How does the lower face change as we age?

The lower face is defined as the area below a hypothetical horizontal line which passes through the corners of the mouth between the upper and lower lips. It is important to understand how the lower face ages when considering chin augmentation, wrinkle treatment, and the treatment of marionette lines. Ageing of the lower face involves the decent of tissues, changes in facial skin, the loss of fat from beneath the skin, and loss of bone volume.

Descent of tissues from the areas higher up on the face, such as the cheeks, leads to down turning of the angles of the mouth where the upper and lower lips meet. This also leads to the development of marionette lines, vertical lines running from the corners of the mouth and down either side of the chin, which cause people to appear dissatisfied, and are associated with frowning. Descent of the cheek tissue also leads to deepened nasolabial folds, the folds of skin running from either side of the nose to the corners of the mouth.

The facial skin becomes thinner as we age and photoageing occurs. This is premature ageing of the skin, particularly that of the face, due to ultraviolet light exposure, often visible in the form of wrinkles and discolouration of the skin. The skin becomes less elastic and more amenable to wrinkle formation.

The loss of volume is an important principle to consider when thinking about chin augmentation. Loss of fat volume and resorption of bone as we age leads to a loss of jawline definition. A hollowing either side of the chin can also develop, these are known as pre-jowl sulci, and have a detrimental impact on the appearance of a smooth youthful jawline.

The lower face is the most commonly treated area of the face. Understanding the principles behind ageing of the lower face empowers patients to choose, with guidance from their clinician, wrinkle treatments and methods of chin augmentation which will best achieve their desired cosmetic outcome.