Anatomy is complex, and when we assess a face at Skin Worthy not only are we looking at the 5 facial layers and how they age, we are also looking at the neighbouring anatomical regions. The surrounding areas and their aging process creates changes and concerns that patients come to us with. At Skin Worthy one of our three pillars is education. When we provide a Beauty Evolution assessment, a part of the process is to educate on what is happiness in an individual's face. Understanding the complex changes that occur in a face and why we recommend certain treatments is based in education and ensuring our patients are informed.
Let’s dive in to what happens in the upper third of the face and specifically focusing on the forehead this month. As a general overview here are the outward changes we see in a forehead during the a patient's lifespan: Loss of superficial fat in the forehead, brow, temples and upper eyelids will accentuate underlying structures such as the muscles, vasculature and bony ridges. With the loss of parts of the bone and protrusion of other areas, we start to show shadows, and there is an overall off of support to the muscle and skin, causing more wrinkles and sagging of the skin.
Layer 5 : Bone
At the deepest layer we have the skull , overall the whole skull tends to recess back , however some areas protrude more. The temporal crest, frontal bone of the forehead and orbital rim of the eye are 3 areas that become more noticeable as layers above become thinner and expose the boney ridges. The forehead in youth has a curvature and convexity to it , with age the forehead flattens back, and even indents inwards. The skull is the scaffolding for all layers above, and as we lose structure here, this affects how all tissues above behave and function.
The skull is the scaffolding for all layers above, and as we lose structure here, this affects how all tissues above behave and function.
Layers 4 & 2 : Deep and Superficial Fat
We have 2 layers of fat in the forehead, one layer just above the bone and below the muscle and another layer above the muscle just below the skin. These fatty layers thin as we age, which results in less “padding” to the forehead. With less of this padding, you can see bony ridges, the muscles of the lower forehead - (Corrector muscles, or procures ) can be seen under the skin and patients notice “bumps” or protrusions above the brow that they have never noticed before
In addition, loss of volume in the temple and tissue fullness below the brow causes the tissues in the area to begin to sag, causing the appearance of droopy eyelids
Layer 3 : Muscular layer
With the loss of the layers below (bone and fat), muscles now contract in a stronger way and their position at rest is different than with the previous support. More wrinkles are formed due to more muscular activity and with the loss of fat above the muscle, this decreased “padding: causes the skin to collapse and fold more easily.
Layer 1 : Skin
With age, skin thins due to loss of collagen and elastin. As a result every contraction caused by the muscle, deepens wrinkles and makes them more permanent. Additionally thinning of bone and 2 fatty layers, further adds to the sagging appearance of skin as there is less support for this layer.
So, all this aging information and what can we do with it? Some simple non-surgical solutions that provide quick and effective results:
Hyaluronic Acid based filler: These fillers are safer as they are reversible and when working in riskier areas such as temples and the forehead they are a nice option. Fanning filler into the forehead where volume is lost or into the temple we restore support for the skin and muscle, soften the transitions of volume loss, and finally, the youthful curvature of the forehead can be replicated.
Botox/Nuceiva: Injecting a neuromodulator decreases the unclear activity and can manipulate how the muscles sit at result. With this, we can soften and prevent wrinkles from worsening, and change the position of how the brow sits at rest.
Collagen induction therapy : Although this is a broad spectrum of treatments, the goal here is to create a controlled injury with lasers, or by microneedling to start to increase collagen and elastin in the skin to restore thickness, elasticity and resilience in the skin. As we age out skin changes from a thick rubber elastic band, to tissue paper. With the treatments mentioned above, we can get the skin to move back towards the resilient elastic band.
In summary, aging is complex, multilayered and neighbouring areas play an impact in how we perceive age. We don’t write these blogs to confuse or scare you but to give you a hint at what to expect in education, care and support here at Skin Worthy.
Ready to learn more? Click here or call or text 657-350-7546 to book your 54321 consultation with Nurse Barb and Dr. Hemsworth.