Premaxilla and anterior nasal spine: anatomy
- Highlighted area
Quick facts
- Definition
- Anterior and central portion of the maxilla, which supports the upper incisors and the base of the nose.
- Anterior nasal spine
- Bony projection on the midline, at the lower edge of the piriform aperture, just behind the base of the columella.
- Supporting structures
- Base of the columella, of the nostril wings and of the upper lip.
- With age
- Bone resorption of the anterior maxilla tends to reduce this support.
- Relevance in HOF
- Influences the nasolabial angle and the position of the nasal tip; a high vascular risk area.
The premaxilla is the anterior and central portion of the maxilla, the area of bone that supports the upper incisors and, above them, the base of the nose and the upper lip. At the center of its upper edge sits the anterior nasal spine, a small bony projection on the midline, just behind the base of the columella. In orofacial harmonization (HOF), the area matters because this bony support influences the nasolabial angle, the position of the nasal tip and the look of the upper lip.
What does the word premaxilla mean?
In embryology and anatomy, the premaxilla (or incisive bone) is the part of the maxilla that carries the incisors, formed separately and joined to the rest of the bone by the incisive suture. In aesthetic practice, the term is used more broadly for the bony area below the base of the nose, around the anterior nasal spine and the lower edge of the piriform aperture.
| Structure | Where it is | Why it matters |
|---|---|---|
| Anterior nasal spine (ANS) | Midline, lower edge of the piriform aperture | Support for the base of the columella; cephalometric point |
| Edge of the piriform aperture | Bony outline of the nasal entrance | Support for the nostril wings and the start of the nasolabial fold |
| Incisive fossa | Above the roots of the incisors | Origin of the depressor septi nasi muscle |
| Anterior alveolar process | Around the roots of the incisors | Support for the upper lip |
What changes with age?
The maxilla loses volume with aging, and the area around the piriform aperture is one of those that recedes the most. With less support, the base of the columella and the nostril wings lose their footing, the tip can look lower and the nasolabial angle can become more acute. The upper lip also loses projection, and the start of the nasolabial fold tends to deepen. Loss of front teeth and resorption of the alveolar bone add to the effect.
Why does it matter in HOF?
- Nasolabial angle and nasal tip: support at the base of the columella can open the angle and improve the relationship between nose and lip. It is one of the areas described in nonsurgical rhinoplasty.
- Upper lip: part of the lack of lip projection comes from the bone, not from the lip itself. Volume in the lip does not replace support at the base.
- Upper nasolabial fold: the portion near the nostril wing depends on the bony support of the area.
How does it show up in the assessment?
- Profile: nasolabial angle, position of the base of the columella and projection of the upper lip.
- Incisor exposure: teeth tilted backward or missing reduce lip support.
- Dental and orthodontic history: extractions, prostheses, front implants and maxillary surgeries.
- Existing imaging: dental X-rays and CT scans show the thickness of the bone in the area.
Also called: incisive bone, nasal base area, anterior nasal spine (ANS), premaxilla.
Frequently asked questions
What is premaxilla filler?
It is the use of filler in the area at the base of the nose, in front of the anterior nasal spine, to support the columella and the upper lip and to modify the nasolabial angle. It is a high vascular risk area, and the indication and technique are the decision of the qualified professional.
Where is the anterior nasal spine?
On the midline of the maxilla, at the lower edge of the nasal opening in the skull, just behind the base of the columella. It is also a cephalometric point (ANS).