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Facial Bones Change With Age

Reviewed by David Kahn, MD

Facial bone structure, size, and condition change with age, according to a recent study by the American Society of Plastic Surgeons (ASPS). This article explains how the ASPS study helped improve treatment strategies for aging faces.

The Aging Process

Facial bones and soft facial tissue change over the years. Decreased collagen production and epidermal thinning of the skin causes the loss of skin elasticity. Gravity, muscle movement, and fat loss contribute to wrinkling, skin folds, deep lines, and a sagging appearance of the face. Bone changes also contribute to the aging appearance we see in our faces over the years. Today attention is increasingly being paid to the changes that occur in facial bones. The best treatment plans address both of these areas:

  • The first step includes procedures that build volume in areas of bone loss. These procedures may include facial fillers or injectables.
  • The second step involves plastic surgery procedures that include lifting, repositioning, and reducing the soft facial tissue that has become less elastic with age.

Facial Bone Changes: T Zone Area

The ASPS study involved 60 participants to measure the changes in the T-zone area of the face. It concluded that facial bones remodel their three-dimensional shape with age. There were some differences in tendency between women and men.

In women, the area between the eyebrows and the top of the nose (the glabella angle) decreased as the area under the rim of the eyebrows receded. This caused sagging eyebrows and the appearance of deflated eyelid skin from younger ages to middle age.

In men, the glabellar angle decreased from middle to senior age. The area that provides support to the cheeks (maxillary angle) showed a decreasing skeletal area causing the malar fat pad to slide down and forward, pushing up against the nasolabial fold crease. This made the maxillary angle appear larger.

The pyriform angle demonstrated that bones recede in this area, causing the appearance of an elongated nose and drooping in the surrounding area. In fact, the nasal area significantly increased with age, especially by senior age.

Treatments

Injectables and Fillers can help augment specific areas where bone volume is reduced. Surgical procedures can help reduce excess fat and skin that result from bone structure changes. Changes that occur in the glabella area can be surgically improved with bone grafts or implants.

While age-related bone changes cannot be reversed through surgery, the study demonstrated how advances in understanding can improve treatments.

Related Topics

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About the Reviewer of This Article

David Kahn, MD, is a board-certified cosmetic surgeon and received his medical degree from the University of Michigan Medical School. Dr. Kahn completed his residency in head and neck surgery and facial plastics at the University of Southern California. He completed a fellowship in facial cosmetic surgery at Wayne State University and currently practices in San Francisco.

[page updated June 2008]