The Anatomical Changes of Facial Aging
You can usually estimate someone’s age with just a momentary glance at their face. How? Facial proportions, skin texture, and sometimes skin color change drastically between childhood and old age.
Babies and children have smooth, uninterrupted facial contours while older people’s faces develop depressions that cause shadows and sagging. Smooth, highly elastic skin eventually becomes flaccid and thin, with enlarged blood vessels, brown spots, and bumpy growths.
Volume Loss in the Aging Face
Much of what produces the three-dimensional changes seen with facial aging is the loss of fat and bone volume that supports the skin.
One of the cruelties of aging is that we tend to lose fat from the upper & mid-face before losing fat in the lower face. The inverted triangle shape of the youthful face becomes more of a square as we age, with our cheeks becoming our jowls and our lower facial skin slipping down under our jaw.
In the last few years, research has shown that fat in the face is partitioned into compartments in two layers, with the superficial fat compartments on top of the muscles and the deep compartments below, with each contributing to the overall proportions of the face.
The deep fat pockets begin deflating at different ages starting with the fat under our eyes in our twenties and followed in our thirties by fat in the temples and parts of the cheeks.
The superficial fat tends to persist unless there’s major weight loss. With the loss of deep fat the superficial fat loses some of its underlying structure and starts to sag.
Ligaments attach the skin to the bone at the borders of the fat compartments, and as the fat in the compartments shrink and the skin is no longer filled out, grooves develop where the skin is tethered.
These grooves break up the previously smooth contours of the youthful face into the hills and valleys associated with an aged face.
To understand how much volume we’re losing from our face, consider that we lose about 1 teaspoon of fat & bone each year after the age of 25 so that by the age of 50, we’ve lost about 1/2 cup of facial volume.
Besides fat, we also start losing facial bone as we age, which is the frame upon which our facial fat, muscle, and skin is suspended.
Like fat, some bony areas start to shrink faster than others, especially around the eye sockets, under the nose, around the mouth & chin, and the outer jawline.
As the frame of bone and fat shrink, the skin sags downward and the front of the face appears flat from the side.
Skin Changes With Aging
With aging, the skin gets may thin up to 80%, its texture becomes rougher and it loses some of its elasticity, especially in sun-exposed areas. Oil glands produce less oil so the skin becomes drier and skin color looks more mottled as the pigment production becomes erratic. Blood vessels may become dilated and visible, especially around the nose. Skin cells turn over slower leading to dull, rough skin at the surface and growths like crusty seborrheic keratoses and cherry angiomas occur more commonly in older adults.
So how do we reverse these changes so that we don’t look our age?