Does your head widen with age? The surprising science of craniofacial changes

While the skull's main cranial vault is largely set in early adulthood, fascinating research, including studies published in Plastic and Reconstructive Surgery, confirms that subtle yet significant age-related changes occur in the facial bones and soft tissues. These shifts help answer the question, does your head widen with age?

Quick Summary

The perception of a widening head with age is largely an illusion created by soft tissue changes, such as fat redistribution and skin laxity, combined with the continuous remodeling of the facial skeleton and cartilage, not expansion of the main cranial bone structure.

Key Points

• Skull vs. Face: The bony cranial vault becomes fixed in early adulthood, but the facial skeleton continues to remodel and change throughout life.

• Bone Resorption: Facial bones, particularly in the midface and jaw, lose volume and density with age, changing overall facial proportions.

• Soft Tissue Shifts: The perception of a wider head is often caused by fat redistribution, skin laxity, and sagging soft tissues, not an expanding skull.

• Cartilage Growth: Cartilage in the nose and ears grows continuously, contributing to the appearance of larger features in older age.

• Medical Conditions: In rare cases, medical issues like acromegaly or Paget's disease can cause actual bone thickening or enlargement, which warrants a medical evaluation.

• Illusion of Size: Factors like weight gain and hair loss can also contribute to the illusion of a larger head circumference over time.

The Surprising Truth About Skull and Facial Bone Remodeling

Many people notice that their hats fit differently or that their head and facial features appear broader or larger as they get older. The common assumption is that our bones, including the skull, continue to grow throughout life. In reality, the adult human skull is a complex structure that undergoes continuous, but often subtle, changes that affect its overall appearance.

The cranial vault, which houses the brain, is the upper part of the skull. The bones of this vault fuse together at joints called sutures during early adulthood, typically by the mid-twenties. After this fusion, the size of the cranial vault remains largely fixed. However, the facial bones, which form the face and jaw, continue to remodel and change in a predictable pattern throughout a person's life.

The Mechanisms Behind Age-Related Facial Changes

Bone Resorption and Growth

Bone is a living tissue that is constantly being broken down and rebuilt in a process called remodeling. With age, the rate of bone resorption (breakdown) can sometimes outpace new bone formation in specific areas. In the facial skeleton, this can lead to volume loss in key areas:

• Midface: The maxilla, or upper jaw, experiences significant age-related bone loss. This causes the midface to recede, leading to a loss of support for overlying soft tissues and contributing to deeper nasolabial folds (smile lines).
• Eye Sockets: The eye sockets (orbits) become larger and wider with age as the bone around the rims resorbs. This change contributes to the appearance of hollow, deep-set eyes.
• Jawbone: The mandible, or lower jaw, loses vertical projection and bone density over time, which can contribute to a less defined jawline and the appearance of jowls.
• Forehead Expansion: Curiously, while some areas recede, the forehead can experience bone deposition, particularly in the supraorbital rim (brow ridge), leading to a continuous expansion of this area with aging.

Soft Tissue Changes

Complementing the underlying bony shifts are significant changes in the soft tissues that cover the face and head. These changes are often the most noticeable and can create the illusion of a widening head.

• Fat Redistribution: The subcutaneous fat pads in the face that provide a youthful fullness descend and atrophy with age. The redistribution of fat can create a heavier, wider appearance around the lower face and jawline.
• Skin Laxity: As collagen and elastin fibers in the skin break down, skin loses its firmness and elasticity. Gravity and the lack of underlying bony support cause the skin to sag, leading to jowls and a less taut appearance.
• Cartilage Growth: The cartilage in the ears and nose continues to grow throughout life. While the effect is subtle, this ongoing growth can make these features appear larger over time, altering overall facial proportions.

How Hair Loss Affects Perception

As hair thins or recedes with age, more of the scalp and forehead become visible. For those who once had a thick, full head of hair, this change can create the visual illusion that the head is larger than it was previously, when framed by hair.

Comparing Age-Related Changes: Bony vs. Soft Tissue

Feature	Bony Changes (Skull)	Soft Tissue Changes (Head)
Cranial Vault	Stops growing in early adulthood; shape is stable.	Does not apply; soft tissue follows bone changes.
Face Shape	Facial bone volume decreases, particularly in the midface and jaw.	Fat pads shift and descend, causing a heavier, less defined lower face.
Eye Sockets	Eye sockets widen and lengthen as bone resorbs around the rims.	Eye area appears more hollow or deep-set due to underlying bone changes.
Jawline	Mandible loses vertical height and projects less, contributing to lack of definition.	Skin laxity and fat descent create the appearance of jowls and a less sharp jawline.
Head Circumference	Minimal, subtle changes occur due to slow bone remodeling and thickening (like in the forehead).	Increases can occur temporarily due to fluid retention or overall weight gain.

Medical Conditions Affecting Head and Facial Dimensions

While most age-related changes are a normal part of the aging process, certain rare medical conditions can cause noticeable enlargement or thickening of the skull bones. These conditions are distinct from the typical aging process and often come with other symptoms.

1. Acromegaly: A hormonal disorder caused by an excess of growth hormone, usually from a benign pituitary tumor. It can cause the bones and soft tissues of the face, hands, and feet to thicken, leading to a more prominent brow ridge and jaw.
2. Paget's Disease of Bone: This chronic condition disrupts the normal cycle of bone renewal, causing bones to become enlarged and misshapen. When it affects the skull, it can cause a noticeable increase in head size and lead to headaches or hearing loss.
3. Hyperostosis Frontalis Interna (HFI): A benign condition more common in older women, causing a thickening of the inner table of the frontal skull bone. While it reduces intracranial volume, the effects are not externally noticeable in most cases.
4. Fluid Retention: While not a bone disorder, conditions causing generalized fluid retention (edema) can cause temporary facial puffiness and swelling, affecting hat size.

Conclusion: Perception vs. Reality

So, does your head widen with age? The answer is that while the main part of your skull does not expand, your facial structure and head's overall appearance do change in subtle but significant ways. These changes are a combination of two primary factors: the continuous remodeling and volume loss of the facial bones and the redistribution and sagging of soft tissues. The net effect can often be a broader, less-defined facial shape that feels and looks different. Understanding these normal aging processes can provide clarity and peace of mind, distinguishing natural changes from rare medical conditions. For those concerned about significant changes, it is always best to consult a healthcare professional for a proper evaluation.

For more information on bone health, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Frequently Asked Questions

Is it normal for my hat size to increase with age?

A slight increase in hat size is common and is often due to an increase in weight and accompanying fat deposits on the scalp, changes in soft tissue, or slight thickening of the skull bones. It is usually not a sign of a serious problem.

Do my nose and ears really get bigger as I get older?

Yes, studies show that cartilage in the nose and ears continues to grow throughout your life. This, combined with the effects of gravity, causes these features to appear longer and larger with age.

How do facial bone changes affect my appearance as I age?

Facial bone remodeling leads to volume loss in areas like the midface and jaw. This diminishes the underlying support for the skin and fat, contributing to wrinkles, deeper folds, a less defined jawline, and the illusion of a receding chin.

What is the difference between bone remodeling and bone growth?

Bone remodeling is the continuous process of old bone tissue being removed and new bone tissue being formed, which happens throughout life. Bone growth, or expansion, is primarily limited to adolescence and early adulthood and is distinct from the subtle, lifelong reshaping process.

Can weight gain affect the size of my head?

Yes, significant weight gain can lead to fat deposits accumulating in the face and scalp, which can increase your head's circumference and make it appear larger. This effect is often reversible with weight loss.

When should I be concerned about my head's changing size?

While gradual changes are typically benign, you should seek medical attention if you notice a rapid increase in head size, especially if it is accompanied by other symptoms like persistent headaches, vision changes, or neurological issues.

Does brain atrophy make the skull get smaller?

No, brain atrophy does not cause the skull to get smaller. Since the adult skull cannot shrink, the brain tissue loss creates empty space, which can lead to increased thickening of the inner skull in some cases.