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.
人老化时，眼眶内上方及外下方骨骼吸收造成眼睛下垂，颧骨及上颌骨吸收造成苹果肌消失，鼻骨孔(piriform aperature)吸收变大造成上唇后缩、鼻尖下垂、法令纹变深，下巴承浆处吸收凹陷造成下巴变长、脸颊肉下垂。因此整形医师在计画手术时应当将这些因素一并考虑进去才能得到好的结果。
