Adult facial growth: applications to aesthetic surgery.
BACKGROUND
Reshaping of the face with age is a result of volume change and loss of support. It is not well understood which tissues are involved in this process. Recent publications suggest that adult bone growth may have a significant role.


OBJECTIVE
We report a longitudinal cephalometric analysis of midfacial growth in adults to determine the role of bone in facial aging.


METHODS
The Behrents modification of the Bolton Cephalometric study in patients up to age 83 was reviewed. A trigonometric analysis targeted orbital and anterior maxillary growth.


RESULTS
Facial bone growth is shown to continue throughout adulthood. Anterior descent creates increased bone projection.


CONCLUSIONS
The appearance of facial aging is caused by attrition of soft tissue volume and loss of support. The deficiency of maxillary bone projection seen in some patients, with tear trough depression and negative vector eyelid (polar bear), preexists adulthood and is unmasked with age.
Levine
Richard A
RA
ralevinemd@att.net
Garza
Jaime R
JR
Wang
Peter T H
PT
Hurst
C Lynn
CL
Dev
Vipul R
VR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D002508:Cephalometry; D004954:Esthetics; D005145:Face / Q000033:anatomy & histology* / Q000601:surgery; D005147:Facial Bones / Q000254:growth & development* / Q000601:surgery; D006801:Humans; D008445:Maxillofacial Development; D008875:Middle Aged; D013997:Time Factors