Do facial bones shrink with age? Examining the evidence

Recent research using 3D imaging has revealed that, contrary to older beliefs, facial bones do indeed undergo significant remodeling as we age, leading to a loss of volume in key areas. This phenomenon can significantly impact the facial structure, contributing to visible signs of aging. In effect, as our soft tissues age and descend, they do so over a changing and diminishing bony framework, which influences wrinkles, sagging, and other aesthetic changes.

Quick Summary

The bones of the face experience age-related remodeling, with specific areas losing volume and shifting shape over time. This foundational shift affects the overlying soft tissues, contributing to changes like sunken eyes and a less defined jawline. It is a critical component of the aging process, working in concert with alterations in skin elasticity and fat pads.

Key Points

• Age-Related Resorption: Facial bones undergo predictable, age-related resorption, which is a process of bone volume loss and change in shape.

• Visible Aging Effects: This reduction in the bony framework causes the overlying soft tissues—including skin and fat pads—to lose support, contributing to wrinkles, sagging, and deep facial folds.

• Eye Socket Expansion: The orbital aperture, or eye socket, expands with age due to bone resorption around its rim, making eyes appear more sunken.

• Midface Flattening: The maxilla and zygomatic bones lose volume and projection, which can lead to flatter cheeks and deeper nasolabial folds.

• Jawline Recession: The lower jaw (mandible) loses height and length, particularly around the prejowl area.

• Dental Health Impact: Tooth loss significantly accelerates bone resorption in the jaw, further impacting facial structure.

• Cosmetic Implications: Modern cosmetic procedures now address underlying bone changes through methods like fillers, fat grafting, and implants to restore youthful facial contours.

The Foundation of Facial Aging: Skeletal Resorption

While many focus on skin changes, studies using advanced imaging confirm that the facial skeleton significantly changes with age due to skeletal resorption. This involves bone density and volume loss in predictable areas, reducing support for overlying soft tissues and contributing to an aging appearance.

Key Areas of Change in the Facial Skeleton

The Orbits (Eye Sockets) Age causes eye sockets to widen due to bone resorption around the rim, particularly in the upper-inner and lower-outer regions. This makes eyes appear more hollow and contributes to tear troughs.

The Midface (Cheeks and Upper Jaw) The maxilla (upper jawbone) and zygoma (cheekbones) in the midface also change. Maxillary bone loss, especially around the nasal aperture, deepens nasolabial folds and can make the nose seem longer. Cheekbone volume loss makes cheeks flatter, reducing youthful contour.

The Mandible (Lower Jaw) The lower jaw loses height and length, particularly where it supports teeth. This recession contributes to a less defined jawline, jowls, and can affect dental alignment.

The Resulting Impact on Facial Appearance

Bone resorption drives many aesthetic aging changes. It reduces support for soft tissue, leading to:

• Sunken Eyes: Enlarged eye sockets make eyes appear more recessed, highlighting dark circles and tear troughs.
• Deepening Folds: Midface bone recession reduces soft tissue support, causing descent and deepening nasolabial folds.
• Jowl Formation: Mandible bone loss in the prejowl area leads to soft tissue sagging and jowls.
• Thinning Lips: Reduced bone support around the mouth makes lips appear thinner and can cause retraction.

Comparison of Bony vs. Soft Tissue Changes with Age

Feature	Bony Changes with Age	Soft Tissue Changes with Age
Cheeks	Flatten as zygomatic bones lose volume and projection.	Fat pads shrink, shift downward, and thin out, contributing to a sunken appearance.
Eyes	Eye sockets widen and enlarge, especially along the rim.	Fat pads around the eyes either shrink or bulge, and skin loses elasticity, causing baggy eyelids and under-eye hollows.
Jawline	Mandible loses height and length, particularly around the prejowl area.	Skin and tissue sag over the diminished jawbone, leading to jowl formation and a less defined contour.
Nose	The piriform aperture widens as bone is resorbed, especially at the lower portion.	The nasal tip can droop and the nose can appear longer as underlying support is lost.
Lips	Resorption of the maxilla and mandible reduces skeletal support.	Lips thin out and lose volume, and fine vertical lines can form around the mouth.

Can You Prevent Facial Bone Shrinkage?

While inevitable, certain factors influence bone loss rate. Good overall bone health, including sufficient calcium and vitamin D, avoiding smoking and excessive alcohol, and addressing tooth loss promptly, can help. Plastic surgeons also address underlying bone changes in cosmetic interventions using fillers, fat grafting, or implants to restore volume and achieve natural results. Consult a board-certified plastic surgeon for more information.

Conclusion

Facial bone shrinkage with age is a scientifically supported reality and a critical factor in visible aging signs. Loss of bone volume and structural shifts in key areas diminish the scaffold for soft tissues, impacting appearance. This understanding has advanced cosmetic medicine, focusing on restoring the bony framework for more balanced rejuvenation. Recognizing the role of the facial skeleton helps in understanding aging changes and available treatment options.

Frequently Asked Questions

Does losing bone in my face cause my skin to sag?

Yes, facial bone loss is a significant factor in skin sagging. As the bony framework of the face diminishes, the overlying soft tissues, like skin and fat, lose their support structure. This lack of support, combined with gravity and decreased skin elasticity, causes the skin to descend, resulting in sagging, jowls, and deeper wrinkles.

Do male and female facial bones shrink differently with age?

Yes, research indicates that the rate and pattern of facial bone changes can differ between men and women. For instance, some changes may occur earlier in women, between young and middle age, while similar changes in men might happen later, between middle and old age.

Which facial bones are most affected by age-related shrinkage?

The most significantly affected areas include the midface skeleton (maxilla), the orbital rims around the eyes, and the mandible (lower jaw). Bone resorption in these areas is predictable and contributes to many of the visible signs of facial aging.

Can diet and exercise prevent facial bone loss?

While facial bone loss is an inevitable part of aging, maintaining a healthy lifestyle can support overall bone health. A diet rich in calcium and vitamin D, along with regular exercise, can help maintain bone density throughout the body, including the face. However, some level of facial bone change is unavoidable.

How does dental health affect facial bone structure in older age?

Dental health has a profound effect on the facial skeleton, particularly the jawbone. When teeth are lost, the surrounding bone is no longer stimulated and begins to resorb. This can lead to a significant reduction in jawbone size, impacting the lower face's contours and overall structure.

What is the 'upside-down pyramid' effect in facial aging?

The "upside-down pyramid" or "pyramid of age" describes the inversion of youthful facial proportions over time. A young face often has a "triangle of youth" with the base at the cheeks and the apex at the chin. As fat shifts and facial bones recede, the lower face can appear wider and heavier, inverting this triangle.

Can cosmetic procedures address age-related bone changes in the face?

Yes. Modern cosmetic procedures aim to restore the underlying structural support lost from bone resorption. Treatments like dermal fillers, fat grafting, or facial implants can add volume to the cheekbones, jawline, and orbital area, helping to restore youthful contours.