Aging and the Basic Anatomy of Your Face

Your facial skeleton determines the basic shape of your face. The shape of your nose, the prominence of your chin and cheekbones, and the height and width of your face are deter­mined by the anatomy of the facial bones. Aside from changes in the teeth, very few of the changes we see in the aging face are due to skeletal changes. The soft tissues overlying this bony framework exist basically in three layers, each of which contributes to aging changes in the face.

The deepest layer consists of the muscles of facial expression. These muscles are arranged around the forehead, eyes, ears, nose, mouth, and neck. All of the movements of the face are due to contraction of these muscles. Stretching and losing tone in these muscles results in sagging of the face. The most important of these is the platysma muscle, which is a thin sheet‑like muscle that extends from the lower neck up to the lower face. In youth, these muscles are tight and give the throat and neck a clean and sculpted look. With the passage of time this muscle loosens and the area under the chin becomes loose and folds appear. These folds are sometimes referred to as the "turkey gobbler" effect. The prominent bands that often exist on each side in the upper front of the neck are actually the front edges of the platysma muscle.

Your skin is the outermost layer, which becomes looser and more wrinkled as you age. This process is accelerated by excessive sun exposure and smoking. Your choice of parents is also important because youthful skin definitely is inherited. With time, the elasticity of the skin decreases and becomes looser, just like the elastic in old socks stretches out and actually seems bigger than when the elastic was new and tight. As the skin becomes looser, creases and wrinkles form at the areas of greatest mobility. The areas of the face with the most movement (the eyes, mouth and forehead) show the greatest changes.

The fatty middle layer, lies between the muscular layer below, and the skin above. In youth, the fat was evenly distributed throughout the face. With the passage of time, the fat responds to gravity and is pulled down, accumulating in the jowl area and the area under the chin. The fat usually decreases in the cheek area giving a hollow look to the cheeks.