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What is facial aging?

Facial aging is a gradual and complex process that affects everyone. As we age, changes in the soft tissue (fat and muscle) and bone of the face lead to the hallmark signs of aging, such as prominent nasolabial folds, marionette lines, jowling, and skin laxity.

While everyone’s face changes as they get older, the initiation of the aging process and rate at which it progresses is highly individualized. While people can control some factors which impact the aging process, such as using sun protection, avoiding tobacco products, and exercising, much of this process is hereditary.

Characteristics of a Youthful Face

A youthful face is characterized by smooth contours and gradual, harmonious transitions between different facial features such as the eyes, cheeks, jawline, and neck. The fat beneath the skin camouflages the underlying bony skeleton so that no harsh transitions are visualized. The skin has an even texture without lines, wrinkles, and discolorations. The face has an aesthetically pleasing heart shape with fullness of the upper cheeks, and relative narrowing around the mouth.

As the face ages, the soft tissues of the upper cheeks get smaller and drop lower in the face. While there is some loss in soft tissue volume with age, the primary cause for age-related changes in the face is the gravitational ptosis of these tissues. This soft tissue descent leads to the following changes:

  • The bones below the eye and in the upper cheek become more apparent, creating more uneven contours and harsher transitions between facial features.
  • The nasolabial folds and Marionette lines deepen due to descent of volume from the upper to lower cheeks. The youthful heart-shaped face becomes square shaped, or even trapezoidal, as the lower cheeks become as wide or wider than the upper cheeks.
  • The soft tissues of the lower face fall over the lower border of the jawbone, effacing this transition which helps define a youthful face.
  • Weakening of facial muscles and mild loss of fat creates excess and sagging skin in the cheeks and neck (see photo below).

Aging face treatment - UNC Center for Facial Aesthetics Another contributing factor to signs of facial aging is, similar to bone in other areas of the body, a small amount of facial bone is lost as a person ages. This bone loss further effaces the border of the jawbone, especially below the ear where it becomes hollowed with a scooped appearance (see photo below).

Aging face treatment at the UNC Center for Facial Aesthetics

How can the aging face be treated?

The goal of facial rejuvenation is to restore a natural but more youthful appearance to the face. This may involve multiple procedures to the different facial regions. Some of the procedures include:

Why Choose the UNC Center for Facial Aesthetics for aging face treatment?

During your consultation at the UNC Center for Facial Aesthetics, we will discuss your goals for facial rejuvenation surgery. Our facial aesthetics care team works together to provide the best outcome possible for each facial aesthetics patient. To achieve the best possible outcome, we may recommend that you see more than one provider at our center since each clinician has a specific area of expertise in the different aging face treatments. While many facial aesthetic practices do not have multiple expert clinicians practicing together, at the UNC Center for Facial Aesthetics our team-based approach provides the highest level of expertise for each aspect of your aging face treatment.  Each patient presents a unique anatomic picture and requires a different set of tools for optimal, natural facial reanimation. Every patient’s treatment is customized to fit their unique condition and goals. We will work with you to help restore facial form and function.


If you would like to schedule a consultation for aging face treatment at the UNC Center for Facial Aesthetics, please call 984-974-2255 to make an appointment.