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Jaw Angle Changes Add To Aging Appearance, May Lead To Two-Step Approach To
(press release from University of Rochester Medical Center)
Facelifts and other wrinkle-reducing procedures have long been sought by
people wanting to ward off the signs of aging, but new research suggests that it
takes more than tightening loose skin to restore a youthful look. A study by
physicians at the University of Rochester Medical Center indicates that
significant changes in facial bones - particularly the jaw bone - occur as
people age and contribute to an aging appearance.
Presented at the American Association of Plastic Surgeons annual meeting in San
Antonio, Texas, and published in the Journal of Plastic and Reconstructive
Surgery, the study suggests that the future approach to facial rejuvenation
may be two-fold, first restoring structure underneath before performing
Reviewing a collection of 120 facial CT scans taken for other, unrelated medical
reasons, plastic surgeons measured changes that occurred to facial bones over
time. The CT scans were divided equally by gender and age, 20 men and 20 women
in each of three age groups: young (ages 20-36), middle (41 to 64), and old (65
and older). Researchers used a computer program to measure the length, width,
and angle of the mandible, or jaw bone, for each scan, and compare the results
for each group. Using CT scans for this study allowed for more accurate
three-dimensional reconstruction and increased accuracy of measurements,
disputing previous research that relied on traditional head x-rays and suggested
that the jaw bone expands with age.
The angle of the jaw increases markedly with age, which results in a loss of
definition of the lower border of the face, according to the study. Jaw length
decreases significantly in comparisons between the young and middle age groups,
whereas the decline in jaw height from the middle to old group was noteworthy.
"The jaw is the foundation of the lower face, and changes to it affect facial
aesthetics," said Howard N. Langstein, M.D., professor and chief of Plastic and
Reconstructive Surgery at the University of Rochester Medical Center. "These
measurements indicate a significant decline in the jaw's volume as a person
ages, and therefore less support of soft tissue of the lower face and neck."
This loss of bony volume may contribute sagging facial skin, decreased chin
projection, and loss of jaw-line definition. As jaw volume decreases, soft
tissue of the lower face has less support, resulting in a softer, oval
appearance to the lower face and sagging skin, which also affects the aging
appearance of the neck.
"Physicians have long been taught that facial aging is caused by soft tissue
descent and loss of elasticity," Langstein said. "Though we have always known
that bones change over time, until now, the extent to which it causes an aged
appearance was not appreciated."
The study by Langstein and plastic surgery resident Robert Shaw, M.D., gives
evidence that facial bones are constantly subjected to forces that remodel them.
Understanding there are predictable changes in facial bone structure as people
age gives physicians new insight into procedures that may successfully restore
youthful appearance. Shaw and Langstein led the three-institution collaboration,
which also involved Stanford University and Harvard University.
"The future of facial cosmetic procedures to restore a youthful look may include
methods to suspend soft tissue - such as chin and cheek implants - to rebuild
the structure that time has worn away, in addition to lifting and reducing
excess skin," Shaw said.
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