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Embryology · Head and neck: pharyngeal arches

The face: five prominences !

  • Process

The face forms between weeks 4 and 10 as five swellings fuse around the primitive mouth. If they fail to join, clefts appear.

Updated 2026-11-01

See it in 3D: Maxillae · Mandible · Frontal bone · Nasal bones · Nasal cartilages · Nasal septum · Zygomatic bones · Tear drainage · Orbicularis oris

What it is

The face is built around the stomodeum (the primitive mouth) from five prominences: an unpaired frontonasal prominence and paired maxillary and mandibular prominences from the first arch. Medial and lateral nasal prominences then form on the frontonasal one. Orderly fusion of these swellings in weeks 5 to 7 forms the upper lip and nose; failure gives cleft lip.

Key facts

  • The lateral nasal prominences take no part in the upper lip.
  • The face forms mainly between weeks 5 and 10.
  • The intermaxillary segment is the fused pair of medial nasal prominences and is continuous with the nasal septum.

Step by step

  1. End of week 4: the five prominences, filled with neural crest mesenchyme, surround the stomodeum.
  2. Nasal placodes appear on each side of the frontonasal prominence.
  3. Week 5: the placodes sink in (nasal pits), ringed by medial and lateral nasal prominences.
  4. Weeks 6–7: the maxillary prominences grow medially and fuse with the medial nasal ones, forming the upper lip.
  5. The two medial nasal prominences fuse deeply: the intermaxillary segment (philtrum, four incisors and primary palate).
  6. The nasolacrimal groove, between maxillary and lateral nasal prominences, gives the nasolacrimal duct.
  7. The mandibular prominences meet in the midline and form the lower lip and mandible.

What each facial prominence forms

ProminenceWhat it forms
Frontonasal (unpaired)Forehead, bridge of nose; gives rise to the nasal prominences
Medial nasal (paired)Philtrum, tip and columella of nose, premaxilla, primary palate
Lateral nasal (paired)Alae of the nose
Maxillary (paired)Cheeks, lateral upper lip, maxilla, secondary palate
Mandibular (paired)Lower lip, chin and mandible

Markers

  • Neural crest
  • SHH
  • FGF8
  • BMP4

Clinical notes

  • Cleft lip: failed fusion of the maxillary and medial nasal prominences, one or both sides.
  • Oblique facial cleft: failure of maxillary with lateral nasal prominence, along the nasolacrimal groove.
  • Median cleft lip: failure of the two medial nasal prominences; associated with holoprosencephaly.
  • Alcohol in week 3 harms the midline: the smooth philtrum and thin upper lip of fetal alcohol syndrome.

Test yourself

Think of the answer, then tap the question to see it.

Which prominences form the upper lip?

The two medial nasal prominences (philtrum) and the two maxillary prominences (sides).

Which developmental failure causes lateral cleft lip?

Failure of the maxillary prominence to fuse with the medial nasal prominence on that side.

What does the intermaxillary segment form?

The philtrum, the part of the maxilla carrying the four incisors, and the primary palate.

What does the nasolacrimal groove leave behind?

The nasolacrimal duct, with the lacrimal sac at its upper end.

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See it in 3D

The structures of Durgical's 3D anatomy where it is found.

← All of embryology

Educational content on embryonic development; not a guide to prenatal diagnosis or to medicines in pregnancy and no substitute for a health professional's advice. No doses are given.

Sources: Embryology, Face - StatPearls - NCBI Bookshelf (StatPearls Publishing (NCBI Bookshelf), 2024); Embryology, Craniofacial Growth, And Development - StatPearls - NCBI Bookshelf (StatPearls Publishing (NCBI Bookshelf), 2023); Langman's Medical Embryology, 13th ed., ch. 17: Head and Neck (Wolters Kluwer, 2015).

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Representative model, for educational purposes only.