Facial aging process - anatomical underpinnings

Despite the fact that everyone ages in their own way, the aging process of the face is about the same, regardless of ethnic background or lifestyle. Facial aging occurs at 3 levels at the same time:

• skull shape,
• amount of subcutaneous volume
• skin structure.

Does the shape of the skull change with age?

Bone atrophy is one of the main causes of facial change and aging. Over time, the skull literally shrinks.. (The skull shrinks with age; because the skin does not shrink, the skin becomes too large in relation to the skull.) The shrinking of the skull is due to progressive osteoporosis. Bone tissue is continuously broken down and rebuilt. As people get older, bone build-up slows down and the amount of bone decreases. An unobtrusive process of continuous bone resorption that causes the eye cavities to enlarge, the cheekbones to shrink:

• Loss of projection of the cheekbones. The cheekbones flatten out at the side, become narrower and stand out a little less. At the front, the cheekbones go more inward.
• Eye sockets are getting bigger. Because there is less volume and 'hold' around the eyes, the eyes lie a little deeper and puffiness and wrinkles occur.

• The height/length of face decreases due to changes in the upper and lower jaws, and due to a modest increase in facial width and depth.
• The eye cavities are getting bigger, while the upper jaw narrower becomes. As a result, the fat pads on the cheeks have less' hold 'and sink downwards and the nostril folds are accentuated.

• Bone degradation and tooth loss in the upper jaw will also lead to the loss of upper lip support, causing the lips to become smaller, longer and tend to fall inward.
• Bone degradation and tooth loss in the mandible changes the shape and projection of the chin and causes the lips to have less support. As a result, the lips and especially the corners of the mouth sink down.
• There will be a softening the lower jaw at the level of the masticatory muscles, and the rest of the jaw becomes rounder. As a result, the skin is held less in place and sinks down, Fat distribution in the face

Does subcutaneous volume change with aging?

Subcutaneous volume changes during aging. The connective tissue becomes less firm and the muscle volume slowly decreases. As a result check volume drops down/front. This causes a lack of volume under the eyes (puffiness/dark circles) and an excess of skin between the nose and corner of the mouth (nasolabial fold) and between the corner of the mouth and jaw (marionette line). The muscles in the face, around the eyes, try to stop this drop in cheek volume, which in turn leads to more laugh lines and cheek lines. In a young face, you can see a balanced distribution of superficial and deep fat. Because it flows smoothly into each other, a face looks soft and young. Soft arches and curves define youthfulness on the face. As we age, in addition to loss of volume, we also see a redistribution of facial fat. The loss of volume due to decrease in subcutaneous fat we see in the following places;

• The temples become hollow,
• Loss of projection of the cheekbones causes the cheekbones to flatten slightly. As a result, check volume drops down/forward. The muscles around the eyes try to stop this drop in cheek volume, which in turn leads to laugh lines.
• The fat around the eyes decreases and sinks down, causing bags under the eyes.
• Loss of volume between the eyebrows causes frown lines.
• Lips become smaller, straight and angular

As we age, fat pads from the cheeks gradually move forward/down. As a result, we see a increase in (excess) skin/fat originate:

• Lateral nasal lip fold (from nose to corner of mouth),
• Puppet fold (from corner of mouth to chin),
• The front of the jawline gets lovers,
• Fat bags under the eye socket, which are visible as puffiness,
• Fat pockets on the cheekbones that become visible as thickenings

The fat compartments do not age all at the same time. the order of aging is shown in this illustration. The bottom line is that fat compartments that you didn't see at first when you were young are now visible as separate units. They are no longer so snug together (just like the cushions on an old sofa don't fit as much). Due to the changed fat distribution, the “arches and curves that define youth” are ultimately disrupted. Skin structure The production of elastin and collagen in the skin decreases as you age. As a result, the skin becomes less elastic, thinner and is less able to adapt to the underlying volume. Because the skull also shrinks and the subcutaneous volume decreases, the skin becomes”too big for the face”. (Similar to a 2-person mattress cover on a single bed, you also get wrinkles and creases.) The difference in volume vs skin around the eyes partially compensated by tightening the eye muscles. As a result, the skin sinks down less, but crow's feet also occur. On the forehead this excess skin causes the eyebrows to sag. This is compensated by tightening the forehead muscle, resulting in lines on the forehead. Around the mouth you see that the mouth muscle and chin muscle compensate for the volume deficit. This causes lines around the mouth and chin. Facial aging is therefore ultimately the result of the face shrinking, while the facial skin is actually getting a little bigger and the ratio is no longer ideal.

Treatment

Based on decades of research into anatomy, attraction, and evolutionary beauty, I am convinced that beauty is an evolutionary process for communicating prosperity and health. This process mainly takes place in the subconscious mind. A treatment is therefore unsuccessful if other people can see that something has been done. In fact, you are sending the message of vulnerability and aging. It is precisely by staying true to the changed anatomy and gently correcting the aspects that the result of a cosmetic treatment is truly amazing. That's what makes the job fun.