Age-related and positional changes in facial angles: insights from an Asian cohort

Since aging leads to changes in facial angles, the effect of age on impressions of facial appearance involves factors such as face shape, eye color, nose size and placement, and mouth size and placement, as well as skin morphological and tonal characteristics, including wrinkles, spots, and sagging. Identifying the extent of change in facial angles can aid surgeons in interpreting facial landmarks before nasal surgery. Hence, this study evaluated changes in facial angles at different positions in a cohort of older Asian patients.

This study enrolled 47 patients admitted for nasal surgeries, including 33 men (70.2%) and 14 women (29.8%). The average age was 48.15 ± 18.7. Nasolabial, nasofrontal, nasomental, and nasofacial angles were measured in the sitting, supine, and neck extension positions. Patients were divided into two groups: younger (≤ 60 years, n = 28) and older (> 60 years, n = 19) to evaluate the effect of age on facial angles.

The supine-extension nasofacial (p = 0.031) and nasomental (p = 0.023) angles decreased with age. Concurrently, nasolabial angles increased with age in the sitting-supine position (p = 0.012) and sitting-extension positions (p = 0.019). Additionally, the analysis of variance and regression model demonstrated a decrease of 0.019°/year in nasofacial angle between the supine and neck extension positions, whereas the nasomental angle between these positions declined by 0.032°/year. In contrast, between the sitting and supine postures and the sitting and extension positions, the absolute difference in nasolabial angles increased (0.140°/year and 0.128°/year).

This preliminary study showed that facial angle characteristics changed more between different postures in the older age group; thus, clinicians should exercise caution when performing aesthetic nasal procedures in older patients.