Facial ageing in mature patients (45 years and up) often leads to some drastic changes in the facial expression that can be hard to accept. In clinical practice, we often see that mature patient more easily accept the deterioration in skin texture and the appearance of distinct wrinkles than the typical sad-looking, ageing face with prominent jowls.
As a result, the predominant request is “to look better and fresher” rather than younger.
How the face ages
The age-related changing of the face is a complex process that involves each layer of tissue – from the facial skin, soft tissue, retaining ligaments, and fat compartments to the bony scaffold.
To provide patients with the best possible rejuvenation strategy, an appropriate diagnosis of each layer’s changes is imperative. Even more important is explaining to patients the possibilities and limitations of aesthetic procedures in such a complicated process.
Bone tissue has been shown to recede with increasing age, leading to a change in facial shape. After menopause, women show a greater reduction in the jaw area, particularly the chin, as facial bone resorption is primarily controlled by oestrogen. Women generally have a faster average rate of facial ageing than men, which increases considerably at around 52 to 55, when menopausal changes are exceptionally rapid. Soft tissue related to fat compartments, retaining ligaments and muscles undergoes dramatic changes with ageing. The amount and distribution of subcutaneous fat largely contribute to the facial shape of mature patients. The fat is stored diffusely in young faces, but older faces contain pockets of fat in distinct areas, which are thicker and more unevenly distributed in women than men.
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