The Predictable Signs of Facial Aging

Sep 13

Facial aging is a complex, dynamic, and interrelated process involving bone, muscle, fat, and skin. These changes occur at different rates in different areas at different times. While each layer undergoes an aging process of its own, changes in one layer can cause a cascade of adaptations in neighboring structures. While the sequence of aging is quite predictable regardless of gender or race, differences between the extent and rates of aging vary amongst individuals.

Skin & Aging: Aging skin is affected by both intrinsic and extrinsic factors. Intrinsic aging affects individuals at varying rates and happens over time (i.e., natural aging). Extrinsic aging is a result of environmental exposures and lifestyle habits (i.e., sun damage, pollution, smoking). Intrinsic aging slowly develops fine lines, wrinkles, and distributed hyperpigmentation whereas extrinsic aging is associated with coarse, deep wrinkles and mottled hyperpigmentation.

Fat & Aging: Fat pads are categorized into two types: superficial and deep fat pads of the face. They help to provide facial volume and contour. Fat pads exist in compartments with superficial fat pads having smaller and more uniformly arranged fat cells that can move with the face. The deep fat pads are anchored to the bone and help to provide contour and support for overlying structures. Fat pad repositioning occurs because of bone remodeling, weakening of supporting ligaments, and descent of tissues from gravity.

Muscles & Aging: Facial muscles lie beneath our superficial fat pads and are responsible for facial expressions. As we age, the loss of facial fat in addition to the repetitive muscle contraction and changes in muscle tone result in the appearance of superficial and deep wrinkles.

Bones & Aging: The facial bones provide stability, structure, and definition to the face. With age, we lose support as the bones recede and remodel resulting in the repositioning of tissues. Despite the small magnitude of these changes, the effects are often dramatic. These bony changes are seen clinically as flattening of the forehead, flattening of the cheeks, deepening of nasolabial folds, loss of jawline definition, shorter chin length, and deeper tear troughs with a smaller and rounder eye shape.

Signs of Facial Aging: