Facial esthetics are most often judged by clinicians by measuring the position and form of the parts of the face and teeth. Whether its cephalometric analysis or Smile Design, these diagnostic and treatment approaches only focus on form and position. A mostly ignored aspect of facial esthetics is function. While the lips and teeth, if measured, might be found in a “proper” position, if they do not fit the patient’s overall system they will never look esthetic. This is what is meant by functional esthetics.
The lips are an important functional unit when it comes facial esthetics. Lip function, form and position are all influenced by the teeth and their fit, the temporomandibular joints, the airway and the skeleton. If this system is not working correctly, it will be seen in the lips. If the lips are not working correctly, the system can break down.
In this patient, orthognathic surgery positioned the bones and teeth in such a way that his lips can now close without using his facial muscles. Before surgery he would use his upper lip (which causes nasal narrowing and nasolabial folds), his mentalis or chin muscle (which causes dimpling and balling) and his mandible (which causes muscle pain and joint noises) when he closes his mouth. Now with his lips touching passively, the nasolabial folds are flattening, the chin is more relaxed and esthetic and his mandible is comfortable. This is Functional Esthetics.