The cheeks and the maxillae are derived from the maxillary prominences.

The maxillary
prominences enlarge considerably to develop the majority of the midface area in the
mature human face (Fig. 2.9) [10].
The distal nasolacrimal lacrimal system is formed by the fusion of the lateral nasal
prominence and the maxillary prominence and starts as a nasolacrimal furrow (Fig. 2.10). As
these two prominences fuse, a double layer of epithelium is trapped between them. At first,
this cord of epithelial cells is in a relatively horizontal orientation as depicted in Fig. 2.10, but
as the maxillary prominences develop and the midface enlarges, this cord of cells assumes a
more mature vertical position (Fig. 2.10). Near birth or soon after, this solid cord of cells
canalizes and forms the nasolacrimal duct [11].
Mandibulofacial dysostosis syndrome, also known as Treacher Collins syndrome, is a good
example of how insults at the embryonic stage can result in craniofacial deformities. This
condition can be induced when a 9-day-old mouse embryo (approximately equal to a 4-
week human embryo) is treated with retinoic acid. This produces a cell deficiency in the
proximal aspect of the maxillary and mandibular prominences (Fig. 2.11). This early
embryonic cell deficiency is manifested in the mature infant as the hypoplastic midface and
jaw area seen in this syndrome [12–14].

Eyelid and Orbital Development

Eyelid formation is closely related to the development of the eye. The eyes begin their
development as swellings called the optic placodes on the sides of the embryo’s forebrain
early in the fourth week of gestational age (Fig. 2.15a). Optic placodes later give rise to the
optic vesicles, which project from the sides of the forebrain. The optic vesicles’ surface layer
then invaginates to form the optic cups. As the optic cup begins its indentation, the
overlying ectoderm thickens and forms the lens placode. The surrounding edges of the optic
cup continue to migrate forward, and the lens placode is pinched off internally and migrates
to become the ocular lens (Fig. 2.15b, c). The ectoderm overlying the optic cup later
becomes the cornea. During the sixth week, small folds of surface ectoderm appear cranial
and caudal to the developing cornea, with a mesenchymal core (Fig. 2.16). These two folds
give rise to the upper and lower eyelids. They continue to grow toward each other, until
they meet and fuse together between weeks 8 and 10. They remain fused until the fifth to
seventh month, at which time they separate again (Fig. 2.17). During this period, muscle
cells originating from the mesenchyme begin to form the circular orbicularis muscle around
the palpebral fissure.