We often focus on wrinkles and sagging skin when we talk about aging, but the real story of facial change is rooted much deeper—right down to the bone. Aging is a comprehensive process that impacts every layer of the face, fundamentally altering its structure and contour.
The Foundation: Bone Resorption
The facial skeleton, the bedrock of your features, doesn’t stay static. As we age, we experience bone resorption, a process where the bones lose density and volume. This loss of scaffolding leads to predictable shifts:
- Around the Eyes: The bone around the eye sockets (orbits) recedes and widens. This loss of support makes the eyes appear more hollow and contributes to the formation of tear troughs and crow’s feet.
- The Midface: The upper jaw (maxilla) flattens and recedes.
The Descent: Fat and Skin and the ligaments
As the underlying bone structure shrinks, the overlying soft tissues are left with less support, exacerbating their own age-related changes:
- Fat Repositioning: Key fat pads in the cheeks atrophy (shrink) and descend due to gravity and lack of support. This shifts volume from the youthful, high-cheek position down to the lower face, creating the square, aged contour.
- Skin Quality: The production of collagen and elastin slows dramatically. The skin becomes thinner, drier, and loses its snap. It effectively becomes “too large” for the reduced foundation, leading to significant laxity and the deep folds we associate with an aged appearance.
The image of Phil Collins is a great example of natural facial ageing. The first photo was taken for the cover of his album – Face Value – and he subsequently took a similar photo many years later in a retrospective release.
Understanding these multi-layered changes—from the shrinking bone to the sagging soft tissues—reveals why a holistic approach is essential to addressing facial aging. The following manoeuvres as part of the deep plan facelift and neck lift are designed to address these changes:
- Release of the ligaments detach the descended cheeks and lax jawline to allow for vertical re-positioning
- Elevation of the cheek tissues and the jowls allow for restoration of a more rejuvenated appearance
- Removal of skin without over-tightening the skin removes wrinkles (also know as rhytids) and creates a smoother appearance
- The careful addition of fat grafting will help to restore loss of cheek and tear trough volume