Atonomy of An Aging Face
Looking at gorgeous Sophia Loren’s pictures through the last few decades, we get a sense of time travel with a front row seat witnessing a beautiful youthful face change with age. Facial aging is a fascinatingly intricate process, but our vision mostly is limited to what’s happening on the surface of the skin. Taking a closer anatomical look, scientists have discovered that a lot of major changes are happening underneath the skin too. To better understand how a visage plumped with youth, transforms into a creased and sagged poster child of age lets indulge in anatomy 101 to see closely what’s really happening underneath the skin with the passage of time.
Facial aging process begins second decade of life, with surface and subsurface structural changes in multiple tissue layers —including skin, fat, muscle and bone. All layers age interdependently, contributing to the overall facial appearance that keeps on changing with age.
Journey Of Our Skin Through Time: As we age our skin goes through several changes —on the surface the skin becomes more rough and pigmented as the epidermal renewal cycle become less efficient. Past second decade of life, skin collagen remodeling and replenishing processes begin to slow down, with progressive loss in collagen skin becomes thinner and hence more likely to wrinkle & sag. As the skin becomes progressively drier, thinner and less elastic with age along with daily wear and tear going unchecked skin begins to wrinkle, sag and look lusterless.
Fat & Bone Changes With Aging: A youthful plump face has the right amount of facial fat in all the right places. Redistribution, accumulation, and atrophy of fat with age, leads to facial shape changes and sagging. Some areas lose fat e.g. the forehead, temples and upper cheeks. Other areas gain fat e.g. neck, lower face and jaw. Modification of the fat pads leads to contour deficiencies. In addition, the areas of fat tend to become farther apart. Instead of a smooth, almost continuous layer, the fat pads appear as separate structures.
There is a significant loss of facial bone volume with age. Aging of the craniofacial skeleton may be due to changes in the relative dynamics of bone expansion and bone resorption. Bone resorption leads to biometric volume loss. Without the structural support of bone, there are noticeable changes in the other layers of overlying soft tissue and skin.
Age Proofing The Visage — Modern Medicine To The Rescue
Facial rejuvenation treatments can be classified in three categories:
Resurfacing Options —Skin peeling techniques can be used to modify the surface of the skin. Peeling the suface can correct the effects of photoaging, which includes correction of fine lines, irregular pigmentation and blemishes. Common skin resurfacing techniques include:
• Chemical peels
• Laser resurfacing
Injectables —Injectables include a broad range of substances, which can be administered by injection into the skin, fat or muscles. Their main usage is for the treatment of lines, wrinkles and folds, as well as hollowing and volume loss. Three of the most common types include:
• Traditional fillers
• Collagen stimulators
Surgery —Surgery includes a wide range of procedures from lifts to liposuction to fat transfer. These treatments can address a range of desired outcomes. Three of the most popular surgeries are:
• Fat transfer
• Laser/RF Surgery