Facial aging more than skin deep

Facelifts to ward off the signs of aging are only fixing half the problem, according to University of Rochester Medical Center researchers who say that changes in facial bone structure – particularly with the jaw bone – occur as people age and contribute significantly to an aged appearance. Published in the Journal of Plastic and Reconstructive Surgery, the new study suggests that the future approach to facial rejuvenation may be two-fold, first restoring structure underneath before performing skin-tightening procedures.

The study involved reviewing a collection of facial CT scans taken for unrelated medical reasons and measuring changes that occurred to facial bones over time. The CT scans were divided equally by gender and age, 20 men and 20 women in each of three age groups: young (ages 20-36), middle (41 to 64), and old (65 and older). The researchers used a computer program to measure the length, width, and angle of the mandible, or jaw bone, for each scan, and compare the results for each group.

The angle of the jaw increases markedly with age, which results in a loss of definition of the lower border of the face, according to the study. Jaw length decreases significantly in comparisons between the young and middle age groups, whereas the decline in jaw height from the middle to old group was noteworthy.

“The jaw is the foundation of the lower face, and changes to it affect facial aesthetics,” said research team leader Howard N. Langstein. “These measurements indicate a significant decline in the jaw’s volume as a person ages, and therefore less support of soft tissue of the lower face and neck.”

This loss of bony volume may contribute sagging facial skin, decreased chin projection, and loss of jaw-line definition, explains Langstein. As jaw volume decreases, soft tissue of the lower face has less support, resulting in a softer, oval appearance to the lower face and sagging skin, which also affects the aging appearance of the neck. “Though we have always known that bones change over time, until now, the extent to which it causes an aged appearance was not appreciated,” he noted.

The study, contend the team, gives evidence that facial bones are constantly subjected to forces that remodel them. “The future of facial cosmetic procedures to restore a youthful look may include methods to suspend soft tissue – such as chin and cheek implants – to rebuild the structure that time has worn away, in addition to lifting and reducing excess skin,” they concluded.

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Source: University of Rochester Medical Center

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