Now, keep up to date
with daily feeds of newly posted stories
about America's Seniors...click on the box
Bones show signs of Aging too
For Optimal Facial Rejuvenation, Plastic
Surgeons should consider what's going on
under the skin
January 5, 2011 — What makes us look older?
Wrinkles and sagging result not just from
changes in the skin, but also from
aging-related changes in the underlying
facial bones, according to a report in the
January issue of Plastic
and Reconstructive Surgery®, the
official medical journal of the
Society of Plastic Surgeons (ASPS).
Led by Dr. Robert B. Shaw, Jr., of
University of Rochester Medical Center, the
researchers analyzed computed tomography
scans of the facial bones in young (age 20
to 40), middle-aged (41 to 64), and older
(65 and up) age groups. All scans were
performed for medical reasons—not for
planning plastic surgery.
to Changes in Eye Sockets, Jaw Bones, and
Detailed measurements in three-dimensional
reconstructions of the CT scans showed some
important differences in the facial bone
structure (or facial skeleton) between age
groups. "The facial skeleton experiences
morphologic change and an overall decrease
in volume with increasing age," Dr. Shaw and
change was an increase in the area of the
"orbital aperture"—that is, the eye sockets.
In both men and women, the eye sockets
became wider and longer with age.
affected the bones of the middle part of the
face, including reductions in the glabellar
(brow), pyriform (nose), and maxillary
(upper jaw) angles.
The length and
height of the mandible (lower jaw) decreased
with age as well. Although these changes
occurred in both sexes, many occurred
earlier in women—between young and middle
age. In men, most of the changes occurred
between middle age and old age.
surgeons are experts at dealing with changes
in the skin and underlying soft tissues that
contribute to an aged appearance of the
face. However, as the new study
demonstrates, they must also understand the
contribution of changes in the underlying
components of the face are important for
overall facial three-dimensional contour as
they provide the framework on which the
soft-tissue envelope drapes," Dr. Shaw and
coauthors write. For example, the enlarging
eye socket and decreasing brow angle could
contribute to frown lines on the forehead,
"crow's feet" at the corners of the eyes,
and drooping of the lower eyelid.
materials and techniques for skeletal
augmentation, plastic surgeons can improve
the outcomes of facial rejuvenation, Dr.
Shaw and colleagues believe. They discuss
the "aesthetic implications" of changes in
the facial bone structure, and outline some
strategies plastic surgeons can follow to
optimize the final results for patients who
desire a more youthful appearance.