Recessed Maxilla: Everything you need to know

Have you ever wondered, what is the math behind an attractive face? Is there any relevant theory or mathematical evaluation that can be done to prove the science behind attractiveness?

The answer is yes. There is! 

In this blog, we are going to be discussing how maxilla and forward facial growth play a pivotal role when it comes to your jawline and facial structure.

But first, let’s understand…

What is Maxilla?

The human skull is made up of 22 bones altogether, 8 of which are cranial bones and 14 are facial bones. Two of these facial bones are called maxillae, these form the upper jaw. The hard palate that is the roof of the mouth, is formed by the two palatine processes of the maxillae join together with the two palatine bones. 

maxilla

The maxillae are in touch with every facial bone except the mandible. The maxilla form most of the hard palate. In simpler terms, the upper jaw is called the maxilla and the lower one is called the mandible.

What is Recessed Maxilla?

A maxilla that is set back more posteriorly in the face is classified as a “Recessed Maxilla”. This converts into a longer and narrower facial structure.

Other than that, a recessed maxilla is typically smaller in comparison, more elongated, and further set back than an ideally developed maxilla. 

recessed maxilla

This results in various elements that are considered unappealing such as a long and narrow face, sunken cheekbones, recessed jaw, tired eyes, crowded teeth, and in some cases, a crooked nose.

How Does Recessed Maxilla Affect The Overall Face?

One of the major setbacks and the most problematic one about having a recessed maxilla is that it heavily affects facial attractiveness and causes quite some functional issues. 

Your maxilla forms the center of the face and covers a wide area. It also has an influence on all the other facial bones and hence, a recessed maxilla can tweak a lot when it comes to the appearance of your face.

recessed maxilla consequences

One of the traits of a recessed maxilla is having droopy eyes that constantly look tired. This takes place when the maxilla is not supported by the tongue, due to which it grows vertically (down) instead of horizontally (forward).

Another trait is a weak chin. The reason being that the development of the lower jaw, the mandible, is strongly related to the development of the upper jaw, the maxilla. If an individual has his/her chin set backward, it is likely due to a recessed maxilla. 

Another drawback of a weak chin caused by a recessed maxilla is an easily developed double chin. Even though the body fat might not be particularly excessive, it can still create an illusion of a double chin.

Consequences of Recessed Maxilla

There are several consequences of a recessed maxilla, some of which we already discussed while learning how a recessed maxilla affects the overall face. However, there’s more to it.

When your face starts downward growth, there are chances of excessive gum display. This happens when the maxilla is elongated and narrow.

In addition to the visual and aesthetic drawbacks, having a recessed maxilla is accompanied by a set of functional problems as well. 

For example, when the maxilla is situated backward than usual, it reduces the size of the airway which can cause sleep difficulties like- snoring and sleep apnea.

recessed maxilla sleep apnea

1 to 4 percent of children in the USA have sleep apnea. This problem is fueled with bad habits such as mouth breathing, the maxilla recession negatively impacts the airway.

Developing a recessed maxilla during puberty can impact an individual’s facial features a lot. This is the reason you might notice that some people look very different as an adult than what they looked as a child.

recessed maxilla mewing

Another functional issue that arises with a recessed maxilla is the temporomandibular joint (TMJ) syndrome. 33% of all people are affected by this syndrome in their lifetime. 

In this case, there is pain caused at the joint that connects the mandible and temporal bone. This is another unfortunate result of a recessed maxilla that might need surgical intervention to cure. 

Additionally, in some cases wherein the joint has been damaged severely, complete repair may be impossible.

What is Forward Facial Growth?

Forward growth is a very simple yet complicated concept. In theory, it simply means horizontal or forward facial growth which results in more space available for the teeth, airway, and tongue.

The examples of forward faces include having a firm under eye support, straight nose, matching lips, and a chin that is right below that lips. More importantly, the maxilla (upper jaw) and mandible (lower jaw) is extended well beyond the nasion.

What is nasion you ask? Nasion is the topmost point of the nose, between the eyebrows, where the skull and face meet. 

recessed maxilla test

By drawing a straight imaginary line down from that nasion reveals the extent of facial growth. The forward the face is from the line, the better the growth.

Recessed Maxilla Test | How to Measure Forward Facial Growth?

A popular forward growth analysis method is the Facial Plane in Photometric Analysis which makes measuring forward growth very simple. 

However, as simple and easy as this measurement is, it fails to provide any solid figures to work with and is significantly prone to error. This is because this method requires the head to be in an ideal state.

This ideal state or position of the head is getting harder and harder to achieve as forward head posture has become a pandemic of its own.

Forward head posture

Most people are tilting their heads backward subconsciously. This moves the forehead back and the chin ahead making the test results difficult to judge.

Due to this issue, even individuals suffering from a recessed face and forward head posture will seem to have a forward growth with this test. 

People with a bad posture have a hard time correcting this error before taking a side profile photograph. 

Some people choose to correct the picture afterward, by tilting the picture to the ideal position. Nonetheless, the results do not come out the best.

recessed maxilla test

As seen in figure (b) the facial line shows incredible facial forward growth, however,  by tilting the entire picture and correcting forward head posture, in figure (d) the new facial line reveals the true growth.

Cosmetic surgeons prefer using different methods of measurement to avoid all of this. Instead of drawing imaginary lines, they arrange angles. This provides valid numbers for valid assessment and cancels out the head tilt issue.

Facial Convexity Angle is one such measurement that works by measuring the angle between the 3 most prominent points on the face. The nasion, the upper and lower jaws. An angle in the range of 175° to 145° is constructed after connecting these points. The higher the degree of the angle the more is the forward growth.

In most cases, when roughly estimated, faces that were 165° and above had forward growth, and faces under that were identified as recessed. For example, in the two pictures below, the measurements are 174° for the first and 158° for the second. Hence, clearly, the first person has a forward face while the second one has a recessed face.

recessed maxilla test

Keeping in mind that this method did a good job illustrating the extent of forward growth on the two pictures above, it is important to know it is not perfect. Why? Because many factors can manipulate the results including a prominent brow ridge or an extremely recessed mandible.

recessed maxilla test

In the above image, it is clear that due to a prominent brow ridge, the facial convexity test indicates forward growth, however, after checking with the imaginary plane line we see that the face is somewhat recessed.

Both the maxilla and mandible can grow disproportionally, hence the terms retrognathic and prognathic appear in orthodontics. 

In fact, experts in orthodontics use two different angles, referred to as SNA and SNB during analysis, to determine facial positioning. 

These methods are highly complex and technical and give a more accurate measure as they require an x-ray for hard tissue points.

recessed maxilla test

The child in the above image has an upper jaw SNA angle of 78° and a lower jaw SNB angle of 75°.

And while all these methods are still not sufficient, to overcome these challenges cosmetic surgeons use additional measures to get an overall understanding of the face. 

These additional measures take into consideration various other factors such as the size and placement of the nose and lips.

Nonetheless, to a great extent forward facial growth is highly correlated with beauty and the Facial Convexity Angle is pretty effective in measuring the same. Below are some popular actors and their angles plotted to prove the above point.

Celebrities with Forward Facial Growth

Celebrities with Forward Facial Growth

How to Fix Recessed Maxilla?

Most of all facial growth completes between the ages of 12-18. Putting aside the option of surgery, there are only two potential areas for any possible improvement, the alveolar bone, and mandibular condyles. These two can remodel throughout your lifetime.

In some cases, treatments such as FAGGA (Fixed Anterior Growth Guidance Appliance) could be necessary. Apart from these treatments, the most important aid to long-term success is developing a proper oral posture and working on actions such as tongue posturing i.e. Mewing and swallowing.

Final Thoughts

Do remember, forward growth is not the ultimate measure of beauty. There are also people who have forward grown faces that are still not satisfied with the way they look and feel.

Additionally, it takes immense practice to understand the methods of identifying forward facial growth. It is recommended that you visit an orthodontics or orthotropic expert before considering any treatments.

The first and most important step would be to correct your posture and start practicing Mewing. 

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