As our faces age, numerous changes occur both within the cells of the skin itself, as well as the structure of the face. Skin changes include thickening of the outer layer (the epidermis) and thinning of the inner layer (dermis) with more uneven pigmentation.

The most notable structural change is reversal of the ‘triangle of youth’ with most of the facial tissue centred along the jawline rather than the midface.

Volume change occurs due to loss of facial volume (with fat loss from the superficial and deep fat pads in the face, as well as bone loss further along the ageing process). Volume increase may also occur in some areas, such as the buccal fat pads in the lower cheeks, fat deep to the superficial muscle layer in the neck, and growth of structures such as the submandibular glands under the jawbone (these are some of the glands that make saliva) and thickening of a pair of deep muscles under the jawbone.

The muscle (SMAS) layer sags and with it the overlying skin, to create heaviness and jowls along the lower jawline area and neck. This helps to create grooves and folds in areas where the tissue is held in place by underlying ligaments, adjacent to tissue that is more susceptible to the effects of gravity. Hence, the appearance and deepening of nasolabial folds- between the side of the nose and mouth, and marionette lines- between the side of the mouth and chin. Lesser-known changes include upper lip lengthening (which is thought to be the only area of the face where true lengthening occurs- as opposed to just sagging), and earlobe enlargement.

Surgical facial rejuvenating techniques such as face and neck lift techniques, with adjunct procedures such as an upper lip lift, eyelid surgery or fat transfer, aim to negate these effects by replacing the lost volume, reducing the areas contributing to unwanted additional volume and lifting the overlying structures (SMAS muscle layer and overlying skin).

If you are considering booking a consultation for a facial rejuvenating procedure, you will be asked to bring old photographs with you to show how your face has changed over time, as the aim is to push the clock back, whilst retaining your facial identity- with a younger version of you, as opposed to an attractive face that looks more like someone else.

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