There are superficial and deep fat compartments within our face. The deep fat planes are strongly anchored to the bone structures, but are prone to atrophy. The superficial fat planes are less prone to atrophy, but are not securely anchored to underlying fixed structure. So, they are more prone to shifting and moving with the pull of gravity over time. The combination of changes results in the appearance of hollows and “jowling” over time.
Muscles are the “driving force” behind the development of fine lines and wrinkles over time. As an aging bodybuilder, I am far too familiar with the challenges of muscular changes and hormone failure over time! When it comes to changes in our facial appearance, “animation” of facial expression sets a pattern of wrinkles. The muscles are attached to bone structures, which are also changing as we age (see The Aging Face part 1}. The muscles have attachments to the overlying dermis (skin). Even though the musculature is weakening over time, the overlying skin is becoming thinner, less dense and easier to deform. So, the youthful face becomes more frowning and puckered with increasingly deep wrinkles.
The changes that we see in our appearance over time is a complicated, three-dimensional process. Failure to recognize the multifactorial change is the main reason that we see patients, treated at other facilities, who are unhappy with their results. Patients tell us that they paid for expensive treatments and saw “no results”. That should never happen. There are so many advances in aesthetic medicine, that EVERY patient should be able to see improvements. But it requires an educated, experienced consultation, and a personalized treatment plan to achieve the results that you are looking for.
