The Philtrum

October 18, 2014

The Philtrum

The philtrum is a central groove located in between the nose and the upper lip. It is also known as infranasal depression. This is a feature that is observed in all mammals and is thought to provide necessary moisture to the nose pad. For mammals that depend on the olfactory sense, a moist nose pad holds much relevance. However, for humans the philtrum is more of an aesthetic feature than of any particular utility.

It helps to define the lips, especially the upper lip. When we move our lips the philtrum also moves and creates a natural impression. If you consider the face as a whole, the upper lip extends beyond the lower lip. The philtrum consists of two lines with a central dip placed vertically between the nose and the upper lip.

The philtrum dimple as well as the Cupid’s bow of the upper lip plays an important part in creating an impression of individual beauty. A flat philtrum is considered to be an indication of fetal alcohol syndrome as well as holoprosencephaly, a severe development disorder of the fetal brain. This along with other characteristic facial features can help doctors to make an early diagnosis of fetal alcohol syndrome. In fact, the University of Washington has developed a Lip-Philtrum Guide in which rank 1 is considered to be normal while rank 5 is the most severe form. A short philtrum is often indicative of Cohen syndrome as well as other genetic defects such as Chromosome 18q deletion syndrome, DiGeorge syndrome and Oral-facial-digital syndrome (OFD). Both, a short philtrum and a long one, along with other typical facial features, point towards rare disorders and need careful evaluation.

The philtrum can also be malformed in the case of cleft lips and cleft palate. Often a nose deformity coexists with cleft lips. Sometimes the philtrum may need to be reconstructed due to surgical removal of tumors. In rare cases the philtrum may just not be clearly defined and does not indicate any kind of disorder. Philtrum reconstruction is undertaken in cases of malformation by birth or by facial trauma. Several procedures exist and the choice depends on the facial anatomy, the extent of malformation and the skill of the plastic surgeon. The aim is not only outward beauty and symmetry but also maintaining proper functioning of the lips. Thus, it is a challenging procedure as it involves construction of the philtral ridge as well as the philtral dimple.

The philtrum, being a major component of facial beauty, is also a common site for piercings. Also known as medusa piercing, it generally involves a horizontal piercing in which the stud is positioned in the philtrum groove. Aftercare for medusa piercing is important as the inner surface of the piercing is within the mouth and needs extra care. It is difficult to eat or drink in the beginning and healing time can extend till 2 months or more. A smaller labret is inserted after 6 weeks after the swelling has subsided.


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