Las Vegas Plastic Surgery
The surgical journal Plastic and Reconstructive Surgery reported that Dr. Robert Shaw Jr. and his team recently documented substantial reductions in facial bone mass over time.
Dr. Shaw and his team performed CT scans of the facial bones on 120 different men and women who were aged 20 to 40, 41 to 64, and 65 years and older. Using three-dimensional reconstructions of the CT scans, they then took detailed measurements of the facial bone structure.
In the article, Dr. Shaw said, “With age, the scans showed that the bones that make up the eye sockets recede, enlarging the sockets. A few less millimeters of bone for the soft tissues of the face to hold on to adds to the appearance of excess or droopy skin around the eyes. Similar losses of volume happen in the bones of the middle face, including the brow bone, nose and upper jaw. The loss of bone can also reduce the angle of the lower jaw, which is why those with a strong jawline in their youth may not be so well-defined in old age. Throughout your life, bone is constantly being made and reabsorbed. Aging may cause the creation of new bone to work a little less well, perhaps causing more bone to be absorbed than is created.”
For men, the most pronounced bone loss was at 65 and older. Bone loss starts earlier sooner with women. Women’s facial skeletons aged between 41 and 64 years old looked very different than their facial bones did during the ages of 20 and 40.
Dr. Shaw states further, “The original thought was that skin goes through changes, such as a loss of elasticity and fat, so the primary approach to facial rejuvenation was skin tightening procedures, but a lot of faces never looked like they did when they were younger. Patients bring in pictures and say they want to go back to that look, but they can never really go back to that look just by tightening their skin alone. If there are changes to those underlying structures it’s going to change the appearance of how the skin looks.”
Dr. Phillip Haeck, President of the American Society of Plastic Surgeons, called the study a “milestone” for its careful documentation of facial bone changes.
“Aging is multi-factorial. There are all these different factors that come into play in how you look at 40, 50 or 60,” Haeck said. “The things that affect it are genetics, external factors such as sun damage and nicotine use. Then there is plain old loss of volume of the soft tissues and bone.”
This study helps us understand the relationships between the hard tissues and soft tissues of the face. It sheds light on what plastic and cosmetic surgeons see clinically. With increased knowledge, plastic surgeons can hopefully go forward and apply this information to better help our patients. My practice, Las Vegas Plastic Surgery, offers several facial rejuvenation procedures, including face lift and brow lift and I will review the results of this study when discussing these procedures with new patients.
Jeffrey J. Roth, M.D., F.A.C.S.