Facial aging process - anatomical underpinnings

How the face ages

Although everyone ages in their own unique way, the facial aging process follows a similar pattern for most people. Regardless of ethnic background or lifestyle, facial aging occurs on three levels simultaneously: changes in bone structure, loss of subcutaneous volume, and deterioration of skin quality.

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Changes in bone structure

One of the most impactful causes of facial aging is bone atrophy – the gradual loss of bone mass. As we age, the skull shrinks due to progressive bone resorption. The skin, however, retains its size, creating a mismatch between the underlying structure and the overlying tissue.

Key changes in bone structure include:

• The skull becomes smaller, making the skin appear too loose.
• Eye sockets enlarge, causing the eyes to appear sunken and leading to the formation of under-eye bags.
• The cheekbones lose projection and start to flatten, moving inward at the front.
• The upper and lower jaw shrink, shortening the face and reducing support for the lips.
• The chin loses structure and volume, which contributes to the downward pull of the mouth corners.
• The jawline becomes rounder, especially near the chewing muscles, resulting in sagging of the lower face.

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Loss and redistribution of subcutaneous volume

As we age, the volume beneath the skin changes due to a decrease in fat, connective tissue, and muscle mass. This volume shifts, leading to folds, wrinkles, and sagging.

Important changes in volume and fat distribution:

• Cheek volume shifts downward and forward, resulting in under-eye hollows and deepening of the nasolabial folds and marionette lines.
• Fat around the eyes diminishes and descends, forming bags under the eyes.
• The temples become hollow, creating a tired appearance.
• Flattened cheekbones reduce support in the midface.
• Volume loss between the brows leads to frown lines.
• The lips become thinner, more angular, and less defined.
• Fat compartments begin to separate, causing visible puffiness and disrupting the smooth facial contour.
• Excess skin and fat accumulate around the nasolabial folds, jawline, and below the eyes.

In youthful faces, superficial and deep fat compartments are evenly distributed, flowing smoothly into one another to create soft contours. As we age, these compartments shift and lose cohesion — similar to the way old cushions separate — which distorts the natural curves that define youthful beauty.

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Deterioration of skin quality

With age, the skin doesn’t just change in appearance; its structure also declines. The production of collagen and elastin decreases, making the skin thinner, less elastic, and less resilient. This makes it harder for the skin to adapt to the reduced volume beneath it, resulting in wrinkles, folds, and sagging.

Facial muscles try to compensate for the loss of volume. Around the eyes, this results in crow’s feet; on the forehead, in horizontal lines from lifting the brows; and around the mouth and chin, in fine lines and dimpling. Over time, the mismatch between the shrinking skeletal structure and the slackening skin becomes more pronounced — and that is what makes aging visibly noticeable.

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Subtle corrections for natural results

According to Dr. Frodo, true beauty is a subtle signal of health and vitality that is mostly perceived unconsciously. A cosmetic treatment is only successful if it looks natural — when others can’t tell anything was done. If it is noticeable, it sends the opposite message: fragility and aging.

By combining anatomical expertise with a careful approach, it’s possible to gently restore facial balance. Not by overfilling or smoothing everything out, but by respecting and enhancing the face’s natural structure and harmony.

Curious what we can do for you? Book a no-obligation consultation — we’ll be happy to explore your options together.

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