The aging face

Aging is an inevitable process. Most patients identify the concept of self-image in their facial appearance. The face is also our interface with the outside world. Changes in the face secondary to aging are the most apparent. Some aspects of aging are fairly uncontrollable, and these are largely based on hereditary factors. Other factors are somewhat controllable and are largely the result of exposure to the elements and harmful habits. The processes of facial aging are slowly becoming understood. Although different patients appear to age at different rates, biologic aging does not seem necessarily to follow chronologic aging in the same fashion in different individuals. However, a fundamental pattern as well as sequence in aging is fairly predictable and describable. The effects of ultraviolet radiation and involutional changes are manifested in the skin as wrinkles. Involutional changes in the suspensory structures in the face result in skin laxity and dependency. In this article, the various factors involved in aging are reviewed. The effects of these factors in different regions are discussed, with representative illustrations to represent concepts.