The Anatomy of Ageing
Why the face changes: volume loss, descending ligaments and the SMAS layer.
Four things change
Facial ageing is not one process but several happening together:
- Volume loss (deflation) — fat pads in the cheeks and temples shrink and descend, so the face looks hollow and heavy below.
- Soft-tissue descent — the SMAS and fat sag against the fixed retaining ligaments, forming jowls and deep folds.
- Skeletal change — bone is reabsorbed around the eyes, mid-face and jaw, reducing support.
- Skin changes — collagen and elastin decline, and sun damage adds wrinkles and pigmentation.
Why this dictates treatment
Because several things change, no single procedure reverses them all. A facelift addresses descent; fat transfer addresses deflation; resurfacing addresses skin; implants can address bone. The art is matching treatment to your pattern of ageing.
★ Key point
This is the single most important idea on the site: a natural result comes from treating each component of ageing, not from pulling skin tighter.