Facial Aging

Facial Aging
  • 6 mins Read
  • August 4, 2024
  • By Dr. Maria Angelo Khattar

Facial Aging

Aging is an inevitable consequence of life and as we age, our bodies undergo various changes. The causes of aging are both Intrinsic and Extrinsic. Intrinsic or Chronological aging is due to several physiological factors that occur with time, whereas Extrinsic aging is caused by environmental factors, including exposure to the sun and pollution. This is the main reason why we often see great discrepancies in aging signs between the sun-exposed areas of the body such as the face, neck, and hands, as opposed to the areas that are covered. In terms of the face, anatomical changes at all levels contribute to the overall aspect of aging. These include skin degradation, deflation and repositioning of the facial fat pads, bone resorption, changes in the tone of the facial muscles and attenuation of the facial ligaments, which are responsible for the maintenance of the face in an elevated position. Overall, the most fundamental changes that occur on the face are skin changes and alteration in facial shape:


Skin aging signs:

Aging skin is characterized by the development of hyperpigmented lesions, known as age spots, broken capillaries, and at times, generalized erythema (redness). The skin loses its natural radiance and may assume a dull lacklustre appearance, with wrinkles, a rough texture, and open pores.  

The first manifestations of skin degradation appear around the eyes, forehead, and lips as a result of the development of fine lines and wrinkles.  Skin laxity also occurs with time due to a loss of elasticity and the skin begins to sag. This is most noticeable in the eyelids, the neck, and around the jawline which becomes irregular, with the development of jowls.

These changes occur due to the loss of integrity of the structural proteins in the skin, namely collagen and elastin, a process that occurs naturally with age but is accelerated by exposure to UV radiation and also by hormonal changes.  We know that one of the main culprits of skin aging is the dramatic decline in oestrogen levels that occurs during menopause.

Another factor that specifically contributes to wrinkle formation is repetitive movements such as constant frowning, smiling, and squinting.

Change in Facial Shape

 Generalized loss of facial volume due to bone resorption, deflation and repositioning of certain fat pads and atrophy of certain facial muscles, ultimately leads to an alteration in facial shape. 

In the main, our skeleton is the foundation of our face, and with time the facial bones gradually lose density leading to changes in facial structure.  

The fat pads under the skin also change whereby generally, there is a deflation of the fat pads in the mid-face, resulting in the development of sunken cheeks and under eye hollows. Moreover, in some cases,  the fat pads of the lower face become displaced leading to the development of jowls and the appearance of a heavy lower face.  

 The result is a facial squaring process, whereby the triangular V-shape of youth changes into the pyramid of age.  

We are very fortunate to live in an era with such great advancements in science and healthcare.  We have, at our disposal, a plethora of treatments that are evidence-based to slow down the physical signs of facial ageing. We do believe that facial aging is optional and we can decide ourselves, whether we will let nature take its course, or opt for anti-aging treatments. Essentially these may be minimally invasive procedures or in certain cases, surgical intervention may be required.

Our minimally-invasive therapeutic options include topical dermocosmecutical products, a multitude of lasers and energy-based devices, and many injectable products.  The lasers and energy-based devices are proven to tighten skin, improve skin texture and colour, and delay skin laxity by inducing powerful regeneration of collagen, elastin and glucosaminoglycans in the skin.  The injectables comprise Hyaluronic acid products to restore lost volume and recontour the face, as well as stimulating agents such as poly-lactic acid to firm and thicken the skin.

 However, one must not forget that maintaining a healthy lifestyle is integral to anti-aging and that adhering to a balanced diet, regular exercise, bio-identical hormone replacement, and avoidance of toxicants play a crucial role in promoting vitality and longevity.

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