Surprise! your face doesn't age evenly

Plastic surgeons are tossing out the old-school belief that gravity is the primary culprit for facial aging. A study in June's Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), reveals the human face is made up of distinct fat compartments that individually change with age and the degree to which our faces age is dependent, in part, on how these compartments change over time.

"Contrary to popular belief, the human face does not age uniformly," said Joel Pessa, MD, ASPS Member Surgeon and study lead author. "We thought facial fat was one confluent mass that eventually got weighed down by gravity, creating sagging skin. However, we were shocked to find not only is the face made up of individual fat compartments but these compartments gain and lose fat at different rates."

According to Dr. Pessa, the face is a three-dimensional puzzle with fat partitioned into discrete units around the forehead, eye, cheek and mouth. A youthful face is characterized by a smooth transition between these compartments, but as we get older abrupt contour changes occur between these regions due to volume loss, volume gains, and repositioning of the compartments. These changes lead to tell-tale signs of facial aging such as sagging or hollowed skin and wrinkles.

With this breakthrough, plastic surgeons will be able to more accurately pinpoint trouble areas and use injectable fillers to add volume to individual sections of the face, creating a more effective way to turn back the clock.

According to the study, this discovery may also benefit cancer and trauma patients who require reconstructive plastic surgery. The authors uncovered that the individual fat compartments have boundaries between them that act like fences. These fences allow the face to maintain its blood supply should it become injured. This anatomical discovery may allow for better results for reconstructive plastic surgery patients. In addition, plastic surgeons can begin to use this new way of thinking to better understand facial deformities, such as cleft lips and vessel tumors.

"Much of facial anatomy remains a mystery," said Dr. Pessa. "This discovery will undoubtedly play a role in how we view aging and how we approach facial reconstructive surgery."