Facial profile relationship to extraction treatment.  Facial profile and lip fullness go hand in hand with skeletal and dental positions.  When a thin or retracted lip appearance is present we try our best to treat the patient on a non-extraction basis.  Likewise, when there is a very protrusive lip pattern we consider premolar extractions a bit more often.  If severe crowding is present, extractions will not change the lip pattern much because most of the extraction space is utilized to uncrowd the dentition.  This can be both a blessing and a curse.  In thin lip patterns you will not lose lip support by pursuing extraction orthodontic treatment.  Likewise, with very protrusive lips you will not get as much softening as you might desire.  Another item to consider is the nasolabial angle (angle between the bottom of the nose and upper lip.)  An obtuse nasolabial angle (with upturned nose) requires careful consideration before removing premolars for treatment.  Next week we'll consider the relationship of the lower incisor to facial profile changes.