Midface

The midface is the middle third of the lateral profile, running from the glabella down to the base of the nose and upper lip. It covers the projection of the nose, the support under the nostrils (paranasal region), and — most importantly for orthodontic diagnosis — the nasolabial angle, which describes how the base of the nose relates to the upper lip.

This region sits directly above the dentition, so it is unusually sensitive to orthodontic decisions. Moving the upper incisors forward or backward, or extracting teeth to create space, changes the support given to the upper lip and can visibly change the nasolabial angle — making the midface one of the profile zones most directly influenced by treatment planning.

What It Evaluates

On the lateral photo, the clinician assesses how much the nose and the area just beneath it (paranasal/infraorbital support) project forward, where the base of the nose sits relative to the upper lip, and the angle formed between the two. This tells the clinician whether the maxilla and upper lip are appropriately supported, under-supported (flat, retrusive midface), or over-supported (bulging midface).

Learn more: Custom Infraorbital–Maxillary Implants - Case Example and Design Principles — Explore Plastic Surgery

Key References / Landmarks

Subnasale (Sn) — the point where the nasal septum meets the upper lip; the vertex of the nasolabial angle.
Columella (Cm) — the tissue forming the lower border of the nose; one arm of the nasolabial angle is drawn tangent to it.
Labrale superius (Ls) — the outer, forward-most point of the upper lip; the second arm of the nasolabial angle runs tangent from here through subnasale.
Nasolabial angle (NLA) — formed by the columella and upper-lip tangent lines meeting at subnasale; commonly cited normal values are around 100–105° in women and 90–95° in men (Fradeani), with an overall average near 102° ± 8°.
Labial vs. nasal component of the NLA — the angle can be split into a labial component (driven by upper incisor position and lip thickness, and therefore modifiable by orthodontic tooth movement) and a nasal component (determined by nasal shape, not changed by braces or aligners).

Learn more: Nasolabial Angle: How It's Measured & What It Does to Your Profile — Qoves Studio

Clinical Interpretation

Because the labial component of the nasolabial angle is influenced by incisor position, this measurement is one of the few soft-tissue profile parameters an orthodontist can predictably move. A very acute (small) NLA often suggests proclined or protrusive upper incisors, while an obtuse (large) NLA may point to retrusive incisors or a deficient maxilla. Extraction-based treatment plans that retract the upper anterior teeth will tend to open (increase) the nasolabial angle, which is why this measurement is frequently checked before deciding between extraction and non-extraction approaches — over-retracting the incisors in a patient with an already-obtuse angle can flatten the midface and age the profile, while under-retracting in a patient with a very acute angle may leave the lips looking strained or protrusive.

Learn more: Extract why? Extract why not? Facial changes and orthodontic extractions — Orthodontics in Summary