Bone Structure
The changes that we see to our face with aging is far more complicated than the development of skin laxity and wrinkles. And, it is not just a simple matter of gravity, sun exposure and lifestyle choices. Understanding the three-dimensional process of facial aging is the key to providing a great consultation and developing the most effective short and long-term treatment plan for each patient.
Aging results in slow changes over time to every layer and compartment of the face. The changes at one layer also results in changes to tissues at adjacent layers. For example, the bone structure provides the framework and attachment points for the overlying muscle structures. The bones recede and remodel over time. Imagine if this was occurring to the foundation of your house. A settling of the “foundation” results in cracks in the walls, water seepage, etc. With the aging face, this results in a cascade of other changes which detract from a youthful appearance. Repositioning of muscle structures and fat pads, changes to the shape of the eye sockets, chin and jaw line, all result in additional compensatory changes at the more superficial layers of the face. Even a few millimeters of bone resorption or angular change is magnified at the more visible levels.
The sequencing of these changes is very predictable and now well described. It is similar despite gender or race. The rate of change and severity varies from patient-to-patient. It’s controlled, in part, by modifiable factors (such as photodamage). But it is also controlled by genetics and ethnicity. We can’t change your natural biology, but we can help you maintain your best appearance and skin health!!
Fat Planes and Muscle Dynamics
There are superficial and deep fat compartments within our face. The deep fat planes are strongly anchored to the bone structures, but are prone to atrophy. The superficial fat planes are less prone to atrophy, but are not securely anchored to underlying fixed structure. So, they are more prone to shifting and moving with the pull of gravity over time. The combination of changes results in the appearance of hollows and ‘jowling’ over time.
Muscles are the “driving force” behind the development of fine lines and wrinkles over time. As an aging bodybuilder, I am far too familiar with the challenges of muscular changes and hormone failure over time! When it comes to changes in our facial appearance, “animation” of facial expression sets a pattern of wrinkles. The muscles are attached to bone structures, which are also changing as we age (see The Aging Face part 1}. The muscles have attachments to the overlying dermis (skin). Even though the musculature is weakening over time, the overlying skin is becoming thinner, less dense and easier to deform. So, the youthful face becomes more frowning and puckered with increasingly deep wrinkles.
The changes that we see in our appearance over time is a complicated, three-dimensional process. Failure to recognize the multifactorial change is the main reason that we see patients, treated at other facilities, who are unhappy with their results. Patients tell us that they paid for expensive treatments and saw “no results”. That should never happen. There are so many advances in aesthetic medicine, that EVERY patient should be able to see improvements. But it requires an educated, experienced consultation, and a personalized treatment plan to achieve the results that you are looking for.
Skin Changes
Both internal and external factors affect the appearance of our skin over time. Some of these variables we have more control over and there are good preventative options. The most obvious examples are smoking cessation and use of sunscreens. Solar aging and the presence of environmental oxidants take a big toll on our skin over the years. There are also genetic factors as well as natural aging changes that affect our skin appearance that we don’t have control over.
Around 30 years of age, we start to produce less collagen and elastin in the dermal layer. These are the main components of skin thickness and strength. This is also the skin layer most responsible for maintaining skin hydration. In addition to less production, there is also increased breakdown of collagen and elastin. Loss of these components lead to the appearance of sagging, wrinkles and dryness. The skin becomes less “springy” and looks less youthful (solar elastosis). Lines of facial expression become more prominent, deepen and become more “set” over time.
Sun exposure (UV light) also results in stimulation of melanocytes which produce melanin. This is what produces the brownish coloration with tanning. Variable numbers of melanocytes and melanin production is what accounts for variation in skin coloration in different ethnic groups. As melanocytes and other skin cells age, they start to become less active (senescence). They start communicating from cell-to-cell inn different ways. It is felt that this results in variation in pigment production and the presence of light and “age spots”.
At Contour You, we have a wide range of products and devices to help reverse many of these aging changes and reactivate helpful cellular activity. Call us for your free consultation.
