Advances in aesthetic medicine are changing how doctors assess facial aging, shifting the focus from treating individual wrinkles to understanding changes across the entire face.
Research shows that aging affects not only the skin but also facial fat, muscles, ligaments, supporting structures, and the underlying facial skeleton. These changes happen at different rates, making facial assessment increasingly dependent on a detailed understanding of anatomy before any treatment is considered.
A review published in Facial Plastic Surgery, “The Anatomy of the Aging Face: A Review,” describes aging as a process involving changes across bone, ligaments, muscles, fat, and skin.
Another review in Aesthetic Surgery Journal, “The Facial Aging Process From the ‘Inside Out,’” examined how changes beneath the skin eventually affect a person’s appearance.
Research published in Plastic and Reconstructive Surgery also found that facial fat is divided into distinct anatomical compartments. These compartments can change in size and position over time, affecting the shape and balance of the face.
Multi-awarded aesthetic physician Dr. James Co, founder of Cosma Institute and Architect of Aesthetic Confidence, said this makes proper assessment important before using aesthetic treatments.
“When you only look at the wrinkle, you are looking at the surface of a much bigger anatomical process,” Co said. “The face ages as a system. Good assessment means understanding what is happening underneath before deciding what should be done on the surface.”
A 2022 review of minimally invasive facial aesthetic procedures also examined patient-reported outcomes, including satisfaction with appearance and aspects of psychological and social well-being.
Co said advances in aesthetic medicine should not simply mean using more treatments or tools.
“What we can do is understand it better,” he said. “We can look at the science, understand the anatomy, listen to the patient, and make decisions that allow them to age while still looking recognizably like themselves.”