What happens to our face with age?
The upper, mid, and lower face all age as we go through the decades. Plastic surgeon Dr. Bryce Cowan explains how symptoms of aging typically manifest over time. In our youth, our face is full of expression. These are called dynamic wrinkles – they form and express our various emotions–they come and go as we change expressions. With age, these wrinkles slowly become more deeply formed, and fixed. As we lose elastin the key protein that gives the skin the ability to stretch. When this happens in the areas like our forehead, the brows begin to drop. The supporting ligaments also lose strength, causing the deep sunken appearance around the eye area, sometimes causing the eyes to have a bulging look. These can cause the expression to change, making the face appear more angry, and even interfering with the ability to see well, called lateral hooding. As the facial muscles are overused to try to make up for this, this eventually leads to the formation of more wrinkles in the upper face.
Fat atrophy and loss of volume are another key factor in facial aging. In combination with malposition of key fat structures, these are the key principles of aging. It’s the fat pads that give our face shape, and they are supported well when young. Malposition occurs as these fat pads, typically higher in the face begin to drop lower as its support structures weaken. The midcheek fat pad or the buccal fat pad tends to drop vertically, eventually resulting in a common feature in people in their 50s, as jowls. The youthful face is demarcated by the shape of an inverted triangle. With age, the support is lost and the fat drops to the lower face. At the same time, thinning of the skin, and resulting crepe-like look also becomes a problem.
See our subsequent videos for treatment options, the pros and cons in considering the various modalities.