The comprehensive, multi-layered biological and structural processes that collectively contribute to the visible signs of aging in the facial region, extending beyond superficial skin changes. This includes bone resorption, fat pad displacement, muscle atrophy, and the degradation of the dermal and subdermal collagen and elastin matrix. Understanding these mechanics allows for targeted, holistic aesthetic and regenerative interventions.
Origin
This clinical concept integrates principles from anatomy, plastic surgery, and geroscience, moving the focus from isolated wrinkles to the entire structural complex of the face. ‘Mechanics’ emphasizes the physical forces and underlying biological causes of the visible changes over time. Hormonal influence is central, as systemic endocrine decline affects bone density, fat distribution, and collagen renewal.
Mechanism
Age-related hormonal shifts, particularly the reduction in growth hormone and sex steroids, accelerate the remodeling of facial bone structure and lead to a loss of volume and projection. Concurrently, gravitational forces and repeated muscle action contribute to the descent and displacement of subcutaneous fat compartments. The cumulative effect of dermal collagen degradation, coupled with these deep structural changes, manifests as skin laxity, jowling, and the characteristic changes in facial contour.
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