The Science Behind Facial Aging
Facial aging is a complex process involving changes to the skin, soft tissues, and underlying bone structure. It's not simply a matter of skin 'sagging,' but a combination of deflation, volume loss, and tissue lengthening over time. The philtrum, or the specific area of skin between the base of the nose and the top of the upper lip's Cupid's bow, is particularly susceptible to these changes. As we get older, our bodies produce less collagen and elastin, the proteins responsible for keeping our skin firm, plump, and supple. The loss of these essential proteins, combined with a natural reduction in facial fat pads, leads to a downward migration of soft tissues. The constant pull of gravity further exacerbates this process, causing the skin to stretch and thin.
Causes of Philtrum Elongation
Gravitational Pull and Skin Laxity
One of the most significant contributors to a lengthening philtrum is gravity. Over the years, the constant downward pull on the face's soft tissues causes the skin to lose its youthful elasticity and sag. In the upper lip area, this results in the philtrum stretching and the vermilion (the red part of the lip) turning inward, giving the appearance of a thinner upper lip.
Volume Loss
Studies have shown that aging is characterized by significant volume loss in the upper lip. As the fat pads in the face diminish, the skin that was once supported by this volume loses its structure. This causes the area to flatten and elongate. The deflation of the upper lip area is a primary mechanism behind the lengthening and thinning of the philtrum.
Muscular and Ligament Weakening
Over time, the muscles and ligaments in the face weaken. This loss of tone contributes to the sagging and drooping of facial features. The orbicularis oris muscle, which surrounds the mouth, loses some of its strength and tautness, allowing the upper lip to lengthen and thin out. This muscular weakening, in concert with reduced skin elasticity, fundamentally alters the proportions of the lower face.
Bone Density Changes
Aging also affects the underlying bone structure of the face. Research indicates a gradual loss of bone density, particularly in the maxilla (the upper jawbone), which can cause it to collapse inward and be reabsorbed. This structural shift changes the foundation of the mid-face, causing the upper lip to stretch and lengthen and deepening nasolabial folds.
Impact on Facial Aesthetics
A longer philtrum and thinner upper lip are widely recognized signs of aging. A youthful face is typically characterized by a shorter philtrum, which allows for a small, visible amount of the upper teeth to show when the mouth is at rest. As the philtrum elongates, this tooth show is reduced or lost entirely, which can contribute to an older or more tired appearance. The change in lip proportions can also affect overall facial harmony, leading some individuals to seek cosmetic solutions to restore a more youthful balance.
Addressing an Elongated Philtrum
Surgical and Non-Surgical Options
For those who wish to address an elongated philtrum, there are several options available. Cosmetic procedures range from temporary, non-surgical fixes to more permanent surgical solutions. Consulting with a board-certified plastic surgeon is recommended to determine the most suitable approach based on individual goals and facial anatomy.
Non-Surgical Solutions
- Lip Fillers: Dermal fillers made from hyaluronic acid can be strategically injected into the upper lip to add volume and enhance the cupid's bow. This can create the optical illusion of a shorter philtrum by increasing the height and prominence of the lip.
- Lip Flip: A lip flip uses a small amount of botulinum toxin (like Botox) injected into the muscle above the upper lip. This relaxes the muscle, causing the lip to 'flip' outwards and appear fuller and more defined, thereby reducing the visible length of the philtrum.
Surgical Solution
- Lip Lift: A lip lift is a permanent surgical procedure that shortens the space between the nose and the upper lip. A small strip of skin is removed from the base of the nose, pulling the upper lip upward and exposing more of the vermilion. This procedure effectively reduces the philtrum length and can restore a more youthful lip-to-nose proportion.
Comparison of Treatment Options
| Feature | Lip Fillers | Lip Flip | Lip Lift |
|---|---|---|---|
| Procedure | Injection of dermal filler | Injection of botulinum toxin | Surgical excision of skin |
| Longevity | 12-18 months (temporary) | 2-5 months (temporary) | Permanent |
| Cost | Less expensive | Least expensive | Most expensive |
| Recovery | Minimal downtime, possible swelling | Minimal downtime, quick recovery | 6-8 weeks, swelling and bruising |
| Best For | Mild to moderate lengthening | Mild cases or as a trial | Significant lengthening, permanent solution |
| Effect | Adds volume, illusion of shortening | 'Flips' lip upward, subtle effect | Physically shortens the philtrum |
Conclusion
Yes, the philtrum does typically get longer with age. This is a common and natural consequence of the aging process, stemming from a combination of gravity, volume loss, and the breakdown of supporting tissues. While it's a normal part of life, for those who are bothered by the change, modern cosmetic and surgical options offer effective ways to address the lengthening and restore a more balanced, youthful facial appearance. By understanding the underlying causes, individuals can make informed decisions about how to best care for their aging skin and features. Read more on facial anatomy and aging.
