The Ageing Face – Heading south for the winter.

As Chaucer famously wrote “time and tide wait for no man”, and so it is that we all must endure the face looking back at us in the mirror becoming more and more unfamiliar as the years go by.

And while many people embrace the laughter lines and softer angles; after all they are beautiful, there are also those of us who want to slow down the process and maintain our youthful appearance for as long as possible.

To achieve natural-looking aesthetic results treatments should target the anatomical changes associated with age, not just simply treat the symptoms. A thorough understanding of these changes is essential.

Read on to find out about the physical changes our faces undergo, and in the next blog post we will consider options to minimise these changes.

The ageing process is slow and multi-faceted occurring even at a cellular level. Here we will explain the 4 main facial structures and how they are affected.

Bone

Fat pads

Muscles

Skin

Bone and skeletal changes

Bone density decreases and actually recedes, this is how age estimates are able to be made from human remains. Notably the eye socket becomes larger resulting in eyes appearing smaller and hollowing below the eyes.

The maxilla (bone that supports the mid-face) and jaw bone also recede which contributes to lines around the mouth and jowling.

(the above image shows CT scans of a young female on the left approx. 20-40 years old and an older female ages 60+ on the right. Notice the larger eye sockets, smaller cheekbones and change in the angle of the jaw )

Fat pads of the face

There are 2 layers of fat pads in the face, deep and superficial. The deep fat pads tend to shrink, while others are pulled downwards (thanks to gravity and lax ligaments) and cause jowling, nasolabial folds and eyelid hooding.

(Note how the fat pads appear smaller and move down the face as we age)

Facial muscles

The face has a complex muscular structure, allowing us to move our faces dynamically, this is extremely important for facial expressions, talking, eating and drinking. The repetitive movements of these muscles lead to fine lines and eventually deep-set wrinkles visible even at rest.

The skin

Collagen is vital for elasticity, loss of collagen in the skin begins slowly from our mid-20s and speeds up as we age, after menopause collagen can decrease by up to 75% per year! Hyaluronic acid keeps our skin plump and hydrated, from around 35 years of age production slows down. The lack of these 2 skin heroes leads to dry, sallow skin and laxity.

As you can see causes of an ageing face are multi-factorial and thus a good treatment plan must address all these things or results will be sub-optimal.

In part 2 of this blog we will discuss treatment options.