Maxilla bone structure
Forward maxillary projection lifts the midface and shortens the apparent lower third. The scan does not measure the maxilla directly. Its closest reading is Midface Ratio, a vertical proportion read from a front photo and scored 0-100 against the first scans of about 2,100 RealSmile users.
Midface Ratio is the one RealSmile metric that relates to maxillary position. The report tags which readings are soft-tissue modifiable and which are structural.
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What the maxilla actually does
The maxilla is the largest bone in the midface. It is paired (left and right halves fuse at the intermaxillary suture in early development), holds the upper teeth, forms the floor of the orbit and the lateral nasal wall, and provides the skeletal support for the cheekbone complex above and the upper lip below. Anything that influences the midface contour passes through the maxillary position.
Forward maxillary projection (sometimes called forward growth) lifts the midface upward and outward, supports cheekbone projection from underneath, shortens the apparent vertical lower third, and prevents the soft tissue under the eyes from pooling. Recessed maxillary position (maxillary hypoplasia) drops the midface support, flattens the cheekbones, lengthens the apparent lower third, and often associates with a tired-looking eye area and a pronounced lower jaw relative to the midface.
The reference standards for maxillary position come from two sources. Farkas 1994 (Anthropometry of the Head and Face) compiled cephalometric and surface anthropometric norms across populations. Rohrich and Pessa 2008 (Plastic and Reconstructive Surgery) documented the midfacial fat compartments that overlay the bony maxilla and contribute to perceived projection.
What signals maxillary projection
Midface ratio
Vertical proportion of the middle third of the face (nasion to nose base, divided by total face height). Forward maxilla compacts this ratio; recessed maxilla elongates it. Scored against the first scans of about 2,100 RealSmile users.
Cheekbone projection
Forward-and-outward extension of the zygomatic complex, which sits on top of the maxillary support structure. High projection correlates with forward maxillary growth; flat or indented paranasal areas correlate with recession.
Mandibular plane angle
Lower jaw angle off horizontal in left-profile photos. Inversely correlates with maxillary projection in the profile photo. Steeper angles often indicate the midface is dropping while the chin is doing structural work alone.
Paranasal contour (proxy)
Surface contour around the alar base and the lateral nose. Flat or indented contours suggest maxillary hypoplasia; full or supportive contours suggest forward projection.
Upper lip support
Vertical position of the upper lip relative to the lower lip in profile. Maxillary recession often causes the upper lip to fall behind the lower; forward projection brings it forward.
Eye area tiredness (proxy)
Pooling of soft tissue under the eyes that often correlates with weak maxillary support of the orbital floor. A confound metric, not a primary maxillary measurement.
What is modifiable and what is not
The bony maxillary position is fixed in adults outside of orthognathic surgery (LeFort I advancement for severe maxillary retrusion). The soft-tissue presentation over the underlying skeleton is meaningfully modifiable. Body fat reduction sharpens the apparent midface contour by removing the soft layer that smooths over the bone. Posture work (chin-tucked neutral) lifts the head and reveals more of the midface in profile. Lip seal correction prevents the chronic mouth-breathing posture that drops the perceived midface support.
The report explicitly tags each maxilla-adjacent metric as structural (surgically gated) or soft-tissue (modifiable in 60 to 90 days), so the prescription lands on the right slab.
Honest limits
- True cephalometric maxillary position requires a lateral cephalogram or CBCT scan from an orthodontist or oral surgeon. A photo-based read is an estimate at best, and the RealSmile scan reads a front photo, so it does not estimate maxillary position at all.
- Severe maxillary hypoplasia (SNA angle below 78 degrees) often requires orthognathic surgical consultation.
- Adult maxillary position does not respond to mewing, jaw exercises, gua sha, or any non-surgical intervention. Soft-tissue and posture work can move the appearance of projection; the bone itself does not move.
- The Farkas reference is largely Caucasian-normed. The paid report does not split by ancestry: every metric is scored against one pooled group, the first scans of about 2,100 RealSmile users.
Maxilla bone structure FAQ
What does the maxilla actually do for facial structure?+
How is forward growth measured?+
Can adults change their maxilla position?+
Does mewing move the maxilla in adults?+
What does maxillary hypoplasia look like in a photo?+
What does the scan return for maxilla-related metrics?+
What does the $14.99 report add for this topic?+
Soft-tissue work can lift the visible midface noticeably. See what is in play.
Surgical-vs-soft-tissue split for your midface.
The $14.99 Looksmax Report tags each maxilla-adjacent metric as surgically gated or modifiable, names the two dragging your composite, and prescribes work ordered by expected impact.
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