In this paper I will explore the anatomical basis and aetiology of lower facial ageing. In particular we shall highlight the changes occurring in the facial skeleton, fat compartments, musculature and skin. Understanding the pathology allows us to generate a treatment protocol in keeping with the most effective sequence of treatments at the correct injection sites in order to generate tissue lift and support. In my experience, effective treatment of this area tends to produce impactful results associated with high levels of patient satisfaction.
During ageing of the lower two thirds of the face we observe the following changes when considering the tissue layers from superficial to deep 1:
Fig 1 and 2 display the ageing process of the lower two thirds of the face
1. Skin – laxity, sagging and excess due to photo damage related loss of collagen and elastin
2. Fat – mid and lower facial lipo- atrophy resulting in deflation and subsequent inferior migration of the fat compartments
