Facial Aging: A Quantitative Analysis of Midface Volume Changes over 11 Years

Area of Science:

• Aging and facial anatomy
• Plastic surgery and facial rejuvenation
• Radiology and medical imaging

Background:

• Anatomical studies reveal distinct superficial and deep facial fat compartments.
• A theory suggests deep midface fat volume loss causes superficial fat pseudoptosis.
• Evidence on age-related facial fat volume changes, particularly differential compartment loss, is limited.

Purpose of the Study:

• To quantify age-related volume changes in superficial, deep, and buccal fat compartments of the midface.

Main Methods:

• Retrospective longitudinal study of individuals aged 30-65 years.
• Facial computed tomography (CT) scans were analyzed at two time points, at least 10 years apart.
• Superficial midface, deep midface, and buccal fat volumes were quantified using Horos radiology software.

Main Results:

• Mean total facial fat volume significantly decreased from 46.47 cc to 40.81 cc (p < 0.01).
• Both superficial (26.10 cc to 23.15 cc, p < 0.01) and deep (11.01 cc to 8.98 cc, p < 0.01) fat volumes showed significant age-related decline.
• Buccal fat volume remained relatively stable (9.36 cc to 8.68 cc, p = 0.04).
• Patients lost an average of 11.3% of superficial and 18.4% of deep fat volume.

Conclusions:

• Significant volume loss occurs in both superficial and deep facial fat compartments over time.
• A greater percentage of deep facial fat is lost compared to superficial fat.
• These findings support the theory that deep midface fat loss contributes to pseudoptosis.