The longer we live, the more we have been able to find out about aging. Most people think about it, try to prevent, and try to correct it – but have you thought about the specifics. Dermatologist, ophthalmologists, and plastic surgeons have to think about the specific parts of the face that cause aging in order to reverse the effects. Below we will explore what the doctors have to say about aging.
The skin has two layers: the epidermis (the most superficial layer) and the dermis (deeper layer of connective tissue). The epidermis is made of a certain type of cells called stratified squamous epithelium cells. These cells are constructed to repel water but keep in moisture, be relatively tough, and to shed every 48 days and be constantly replaced. There are also other cells here, like melanocytes to give the skin its pigment, and keratinocytes, cells that provide a barrier. The dermis is composed of many cells that contain collagen, elastic fibers, proteins, and blood vessels.
Intrinsic vs. Extrinsic Aging
In normal aging, also known as intrinsic, the skin becomes increasingly lax. With more cell turnover, it loses its natural regenerative capacity. This loss is particularly prevalent in the dermis and affects collagen heavily. The collagen and proteins in the skin lose their tight connections, leading to increased loosening of the skin on a molecular level. Melanocytes also decrease with age, causing patchy skin pigmentation.
Extrinsic aging refers to aging secondary to other factors rather than the body’s natural processes. The biggest offender is the sun. Ultraviolet radiation, UV rays, affects the skin. Only the epidermis can be penetrated by UV-B rays. These rays are then absorbed into the DNA of cells, which then damages keratinocytes and melanocytes, leading to sunburn, immunosuppression, and cancer.
Specific Face Regions Implicated in Aging
Doctors look at specific parts of the face when evaluating aging. Knowing these may help clients communicate their wants and needs with their doctors better.
Forehead and Temple
As people age, they lose volume. This happens due to atrophy – loss – of fat and muscles in the face. These causes the temple in particular to look sunken. When people feel they look gaunt, this wasting of fat and muscle is the cause.
Brow and Upper Eyelid
As people age, their eyebrows begin to droop and actually descend onto the lower part of the brow bone. The upper eyelid has the thinnest skin of the entire body. As people age, this thin skin droops. At times, the skin can droop so much that it begins to cover the eyes. Unlike the forehead, the muscles that control the upper eyelid do not lose volume over time, so the aging here is purely related to the skin.
Lower Eyelid and Midface
In young people, the lower eyelid is plump and has full volume. With aging, this volume decreases. A “tear trough” forms in that area. Additionally, that area is particularly vulnerable to sun exposure because of the angle and where it is on the face. This causes accelerated aging there.
The nose appears to look longer with age. That is because the tip inferiorly rotates, meaning it hooks downward with age. Additionally, the bony areas adjacent to the nose are resorbed with age, meaning the bone itself loses volume. This causes the nose to appear like it is standing out more.
Nasolabial and Perioral Region
Think of where a goatee sits on a face. This is the nasolabial and perioral region. With age, these areas form deeper wrinkles and lose elasticity, meaning they droop as well.
Neck and Jawline
With age, the jaw bone actually loses volume. This contributes to “turkey neck”. A muscle in the neck also pulls on the looser skin, contributing to that appearance.
Topical treatments are the least invasive options. The first topical option is preventative: sunscreen. As stated above, UV exposure is the biggest cause of extrinsic aging. Proper sunscreen and sun avoidance helps prevent aging. Topical Vitamin C also prevents UV damage and is a beneficial addition to one’s skin routine. Retinoids are a compound related to Vitamin A. They can significantly improve damage. They also increase damage control at the molecular level, leading to increased protein and collagen synthesis.
Lasers are another popular treatment. They can be used by themselves or in conjunction with some of the other treatment options. One of the least invasive lasers is the 640-nm nonfractional, nonabrasive laser. This stimulates collagen production and reduces the appearance of fine wrinkles. In general, these lasers require multiple applications. Ablative lasers may also tighten pores.
There are two main types of injections: fillers and botox. Fillers are useful tools to correct for volume loss. Categories of fillers include hyaluronic acid, synthetic fillers, and autologous fillers. These are a great option to fill in parts of the face that lose volume or have deep folds, like the brows and nasolabial folds. Botox is a paralytic. Botox helps reduce the appearance of deep wrinkles. If done with certain techniques, it can also act as a lift in the brow area.
Of course, the most invasive option is surgery. Surgery can be performed to lift the brows, forehead, and midface, to remove excess eyelid skin, to add fat to areas with significant volume loss, and to improve lip volume.
There are many options to combat aging. At the Anti Aging and Wellness Clinic, we have developed state-of-the-art treatment protocols to address aging. If you are interested in learning more about how you can use this technology for your own health goals, please contact our clinic today.