Title: Changes in the Facial Skeleton With Aging: Implications and Clinical Applications in Facial Rejuvenation
Journal: Aesthetic Plastic Surgery 2012;36(4):753-760
Authors: Bryan Mendelson, Chin-Ho Wong
Abstract:
In principle, to achieve the most natural and harmonious rejuvenation of the face, all changes that result from the aging process should be corrected. Traditionally, soft tissue lifting and redraping have constituted the cornerstone of most facial rejuvenation procedures. Changes in the facial skeleton that occur with aging and their impact on facial appearance have not been well appreciated. Accordingly, failure to address changes in the skeletal foundation of the face may limit the potential benefit of any rejuvenation procedure. Correction of the skeletal framework is increasingly viewed as the new frontier in facial rejuvenation. It currently is clear that certain areas of the facial skeleton undergo resorption with aging. Areas with a strong predisposition to resorption include the midface skeleton, particularly the maxilla including the pyriform region of the nose, the superomedial and inferolateral aspects of the orbital rim, and the prejowl area of the mandible. These areas resorb in a specific and predictable manner with aging. The resultant deficiencies of the skeletal foundation contribute to the stigmata of the aging face. In patients with a congenitally weak skeletal structure, the skeleton may be the primary cause for the manifestations of premature aging. These areas should be specifically examined in patients undergoing facial rejuvenation and addressed to obtain superior aesthetic results.
人老化時，眼眶內上方及外下方骨骼吸收造成眼睛下垂，顴骨及上頜骨吸收造成蘋果肌消失，鼻骨孔(piriform aperature)吸收變大造成上唇後縮、鼻尖下垂、法令紋變深，下巴承漿處吸收凹陷造成下巴變長、臉頰肉下垂。因此整形醫師在計畫手術時應當將這些因素一併考慮進去才能得到好的結果。
