The normal course of aging alters the harmonious, symmetrical, and balanced facial features found in individuals, not only impacting physical attractiveness but also influencing self-esteem because facial aging alters self-perception and how individuals are seen by others. Signs of aging may affect interpersonal relationships by influencing perceived character or personality traits or by contributing to erroneously projected emotions (e.g. anger, tiredness or sadness) that do not reflect the individual’s true feelings. Therefore, successful treatment of facial aging that achieves attractive, natural-looking results may have a substantial positive impact on an individual’s self-image.
There are 2 primary types of aging that can be distinguished:
Intrinsic Aging
Intrinsic aging is also referred to as chronological aging. It reflects the genetic background of an individual and results from the passage of time. It is inevitable and, thus, beyond voluntary control. The process of intrinsic aging can be considered alongside programmed aging, and it results from continuous chromatic damage by various factors, of which the most representative is oxidative stress caused by reactive oxygen species (ROS).
Extrinsic Aging
Extrinsic aging is engendered by external factors such as sun exposure, air pollution, smoking, excessive use of alcohol, chronic psychological stress, poor sleep quality and poor nutrition, which in many cases can be reduced by effort. This process, then, is not inevitable, and by definition, refers to premature skin aging. It is believed that 80% of facial aging can be ascribed to sun exposure.
Common Signs of Skin Aging:
Fine lines and wrinkles
Skin dryness
Enlarged pores
Uneven skin tone
Hyperpigmentation for example age spot
Thinning skin
Telangiectasia (Visible small blood vessels)
Reduced skin elasticity
Sagging skin
Facial Aging By Layers
Facial aging is a composite, interrelated, 3-dimensional process involving changes to the bone, soft tissue, and skin. While each anatomical layer undergoes an aging process of its own, dependency on the more superficial structures on deeper layers also exists. It is a complex, multifaceted process wherein a change in 1 layer often causes a cascade of changes to adjacent layers.
Bone
The facial bones are the framework for the attachment of overlying soft tissue, providing stability, structure, and definition. Support from this platform diminished as the bones receded and remodeled with age, resulting in the recession and repositioning of the overlying soft tissue. This results in an inferior and medial repositioning of the fat pads and muscles as they realign over the shifting bony foundation. Flattening and hollowing in the cheeks, deepening of the nasolabial groove, and lengthening of the cutaneous upper lip, with rolling in of the vermilion happen as you age due to mid-face bone resorption. This results in an imbalance in the upper, middle and lower third of the face.
*** Vermilion is the lip line, which refers to the raised, pinkish-red colored border of lip mucosa where it meets the skin of the face
Fat
The fat compartments in the face are broadly characterized as superficial or deep relative to the superficial musculoaponeurotic system (SMAS). The superficial fat compartments are more mobile and are subject to both the resting and dynamic tension of the mimetic muscles. On the contrary, the deep fat compartments are immobile because it is firmly anchored to the underlying bone and help to provide contour, support for overlying fat compartments, and a gliding plane for muscle movement. Aging causes fat pad atrophy (fat pad loss) and repositioning which tends to occur in the periorbital, mid-face and lower jaw area. The downward and middle movement displacement of the fat pad due to gravity tends to increase the hollows in the temples and cheeks as well as flatten the angles of the face.
***SMAS layer is an organized fibrous network of tissue located beneath the skin that plays a crucial role in facial expressions and movement.
Muscle
Signs of senescence related to facial muscle aging result from repetitive muscle contraction and muscle tone changes. A typical occurrence in the aging process is that of repetitive muscle contraction resulting in the appearance of superficial and deep dynamic wrinkles during animation. Facial mimetic muscles insert into the skin, thus playing an important role in both the suspension and structural integrity of the soft tissue, thereby affecting the volume and contour of the region.
Skin
Both intrinsic and extrinsic factors are crucial determinants of the appearance of aged skin. Intrinsically aged skin slowly develops fine wrinkles with the occasional exaggerated expression lines; on the other hand, extrinsically aged skin tends to develop coarser wrinkles. Both types of aging display hyperpigmentation. Other characteristic signs of extrinsically aged skin include rough texture, skin dryness, telangiectasia ( “spider veins” ) and yellowish discoloration. Additionally, skin aging causes a decreased number of collagen and collagen which results in loss of skin pliability, elasticity and resiliency which ultimately makes our skin saggy. Consequently, both static wrinkles and dynamic folds manifest as the skin succumbs to the underlying pull of mimetic muscles.
Conclusion
Facial aging is an intricate process involving interrelated changes to bone, fat, muscle and skin. It is typified by deterioration of skin tone and texture, descent of soft tissues due to loss of muscle tone and skin elasticity, deflation due to loss of bone, and disproportion as hollowing or hypertrophy occurs in different facial areas at different rates. Understanding the process of skin aging is like having a roadmap to guide us on our journey to healthier and more youthful skin. It is crucial for each of us before embarking on any aesthetic treatments. Armed with this knowledge, you can appreciate the artistry of aging and ensure that every treatment choice you make in the future enhances your natural beauty.
Stay tuned for my upcoming sharing sessions where I will be revealing effective anti-aging tips and tricks, the latest breakthroughs in anti-aging aesthetic treatments to help you discover the secrets to youthful and radiant skin.