Facial bone structure and the aging face
Beyond surface-level wrinkles, the fundamental framework of the face—the bones—changes over time. The delicate balance of bone formation and resorption that maintains a youthful structure shifts, with resorption beginning to dominate as we get older. This leads to a gradual reduction in bone mass and density, particularly in key areas that support the soft tissues of the face. The result is a diminished bone scaffold that can no longer provide the same support, causing the overlying fat and skin to sag and shift.
The impact of bone resorption on facial features
Specific areas of the facial skeleton are more susceptible to bone loss, leading to predictable and identifiable signs of aging:
- Enlarged Eye Sockets (Orbits): As the bone around the eye sockets resorbs, the orbital rim widens. This makes the eyes appear more sunken and can contribute to the formation of under-eye hollows and bags.
- Flattened Cheeks: The loss of bone in the midface and cheeks (zygoma) reduces their projection and fullness. This flattening contributes to the descent of soft tissue and the deepening of nasolabial folds.
- A Retrusive Jawline: The jawbone (mandible) loses height and length, especially around the prejowl area. This diminished bony support accentuates jowling and creates a less defined jawline.
- Receding Maxilla and Nasal Changes: The upper jawbone (maxilla) can also recede, which weakens the support for the nose and upper lip. This contributes to the apparent lengthening of the nose and the deepening of lines around the mouth.
Understanding the changes in facial fat pads
Facial volume loss is perhaps the most widely recognized contributor to a shrinking facial appearance. In our youth, fat is evenly distributed in distinct pads that create smooth, plump contours. However, with age, these fat pads undergo two significant changes:
- Atrophy (Shrinking): Some fat pads, particularly those in the cheeks, temples, and around the eyes, lose volume and diminish over time. This fat atrophy directly causes a deflated, hollowed-out look.
- Descent (Shifting): At the same time, gravity causes the remaining fat pads to shift downward. This downward migration of tissue leads to the accumulation of fat in the lower part of the face, contributing to jowls and a heavier jawline.
This redistribution of fat and the overall volume loss create a shift from the youthful 'triangle of youth,' which features prominent cheeks and a tapered jawline, to an inverted, bottom-heavy 'pyramid of age'.
Comparing facial changes: Youthful vs. Aged face
| Characteristic | Youthful Face | Aged Face |
|---|---|---|
| Face Shape | Defined by a 'triangle of youth' with broad, high cheeks and a narrow jawline. | Often takes on a 'pyramid of age' shape, with a wider, heavier lower face and flattened cheeks. |
| Fat Distribution | Evenly distributed subcutaneous fat pads create smooth, full contours in the midface and cheeks. | Fat pads shrink in the midface (atrophy) and shift downward (descent), creating hollows and accentuating other features. |
| Bone Structure | Strong, well-projected skeletal framework provides robust support for overlying tissues. | Bone resorption occurs in specific areas like the orbital rim, maxilla, and mandible, weakening the foundational support. |
| Skin Texture | Abundant collagen and elastin keep the skin thick, elastic, and hydrated. | Decreased collagen and elastin production result in thinner, less elastic skin that shows more fine lines and wrinkles. |
| Eye Area | Eyes appear bright and full, with defined but well-cushioned sockets. | Eye sockets enlarge due to bone loss, causing eyes to appear sunken and leading to more prominent hollows and tear troughs. |
Lifestyle factors that influence facial aging
While genetics and natural aging are the primary drivers of facial changes, several lifestyle and environmental factors can accelerate the process:
- Sun Exposure: Prolonged UV exposure damages skin, accelerating the breakdown of collagen and elastin, which in turn speeds up volume loss.
- Smoking: Reduces blood flow and oxygen to the skin, causing collagen damage and faster volume depletion.
- Diet and Nutrition: Deficiencies in key vitamins and minerals, especially calcium and vitamin D, can negatively impact bone density throughout the body, including the face.
- Overall Health: Hormonal shifts, particularly during menopause, can accelerate bone and fat loss in the face. Excessive exercise that leads to low body fat can also cause a gaunt appearance.
Conclusion
In conclusion, the perception that faces get smaller with age is largely a result of structural changes happening beneath the skin's surface. A combination of bone resorption in the facial skeleton and the atrophy and descent of facial fat pads leads to a loss of volume and defined contours. While the process is a natural part of aging, understanding the underlying mechanisms allows for more effective cosmetic and lifestyle strategies. By addressing the loss of support from bone and fat, modern rejuvenation techniques can help restore youthful proportions and reverse the aesthetic effects of these age-related changes.
How to address the effects of facial aging
- Dermal Fillers: Injectable fillers containing substances like hyaluronic acid or calcium-based microspheres can be used to restore lost volume in the cheeks, temples, and jawline, mimicking the structure of youthful bone and fat.
- Fat Transfer (Fat Grafting): For a more natural and potentially long-lasting solution, fat harvested from another part of the body can be injected into the face to replenish lost volume.
- Surgical Interventions: Procedures like facelifts can reposition soft tissues, while facial implants can directly augment the underlying bone structure.
- Lifestyle Optimization: A healthy diet rich in calcium and vitamin D, regular exercise, and avoiding sun damage and smoking can all help mitigate the progression of age-related facial changes.
