Asian woman age progression

Added: Lorene Heyer - Date: 02.12.2021 23:16 - Views: 35798 - Clicks: 4682

The normal course of aging alters the harmonious, symmetrical, and balanced facial features found in youth, not only impacting physical attractiveness but also influencing self-esteem and causing miscommunication of affect based on facial miscues. A general overview of the changes occurring within each of the main layers of the facial anatomy is presented, including facial skeleton remodeling, fat pad atrophy or repositioning, changes in muscle tone and thickness, and weakening and thinning of the skin. This is followed by an in-depth analysis of specific aging regions by facial thirds upper, middle, and lower thirds.

This review may help aesthetic physicians in the interpretation of the aging process and in prioritizing and rationalizing treatment decisions to establish harmonious facial balance in younger patients or to restore balance lost with age in older patients. s of facial aging, such as wrinkles and folds, poor skin tone and texture, and an imbalanced distribution of soft tissue, can have deleterious psychological, emotional, and social effects because facial aging alters self-perception and how individuals are seen by others. Key features of primarily non-Asian youthful faces include large almond-shaped eyes, cheek fullness, a curvilinear profile, slightly protrusive and full lips, an adequately projecting chin, a defined jawline, and homogeneous skin tone.

Knowledge regarding the etiology of facial aging changes has developed considerably, advancing from a simple focus on gravity and skin laxity to an increasing understanding that aging is a complex, dynamic, integrated process involving all layers of the facial anatomy. However, age-related changes in skin texture, pigment, and bone structure affect all populations.

We begin with a general overview of the changes that occur within each of the main layers of the facial anatomy—bone, fat, muscle, and skin—then provide an in-depth analysis of specific aging regions by facial thirds upper, middle, and lower thirds that complements how aesthetic clinicians generally evaluate and treat the face. Facial aging is a composite, interrelated, 3-dimensional process involving changes to the bone, soft tissue, and skin. It is a complex, multifaceted process wherein a change in 1 layer often causes a cascade of changes to adjacent layers.

The facial bones are the framework for the attachment of overlying soft tissue, providing stability, structure, and definition. Support from this platform diminishes as the bones recede and remodel with age, resulting in the recession and repositioning of the overlying soft tissue.

This in an inferior and medial repositioning of fat p and muscles as they realign over the shifting bony foundation. Progressive bony remodeling occurs with age in areas that resorb in a specific and predictable manner. The mandibular angle in females increases, as does the anterior projection of the chin. Images show this process in a young female A vs older B adult. Panel C shows the clinical presentation during young adulthood in this female patient at 22 years of age, whereas panel D reflects changes secondary to bony remodeling of the mandible with aging in the same patient at 70 years of age.

Dashed lines represent areas of the chin and jawline visibly impacted by bony remodeling of the mandible. Patient images in panels C and D provided by B. Kent Remington, MD, owner of these original images, who has granted permission to publish them. Orbital bone resorption occurs mainly in the inferolateral and superomedial regions. Images depict the integrity of the medial cheek fat pad, periorbital bone, medial brow, and lid-cheek junction in a young adult A vs the age-related changes in an older adult B , including exaggeration of the brow and tear troughs as well as smaller, rounder-looking eyes.

The fat compartments in the face Figure 3 are broadly characterized as superficial or deep relative to the superficial musculoaponeurotic system. Fat compartments in the face are broadly characterized as superficial A or deep B. Superficial fat compartments A are separated by fascia and septae that meet at adjacent compartments, where retaining ligaments reside, with each component found in varied amounts, proportions, and arrangements in different regions of the face.

Although in general it is believed that deep fat atrophies and superficial fat tends to reposition or hypertrophy, 23 , 35 fat atrophy has been commonly observed in the superficial fat compartments of the forehead and in the periorbital and perioral regions. Shifting occurs from bony remodeling as the fat p move with the bony changes and from weakening of the supporting ligaments.

This movement tends to increase hollows in the cheeks and flatten angles of the face 39 as well as contribute to hollowing of the temple. s of senescence related to facial muscle aging result from repetitive muscle contraction and muscle tone changes.

A typical occurrence in the aging process is that of repetitive muscle contraction resulting in the appearance of superficial and deep dynamic wrinkles during animation. Figure 4 illustrates dynamic discord in the perioral region. The orbicularis oris muscle overwhelms the perioral skin, resulting in puckered lips in the youthful face but resembling tense, pursed lips with aging. Perioral dynamic discord is illustrated across the ages. With aging, the skin envelope deteriorates faster than the muscle strength, leading to the orbicularis oris overwhelming the perioral skin.

Images provided by Steven Liew, MD. Both intrinsic and extrinsic factors are crucial determinants of the appearance of aged skin. Intrinsic aging is due to the passage of time and affects individuals at variable rates. The resilience of the skin resides primarily in the dermis, because this layer is composed of collagen that contributes to the bulk and strength of the skin, elastin that contributes to elasticity, and glycosaminoglycans that play a key role in skin hydration.

The rate of collagen breakdown increases, whereas the rate of collagen synthesis decreases. At 40 to 50 years of age, elastin biosynthesis begins to decline steeply, and elastin is lost through natural degradation. Glycosaminoglycans increase as opposed to degrade, but they accumulate in disorganized aggregates and become unable to regulate hydration, causing the skin to appear leathery.

As aging progresses, the face undergoes a spectrum of changes resulting from deflation, deterioration, and descent. However, most patients will present with a mixture of aging s that reflect the underlying facial anatomy. In the forehead and glabellar area, the main s of aging include wrinkle formation 7 , 8 and the nasofrontal angle increase that flattens and decreases projection.

The temporal region undergoes age-related change in superficial fat p, resulting in a decrease in bi-temporal width and a scalloped appearance. However, the upper and middle thirds of the compartment thin with age while the lower third becomes progressively thicker. Superficial temporal compartment: volume and size by age group. Mean height increases from 2. Age-related changes to the eyebrow position vary considerably, with some individuals experiencing brow ptosis and others exhibiting brow elevation. This anatomical feature in less support for the lateral eyebrow.

The lateral eyebrow also may sag from the downward force created from the descent of the preseptal and galeal fat p. The earliest s of facial aging are often visible in the periorbital area, with changes in skin color and appearance. There is consistent loss of fat of the superomedial orbit, nasojugal groove, and palpebral-malar junction, averaging 0. This phenomenon is more predominant in African American women than in Caucasian women.

Globe retrusion ie, senile enophthalmos causes the eye to appear to be deep-seated or sunken and narrows the palpebral fissure. The spectrum of age-related changes of the upper and lower eyelids ranges from soft tissue sagginess to under-eye bags to hollowness. The upper eyelids descend with age, causing elongation of the upper lid length, loss of alignment of the upper eyelid fold and upper lid margin, projection of the tarsal region, and increased visibility of the pretarsal region.

Typical A-frame deformity in this year-old Caucasian female A and sunken eye appearance in this year-old Asian male B. The lower eyelids also descend, leading to fat accumulation and scleral show. Infraorbital fat herniates forward, as the inferior orbital rim recedes and inadequate skeletal support fails to maintain the attenuated soft tissues in their proper location. These wrinkles mainly occur from repetitive contraction of the lateral orbicularis oculi muscles when smiling. Eyelash changes include a reduction in length, thickness, and darkness eyelash hypotrichosis.

It has been speculated that age-related hair follicle changes will be similar, regardless of location. Age-related loss of hair color is caused by a reduction of melanocyte activity in the hair follicle. The tear trough often refers to the hollow between the eye area and the upper medial cheek, extending to slightly below the orbital rim. It comprises the medial third of the nasojugal groove, where the orbicularis muscle is firmly anchored to the underlying bone.

The lid-cheek junction comprises that portion of the nasojugal groove that extends below the orbital rim. Tear troughs become more visible with age, mainly from deflation of soft tissue, fat atrophy, and fat descent. Attenuation of the supportive structures of the nose may cause a droopy, more prominent tip and nasal lengthening as an individual ages. In the midface, the cheek loses projection as the ogee curve flattens, and the submalar region becomes increasingly concave.

In addition, deflation of the superficial lateral temporal fat p contributes to lateral cheek atrophy. Nasolabial folds are formed during smiling as the levator muscles of the lip contract, causing tissue expansion pressure within the overlying superficial nasolabial fat pad. These changes cause the forward curve of the muscle to decrease, 89 and as the shape of the muscle changes, structural support beneath the lips diminishes, causing lip retrusion and the lengthening and thinning of the vermilion border loss of the upper lip pout.

This, together with maxillary retrusion, causes a dramatic shift of the overlying soft tissue. The loss of support from changes to the underlying structures of the perioral region creates skin laxity, contributing to the development of perioral lines and folds. These lines often develop in response to repetitive pursing of the lips and are most evident in smokers.

Most vertical lip lines form perpendicular to the orbicularis oris muscle. Other prominent s of aging in the perioral area include drooping of the oral commissures and formation of labiomandibular folds, also known as marionette lines.

The chin zone is a 3-dimensional entity, having height, width, and projection. The major s of chin aging include alterations in the shape and projection of the chin. The jawline loses definition as fat in the jowls becomes more prominent with age and the cervicomental angle, or the break point of the vertical portion of the neck and the transverse portion of the submandibular region, increases.

Facial aging is an intricate process involving interrelated changes to bone, muscle, fat, and skin. Too often, clinicians treat these s of aging without a real understanding of their etiology. Recognizing the anatomical alterations that underlie the changing appearance of specific facial areas may enable clinicians to treat patients more precisely and effectively to achieve optimal outcomes. Although there are still unanswered questions and opposing theories in the literature regarding the effects of aging on specific facial areas, there is, nonetheless, strong scientific evidence for understanding how changes to underlying tissue alter the aging face.

Weinkle has served as a lecturer and advisory board member for, and received research grants from, Allergan plc, an AbbVie Company. Garcia and M. Silberberg are employees of Allergan plc, an AbbVie Company, and own stock or stock options in the company. This research was supported by Allergan plc, prior to its acquisition by AbbVie, Allergan plc provided writing and editorial support for this manuscript, and employees of Allergan plc participated in the research, the interpretation of data, the review of the manuscript, and the decision to submit for publication.

The opinions expressed in this article are those of the authors. The authors received no honoraria related to the development of this article. Psychosocial aspects of aging skin. Dermatol Clin. Google Scholar. Friedman O. Changes associated with the aging face. Effect of facial rejuvenation surgery on perceived attractiveness, femininity, and personality. Fitzgerald R. Contemporary concepts in brow and eyelid aging.

Asian woman age progression

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