Our understanding of facial ageing has evolved and for many years it was thought that the issue was wholly due to our skin succumbing to the effects of the gravity. And while it’s true there is a loss of skin elasticity and a weakening of the ligaments over time, the depletion of volume, particularly in the mid-face, may be the main culprit.

Earlier this year, a study was published in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons, that attempted to determine the link between fat loss and facial ageing. Dr Aaron Morgan of the Medical College of Wisconsin and his colleagues used CT scans of 19 patients to measure the loss of mid-face fat volume.

The patients underwent at least two computed tomography scans at least a decade apart, measuring fat deposits in the area between the eyes and mouth. On average the patients were 46 when first scanned and 57 years at the follow-up scan.

Results showed ‘definite and measurable loss of midface fat volume’. The total volume of facial fat decreased from about 46.50 cc at the initial scan to 40.8 cc at the follow-up scan: a reduction of about 12.2%.

Interesting, fat volume in the superficial layer of the skin decreased less than deep facial fat. This underlines the supposition that deep facial fat loss results in a loss of support. Dr Morgan explains. “That causes deepening of the nasolabial fold, which runs from the nose to the mouth. Meanwhile, fat loss closer to the surface makes the cheeks appear deflated.”

Other factors in facial ageing

Ageing is also a combination of both changes on a deeper level, but also the superficial visual alterations. The appearance of dynamic wrinkles, thinning of the skin, pigmentation changes and loss of the bony structure of the face also play a role.

Ageing is a gradual yet constant process and choosing a plastic surgeon that fully understands the anatomy of the ageing face is a must.

For more advice on facial ageing and the appropriate cosmetic surgery procedures, call 020 7927 6528 to arrange a consultation with Mr Juling Ong.