Anatomy of Facial Aging
You can usually make a rough estimate of someone's age with just a glance at their face.
How? The tissues and proportions of the human face change from infancy to old age in all three dimensions. Babies and young people have smooth, uninterrupted facial contours while older people's faces develop depressions that cause shadows and sagging.
Much of the cause of why a face looks older is due to the loss of underlying volume.
Volume Loss in the Aging Face
In the last few years, research has shown that fat in the face is partitioned into separate compartments in two layers, with the superficial fat compartments on top of the muscles and the deep compartments below.
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 along the ligaments.
These grooves break up the previously smooth contours of the youthful face into hills and valleys associated with an older 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.
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.
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 becomes flatter.
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. Skin cells turn over slower leading to dull appearing skin and delayed healing. And, for icing on the cake, benign growths like crusty seborrheic keratoses and cherry angiomas occur more commonly in older adults.