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Facial Aging May Be Related to Facial Bones

Posted: April 13, 2010

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"The jaw is the foundation of the lower face, and changes to it affect facial aesthetics," said Howard N. Langstein, MD, professor and chief of Plastic and Reconstructive Surgery at the University of Rochester Medical Center. "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 to sagging facial skin, decreased chin projection, and loss of jaw-line definition. 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.

"Physicians have long been taught that facial aging is caused by soft-tissue descent and loss of elasticity," Langstein said. "Though we have always known that bones change over time, until now, the extent to which it causes an aged appearance was not appreciated."

The study by Langstein and plastic surgery resident Robert Shaw, MD, gives evidence that facial bones are constantly subjected to forces that remodel them. Understanding there are predictable changes in facial bone structure as people age gives physicians new insight into procedures that may successfully restore youthful appearance. Shaw and Langstein led the three-institution collaboration, which also involved Stanford University and Harvard University.

"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," Shaw said.