title: Changes in the aging upper lip--a photomorphometric and MRI-based study (on a quest to find the right rejuvenation approach).
abstract: BACKGROUND
  A lack of scientific data about the complex three dimensional changes in relation to the rest of the face is the reason for the multitude of rejuvenation approaches to the aging upper lip. In this study the underlying anatomic changes and facial proportions of the senile upper lip are scientifically evaluated for the first time.
  
  
  METHODS
  (1) In 182 standardized subject photographs proportions of the upper lip were measured, compared to facial dimensions and correlated to age. (2) In cranial MRI scans of 30 women aged 20-35 and 30 women aged 65-80 relevant anatomical dimensions were measured.
  
  
  RESULTS
  Both studies showed a statistically significant lengthening of the aging upper lip. The photomorphometric study further shows an increase of prolabium skin at the cost of a decreasing visible upper lip vermilion. The MRI scans showed a decrease in thickness. A loss of volume could not be shown.
  
  
  CONCLUSIONS
  Isolated volume augmentation is not a causal method of upper lip rejuvenation and it may therefore rather lead to an unnatural 'blown up' look.
authors.affiliation: Department of Plastic Surgery, University of Freiburg Medical Center, Germany. niklas.iblher@uniklinik-freiburg.de
authors.forename: Niklas
authors.initials: N
authors.lastname: Iblher
authors.forename: Jonas
authors.initials: J
authors.lastname: Kloepper
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Penna
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Bartholomae
authors.forename: G Bjoern
authors.initials: GB
authors.lastname: Stark
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000886:Anthropometry; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008046:Lip / Q000033:anatomy & histology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015595:Skin Aging / Q000502:physiology*