3D CT-Based Longitudinal Analysis of Facial Skeletal Aging

Melih K Sifil ¹, David M Kahn ¹

⁰Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, CA.

Aesthetic Surgery Journal +

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July 14, 2025

View abstract on PubMed

Summary

Facial skeleton remodeling occurs with age, showing reduced height and width. These longitudinal findings highlight the importance of considering bone changes in facial rejuvenation.

Area Of Science

Craniofacial anatomy
Aging research
Medical imaging

Background

Facial aging involves complex, region-specific changes in soft tissue and bone.
Previous studies on skeletal remodeling often use cross-sectional imaging, limiting longitudinal understanding.
This study addresses the need for longitudinal data on bony changes over time.

Purpose Of The Study

To quantify and characterize age-related changes in facial skeletal morphology.
To longitudinally assess skeletal facial aging using serial three-dimensional CT scans.
To establish a baseline for understanding individual skeletal aging patterns.

Main Methods

Retrospective analysis of 96 Caucasian adults with two facial CT scans approximately a decade apart.
Three-dimensional reconstruction and anatomical measurements across facial thirds.
Statistical analysis using paired t-tests and ANOVA to identify significant changes.

Main Results

Significant reductions observed in vertical facial height, transverse width, and specific facial angles (glabella, pyriform, maxillary).
Increase in orbital aperture area and mandibular angle with age.
Age-related changes were most pronounced in individuals aged 30-50 years.

Conclusions

The facial skeleton undergoes measurable remodeling throughout the aging process.
Longitudinal data supports the necessity of addressing bony changes in facial rejuvenation.
Enhanced understanding of skeletal aging can lead to more accurate and durable aesthetic interventions.