R, Dellavia C, Sforza C (2009) Labial morphology: a 3-dimensional anthropometric study. J Oral Maxillofac Surg 67:1832–1839PubMedCrossRefGoogle Scholar
  10. 10.
    Fudalej P (2008) Long-term changes of the upper lip position relative to the incisal edge. Am J Orthod Dentofacial Orthop 133:204–209PubMedCrossRefGoogle Scholar
  11. 11.
    Greco TM, Antunes MB, Yellin SA (2012) Injectable fillers for volume replacement in the aging face. Facial Plast Surg 28:8–20PubMedCrossRefGoogle Scholar
  12. 12.
    Guerrissi JO (2000) Surgical treatment of the senile upper lip. Plast Reconstr Surg 106:938–940PubMedCrossRefGoogle Scholar
  13. 13.
    Iblher N, Kloepper J, Penna V, Bartholomae JP, Stark GB (2008) Changes in the aging upper lip: a photomorphometric and MRI-based study (on a quest to find the right rejuvenation approach). J Plast Reconstr Aesthet Surg 61:1170–1176PubMedCrossRefGoogle Scholar
  14. 14.
    Kobayashi H, Tagami H (2004) Functional properties of the surface of the vermilion border of the lips are distinct from those of the facial skin. Br J Dermatol 150:563–567PubMedCrossRefGoogle Scholar
  15. 15.
    Lowe NJ, Yamauchi P (2004) Cosmetic uses of botulinum toxins for lower aspects of the face and neck. Clin Dermatol 22:18–22PubMedCrossRefGoogle Scholar
  16. 16.
    Nakagawa K, Sakurai K, Ueda-Kodaira Y, Ueda T (2011) Age-related changes in elastic properties and moisture content of lower labial mucosa. J Oral Rehabil 38:235–241PubMedCrossRefGoogle Scholar
  17. 17.
    Peck S, Peck L (1995) Selected aspects of the art and science of facial esthetics. Semin Orthod 1:105–126PubMedCrossRefGoogle Scholar
  18. 18.
    Penna V, Stark GB, Eisenhardt SU, Bannasch H, Iblher N (2009) The aging lip: a comparative histological analysis of age-related changes in the upper lip complex. Plast Reconstr Surg 124:624–628PubMedCrossRefGoogle Scholar
  19. 19.
    Perenack J (2005) Treatment options to optimize display of anterior dental esthetics in the patient with the aged lip. J Oral Maxillofac Surg 63:1634–1641PubMedCrossRefGoogle Scholar
  20. 20.
    Pessa JE (2000) An algorithm of facial aging: verification of Lambros’s theory by three-dimensional stereolithography, with reference to the pathogenesis of midfacial aging, scleral show, and the lateral suborbital trough deformity. Plast Reconstr Surg 106:479–488PubMedCrossRefGoogle Scholar
  21. 21.
    Rosati R, De Menezes M, Rossetti A, Ferrario VF, Sforza C (2012) Three-dimensional analysis of dentolabial relationships: effect of age and sex in healthy dentition. Int J Oral Maxillofac Surg 41:1344–1349PubMedCrossRefGoogle Scholar
  22. 22.
    Sawyer AR, See M, Nduka C (2009) 3D stereophotogrammetry quantitative lip analysis. Aesthetic Plast Surg 33:497–504PubMedCrossRefGoogle Scholar
  23. 23.
    See MS, Roberts C, Nduka C (2008) Age- and gravity-related changes in facial morphology: 3-dimensional analysis of facial morphology in mother–daughter pairs. J Oral Maxillofac Surg 66:1410–1416PubMedCrossRefGoogle Scholar
  24. 24.
    Semchyshyn N, Sengelmann RD (2003) Botulinum toxin A treatment of perioral rhytides. Dermatol Surg 29:490–495PubMedCrossRefGoogle Scholar
  25. 25.
    Suryadevara AC (2008) Update on perioral cosmetic enhancement. Curr Opin Otolaryngol Head Neck Surg 16:347–351PubMedCrossRefGoogle Scholar
  26. 26.
    Van der Geld P, Oosterveld P, Kuijpers-Jagtman AM (2008) Age-related changes of the dental aesthetic zone at rest and during spontaneous smiling and speech. Eur J Orthod 30:366–373PubMedCrossRefGoogle Scholar
  27. 27.
    Van der Geld P, Oosterveld P, Van Heck G, Kuijpers-Jagtman AM (2007) Smile attractiveness: self-perception and influence on personality. Angle Orthod 77:759–765PubMedCrossRefGoogle Scholar
  28. 28.
    Vig RG, Brundo GC (1978) The kinetics of anterior tooth display. J Prosthet Dent 39:502–504PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2013

Authors and Affiliations

  • Riccardo Rosati
    • 1
  • Marina Codari
    • 1
    • 2
  • Francesco Maffessanti
    • 3
  • Claudia Dolci
    • 1
  • Virgilio F. Ferrario
    • 1
  • Chiarella Sforza
    • 1
    Email author
  1. 1.Dipartimento di Scienze Biomediche per la SaluteUniversità degli Studi di MilanoMilanItaly
  2. 2.Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB)Politecnico di MilanoMilanItaly
  3. 3.Centro Cardiologico Monzino IRCCSMilanItaly

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