Sagging and Wrinkles

With aging comes many structural changes in our faces. Volume loss in facial fat pads, skin density, bone mass, and muscle atrophy result in sagging skin and wrinkles.
Sagging at ages 35, 45 and 55

With volume loss, overlying structures lose support, and facial features begin their descent.

Notable examples of facial structural changes:

  • Cheeks assume a lower position creating deeper nasal labial folds and undereye hollows
  • When temples become concave, brows droop, the forehead becomes longer, and eyes and lids begin to sag
  • The nasal bridge and tip widens and drops, adding depth to nasal labial folds
  • Bone loss in the chin contribute to “jowling” and marionette lines
  • Loss of volume in lips creates “smoker’s lines” and elongates the space between the nose and lips, etc.

Youthful face vs. Aging faceBasically, without the support of volume, facial features drop, folds form, and we look older.

Volume loss also contributes to wrinkling. In youth, faces are plump, voluminous, and wrinkle-free, much like a juicy grape. As we age, our faces become deflated, and our faces become more like raisins. Many feel that a facelift is the simplest remedy or gold standard in restoring a youthful face. A facelift alone cannot restore an aging face into a youthful, voluminous one. Volume replacement is necessary to reverse the raisin into a grape; otherwise, the result may be the raisin has become more of a pea.

Halle Berry in 2002 vs. 2012

(not our patient)

Further, erasing lines and wrinkles alone does not restore a youthful face. Erasing lines and wrinkles certainly improves skin quality and contributes to a more youthful appearance; however, volume replace remains necessary for true restoration of youthful features.