Do our skulls keep growing as we age? The surprising truth about aging and your bones

While it's a common belief that our skull, along with our ears and nose, continues to expand indefinitely, scientific evidence shows a more complex reality. In fact, the intricate changes to our skeletal and soft tissues, rather than straightforward growth, reshape our faces and answer the question: do our skulls keep growing as we age?

Quick Summary

The bones of the cranium cease growing in early adulthood, but subtle age-related changes in the facial skeleton, cartilage, and soft tissues occur continuously over a lifetime, affecting facial shape and giving the illusion of ongoing growth. Bone resorption and shifts in soft tissue volume are primary factors behind perceived alterations.

Key Points

• Cranial Vault Stops Growing: The main part of the skull ceases expansion in early adulthood, typically by the mid-twenties, when the fibrous sutures between bones ossify and fuse.

• Facial Bones Continue to Remodel: The facial skeleton undergoes continuous remodeling, involving both bone resorption and deposition, which subtly alters facial shape and proportions throughout life.

• Ears and Nose Sag, They Don't Grow: The perceived growth of the nose and ears is an illusion caused by the breakdown of cartilage and connective tissues, combined with the effects of gravity.

• Soft Tissue Changes Affect Perception: The redistribution and loss of facial fat pads and the weakening of ligaments contribute to sagging skin and altered contours, which can emphasize underlying skeletal changes.

• Systemic Bone Loss Impacts Skull: Age-related bone density loss (osteoporosis) is not confined to the long bones; it also affects the skull, potentially increasing its fragility.

• Jawbone Remodeling Causes Dental Shifts: Decreased bone density in the jaw and changes in teeth alignment contribute to a less defined jawline and a shrinking facial profile.

Understanding Bone Growth: From Childhood to Adulthood

To understand why our skulls don't keep growing in the way many imagine, it’s helpful to review the process of human bone development. In childhood and adolescence, our bones grow rapidly, thanks to growth plates located at the ends of long bones. The bones of the skull, which are initially separated by flexible fibrous joints called sutures, also expand to accommodate the rapidly growing brain. As we reach early adulthood, typically between our late teens and mid-twenties, these growth plates and sutures harden and fuse in a process called ossification, essentially locking our cranial vault into its final, fixed size.

This fusion means the main part of the skull—the cranium that protects the brain—no longer expands. Any perceived changes in head size after this point are not due to bone growth but rather a combination of other factors, including fluctuations in weight, fluid retention, or subtle shifts in soft tissue.

The Nuances of Facial Skeletal Change

While the cranium is largely static in adulthood, the bones of the face, mandible (jaw), and mid-face continue to remodel throughout life. This process is different from the growth seen in childhood and involves a balance between bone resorption (the breakdown of old bone) and bone deposition (the formation of new bone). Over time, this remodeling can cause significant, albeit gradual, alterations to facial proportions.

• Orbital Changes: Research has shown that the eye sockets (orbits) tend to enlarge with age. As the bones around the eyes resorb, the orbits expand, which can make the eyes appear deeper-set. This contributes to the deepening of under-eye circles and can make the forehead appear more prominent as surrounding soft tissue and fat descend.
• Mid-face Resorption: The maxilla, or upper jawbone, is particularly susceptible to age-related resorption. This bone loss can diminish the scaffolding that supports the cheeks and mid-face, leading to the deepening of nasolabial folds and marionette lines.
• Jawline and Mandible: The lower jaw also remodels with age. Changes in dentition and bone density can lead to a shrinking jawline and a less defined profile. As jaw muscles weaken and bone density decreases, the skin and soft tissues in the area can sag, contributing to the formation of jowls.

The Role of Cartilage and Soft Tissue

One of the most persistent myths is that our ears and nose never stop growing. While they do appear to get larger with age, this is not due to continuous cartilage growth. Instead, it's a consequence of gravity and the weakening of connective tissues over time.

• Cartilage Breakdown: Unlike bone, cartilage remains flexible. As we age, the collagen and elastin fibers in the cartilage of the ears and nose break down. This loss of firmness and elasticity, combined with the constant downward pull of gravity, causes the structures to sag and stretch, creating the appearance of larger ears and a longer nose.
• Soft Tissue Redistribution: Facial fat pads, which provide volume and contour in youth, descend and shrink with age. This loss of volume, especially in the cheeks and around the mouth, can make the ears and nose appear disproportionately larger in comparison.

Comparison of Facial Changes Over a Lifetime

Feature	Young Adulthood (20-30s)	Middle Age (40-60s)	Old Age (70s+)
Cranial Vault	Fully fused and static	Static	Static
Orbital Sockets	Symmetrical and well-defined	Begin to widen	Widen significantly, eyes appear deep-set
Mid-face	Full cheeks, defined contours	Volume loss, prominent nasolabial folds	Flattening of cheeks, prominent marionette lines
Mandible (Jaw)	Defined jawline	Changes in angle and density	Bone resorption, shrinking jawline, increased jowls
Nose & Ears	Firm cartilage, youthful position	Subtle sagging due to gravity and tissue weakening	Cartilage sags and stretches, appearing longer
Bone Density	Peak density	Gradual decline, accelerates in women post-menopause	Significant loss, increased fragility

Broader Implications for Health

The skeletal changes that affect the skull and face are part of a larger, systemic process of aging that affects the entire body. Reduced bone mass and density, or osteoporosis, can increase the risk of fractures not just in the hips and spine, but also can make the skull more vulnerable to trauma. Chronic inflammation, a hallmark of aging, also contributes to an imbalance in bone remodeling, where resorption outpaces formation, leading to overall skeletal deterioration.

Mitigating the Effects of Skeletal Aging

While we cannot stop the natural aging process, we can take steps to promote skeletal health. A lifestyle rich in physical activity, a balanced diet with sufficient calcium and vitamin D, and avoiding detrimental habits like smoking can help maintain bone strength and density. Medical interventions, including hormone replacement therapy for women and targeted treatments for bone loss, also play a crucial role in mitigating age-related bone deterioration. For more information on maintaining bone density as you age, you can visit the National Institutes of Health website at https://www.nih.gov.

In conclusion, our skulls do not keep growing in the traditional sense. The larger head size or changing facial features we observe with age are the result of subtle, ongoing processes of bone remodeling and the weakening of connective tissues. Understanding these underlying mechanisms helps demystify a common misconception about aging and highlights the importance of maintaining bone and tissue health throughout life.

Frequently Asked Questions

Is it true that my skull gets bigger as I get older?

No, the main part of your skull, or cranium, stops growing in early adulthood when its bony plates fuse together. Any changes you perceive in your head size later in life are likely due to changes in your facial bones, cartilage, and soft tissues, not an expanding cranium.

Why do older people's noses and ears look larger?

The change in appearance is not due to active growth. It is caused by the effects of gravity and the breakdown of collagen and elastin in the cartilage. This makes the nose and ears sag and stretch over time, giving the impression that they have grown.

What happens to the bones in my face as I age?

The bones in your face continually remodel throughout life. For instance, the eye sockets tend to enlarge, and the jaw and mid-face bones may resorb or lose density. These subtle shifts alter facial proportions over time.

Can diet and exercise prevent age-related skull changes?

While diet and exercise cannot stop the natural process of bone remodeling, maintaining a healthy lifestyle with adequate calcium and vitamin D can help support overall bone density and strength, potentially mitigating some effects of age-related bone loss throughout the skeleton.

Is facial sagging caused by my skull changing shape?

Changes in your facial bones, such as bone resorption in the mid-face and jaw, do reduce the underlying support for your skin. This, combined with the loss of facial fat and the weakening of connective tissues, contributes significantly to the sagging and wrinkles associated with aging.

When do the sutures on my skull close?

The cranial sutures, which allow for brain growth in infants, fuse at different times. Some close early in childhood, while others, like the sagittal or coronal sutures, typically close in early to mid-adulthood. The squamous suture may not fully close until well into senior years.

Are there any medical conditions that cause adult skull enlargement?

Yes, true skull enlargement in adulthood is rare and often indicates an underlying medical condition, such as Paget's disease or acromegaly, that requires medical evaluation. Perceived changes are far more common and are related to natural aging processes.