Facial Aging

Facial aging starts early. Even while the face is maturing to one’s twenties, the skin is aging. Volume changes in the face and eyelid aging appear in the thirties and drooping starts to become evident in one’s forties. Wrinkles and skin changes become apparent over time.

Older faces may come to look miserable, tired, sad or unhappy and can convey a range of negative emotions to the world that simply do not reflect the way you actually feel or are. The emotional message conveyed is wrong or out of kilter.

And people age at different rates. Some look older than their years and have an advanced facial age while the lucky ones appear youthful. Genetics plays a role in this, but also sun exposure, smoking, diet, exercise and stress.

There are three major changes of facial aging and a better understanding of these changes has led to a refinement in facial rejuvenation. Most obviously tissue descends. The cheek mass comes down leading to jowls and a sloppy jaw line. The naso-labial folds and marionette lines become deeper and the mouth can become unhappily downturned. The tail of the brow may descend, but the brow itself may become peaked or drop. Cheek descent also results in it falling away from the eye deepening the tear troughs and the grooves under the eye. And the neck descends.

Volume changes in the face may vary from patient to patient but typically, and this occurs when still surprisingly young, there is volume loss from the upper face. The temples can become hollow and the grooves under the eye more pronounced. Volume loss occurs over the cheeks and around the mouth as the lips thin and the naso-labial folds and marionette lines deepen. This deflation affects all tissue layers of the face: the skin thins, the fat and the muscle atrophy and the bone resorbs. It is evident in old people whose bones and veins become visible.

The skin deteriorates with aging: wrinkles and pigmentation appear and the skin loses its elasticity – its ability to recoil back to its pre-stretched state. Skin detioration is made worse by sun exposure, cigarette smoking and an unhealthy diet.

With aging the V or heart shaped face of youth becomes squarer, more masculine looking and less happy, a kind of disproportion typical of an old appearance. The changes, descent of tissue, deflation and volume changes and deterioration of tissue are different in each face which is why treatments need to be individualised. Some patients require more lifting, others more volume correction. The goal of facial rejuvenation is not only to reverse these changes, but to do so safely, simply and with minimal downtime and complications. Further, it is also to find the inner beauty which exists within each face.