Not all signs of ageing are obvious ones, like lines and wrinkles. If you look in the mirror and feel you’re looking older but can’t put your finger on the reason why, it’s because the change is happening on the inside, not the outside.
The culprit is facial fat. Facial fat is a good indicator of someone’s age as it’s something we gradually lose over our lifetimes. It’s easy to identify a baby or toddler by their chubby cheeks, but as a child grows their face slims down and the “puppy fat” is eventually lost.
Unfortunately this process does not stop after puberty; we continue to lose facial volume. The results of this usually start to be seen in the mid to late 30s. There are subtle changes to the face shape, which might make you feel less youthful.
How facial volume changes as we age
A youthful face has a smooth covering of fat, giving an overall rounded appearance. The cheeks have a round projection, the lips are full and the forehead and jawline display clean arcs. As soft tissue fullness declines, the skin begins to sag downwards. Starting from the forehead, this leads to a “heavier” brow, droopier skin around the eyes and hollowing of the eyes and cheeks as the fat moves southwards.
The extra weight in the lower half of the face results in the appearance of nasolabial folds (marionette lines) and jowls, which disrupt the smooth line of the jaw. In contrast to the fat loss seen in certain parts of the face, fat cells in other places increase in size. This can result in a double chin, bulging lower cheeks and under eye bags (the appearance of protruding fat around the eyes is exacerbated by the loss of volume from the cheeks beneath).
The impact of facial bone loss
It’s not just fat that diminishes as we age; we lose bone too. Throughout our lives bone is constantly being made and reabsorbed, but ageing slows the process causing more bone to be absorbed than is created. This means facial bones decrease in density and start to recede. The bones of the eye socket gradually widen, the brow bone shrinks back and the jawbone becomes less defined.
In women, changes to the facial skeleton can be seen between 41 and 64, while the most pronounced bone loss happens for men when they are 65 and older. Facial bones are like scaffolding for the tissue and skin, so a reduction in bone volume is another factor responsible for facial sagging.
The widening of the eye sockets causes the skin above the eyes to droop, as it has less to cling onto (sagging is exacerbated by fat loss around the brow). Likewise, a reduction in the angle of the lower jaw contributes to a less well-defined jawline.
Why skin tightening alone won’t make you look younger
In the old days plastic surgeons used to tackle facial ageing by lifting the skin; pulling it taught, removing the excess and reattaching. Now we understand that skin tightening is only one part of facial rejuvenation. Skin tightening alone won’t ever be able to restore a person’s youthful looks, since the loss of facial volume will still be evident.
To achieve true rejuvenation, it’s vital to “make good” the underlying structures - otherwise it’s like trying to paper over unplastered bricks. Volume can be restored using transplanted fat, dermal fillers or, in more advanced cases, facial implants.
Dr. Kai Kaye, Head Surgeon at Ocean Clinic Marbella, combines fat transfer with all his facelift procedures. Fat is taken from a donor site elsewhere on the body and grafted to key areas of the face, such as the cheeks, lips and jawline. The extra volume not only restores youthful contours, it helps to plump out the skin, smoothing away wrinkles and improving skin tone.
What if I’m not ready for a facelift?
Facial fat loss contributes to the earliest signs of ageing - the subtle differences you start to notices in your 30s, like a decrease in skin tone. Of course, this is far too early for facelift surgery, but you can start fighting volume loss.
Fat transfer to the apples of the cheeks, the lips and hollows of the eyes can have a dramatic effect in rejuvenating the appearance. Meanwhile, grafted fat can also be used to smooth out lines, such as those starting to appear around the mouth.
Fat transfer is a minimally invasive procedure, requiring only local anesthetic for both the removal of the donor fat and the re-injecting. The two procedures can be carried out on the same day.
As living tissue, transferred fat can provide permanent results, unlike dermal fillers that will need to be topped up every 12-18 months. This method also has the benefit of offering a plentiful supply of filler - most of us have pockets of fat on our abdomens or thighs that can provide more than enough for plumping out the face.
On the other hand, hyaluronic acid filler (such as Restylane) must be purchased by 1ml syringe, however, if you have a smaller budget it offers a more affordable way to get started. A single syringe to the lips provides a noticeable difference, while 1ml can also successfully be used to fill in marionette lines around the mouth.
How do I know what areas of my face need treating?
Because of the knock on effect that fat loss can have, it can often be hard for people to understand exactly what treatment it is they need to restore youthfulness to their face. You might actually believe you need a facelift, when in fact you simply require a bit of extra volume here and there. An experienced surgeon, who is familiar with the anatomy of the face, can look at a patient and quickly see where small tweaks could be made to improve the appearance.
To book an assessment for fat transfer or dermal fillers contact Ocean Clinic Marbella on 951 775 518 or contact us via our website.