Structural Changes in the Aging Face

3 Jan

Wrinkles and sun spots aren’t the only things we can expect to happen to our face as we age. There are many structural changes going on below the skins surface that contribute to an aging face that most people would never have noticed when they look in the mirror.

The young face on the left is round, contoured at the cheeks, and has a sharp jaw line (oh and hair and no wrinkles). The face on the right appears narrower, sunken, and droopy.

So besides the integrity of your skin, what else has changed?

Below the Skin

Bone Structure

Let’s start at the ground level. Your bones.

Your bones are always being built up and broken down. The rate at which the bone is broken down slowly starts to exceed the rate at which the bone is being built up as you age.

Bone changes cause:

  • a reduction in facial height
  • Increase in facial width and depth
  • The fat pad under the eye to bulge
  • A change in the shape and projection of the chin

Teeth

Injury and periodontal diseases result in loss of teeth, and it’s not like when you were young and the tooth fairy came and left you a dollar and a new tooth grew in (I hear with inflation it’s like $5 now!).

Loosing teeth affects the jaw bone and the muscles which attach to the jaw bone, which can result in make the face look narrower, hollow, and concave on profile.

Taking care of your teeth is super important, and not just for that pretty smile!

Fat Compartments

Collapsing fat compartments in the cheeks and temples reduce support to the overlying skin (side note: don’t worry! These fat cells go to other places… like your hips! j/k).

Splitting the face into thirds


Upper Third

Most people miss this when they look into the mirror at their aging face, but loss of fat in the temples results in the phenomenon I like to call “peanut head, ” which is also noticeable on super athletic people.

The presence of peanut head reflects a lack of support of the outer brow, which, along with loss of subcutaneous fat in the upper lid, causes the appearance of a droopy upper brow.

Blephroplasty anyone?  (Observing Surgery: Blepharoplasty.)

Middle Third

Eye sockets become wider and longer, resulting in a bulge of the cushiony fat pad that lies underneath the eye.

The cheeks start to flatten out, and the fat from the cheek descends to create a deep nasolabial fold.

The tear trough (area where eye skin and cheek skin meet) becomes noticeable. The middle third no longer has that fluid contour. This loss of fullness and form change causes shadowing in the trough, making a person appear to have dark circles, resulting in a tired appearance (just one of the things that causes dark circles).

Angles of the nose change, giving the appearance of increased length and the tip of the nose begins to droop.

Decrease of collagen and increase in tooth display at rest cause the upper lip to lengthen. Fun Fact: the upper lip can stretch by almost 4mm as you age.

(Stolen from another site…shhhh…) Image A shows a youthful face. Look at the contouring from the eye to the cheek. As you age, it can be convex like image B, which shows the fat pad bulging, or it can be concave like image C, making the eyes look hollow. Both B and C show a flat cheek when compared to Image A.

Lower Third

With all this stuff happening in the upper portions of the face, skin sags and starts to hang in the lower third. Adding insult to injury, the angle of the jaw changes, the jaw line, becomes less defined, and the chin shortens. Excess skin droops from the jaw line from gravity and loss of elasticity. Loss of ligament support in the jaw leads to the formation of jowls.

Even with droopy skin, the lower portion of the face starts to look smaller than the upper and middle third.

advancedskinwisdom.com a

(This image was also stolen).

What are your options?

Don’t worry. There are things you can do for volume loss! They do NOT include Oil of Olay, although the new commercial on tv claims it can (they lie).

Injections

For advanced volume loss, Sculptra is really the best injectable product. This product is a biostimulator; it works by stimulating your body’s own natural collagen. Results are the most natural of all the fillers, and the product lasts 2 years. I plan on writing a lot more about Sculptra, so stay tuned!

If you aren’t mentally or financially ready to jump into Sculptra, Radiesse is a wonderful thick, volumizing filler. It is usually my product of choice for cheek augmentation, naso-labial folds, and marionette lines.

For tear troughs, I LOVE Belotero (which is made by the same company as Radiesse). Filling this area literally takes ten years off your face, but remember, it is a very advanced procedure. Stick to a friend’s referral as to who to go to; I have seen a lot of over treated troughs!

For more help with fillers, check out What Goes Where?.

Surgical

Another option is fat transfer. I have assisted Dr. Russo in several fat transfers; it is a very interesting procedure. If you are planning on liposuction, I highly suggest inquiring about fat transfer as well.

For sagging skin around the neck and jaw line, surgery is the only real option to date.

XOXO, old LK

(I found the ‘Age My Face’ Ap… yes… there’s an ap for that!)

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One Response to “Structural Changes in the Aging Face”

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