The average face is convex, curving outward with the apex at the top lip, as shown in the illustration below.
Building up the skeleton around the nasal opening – or pyriform aperture augmentation – will enhance appearance when the lower part of the midface is flat or concave. It supplements the midface bone structure, corrects the angle of the upper lip, elevates the tip of the nose, and minimizes laugh lines (known in medical terms as the nasolabial fold).
Pyriform aperture augmentation transforms the lower midface from one that is flat or concave to one that is convex, adjusting and enhancing facial proportions.
Because they change the proportions of facial features, paranasal implants can often be a useful addition to aesthetic rhinoplasty. In patients with a flat or concave face, the nose appears larger than it would be if the soft tissues next to it were more prominent. Pyriform aperture augmentation in patients with this facial shape allows a less aggressive surgical approach to the nose while providing an overall better facial balance.
The patient’s previously flat lower midface is now convex, the nasal tip is elevated, the angle of the upper lip is increased, and the nasolabial fold is less prominent.