The Architecture of the Face

The Architecture of the Face

I think it is very important for patients and practitioners to have an understanding of the underlying anatomical structures that impact how we age. With this knowledge, one can then plan the appropriate procedures for restoration and rejuvenation.

To that end, I find it very useful to compare the face to a house. The tendency these days is to be very focused on an area of the house such as the door (lips) or windows (lines and wrinkles) rather than looking at the house, or face, as a whole.

A modern door placed on an old house will look odd as there is a clear mismatch. Similarly, when it comes to facial aesthetics, one needs to take a holistic view to ensure all areas match and blend in to form the whole.

In order to restore a house, or a face, one needs an intimate understanding of its underlying structures, i.e. the building blocks which represent the various layers.

Starting with the supporting foundation, the bones of the face, there is a shrinkage as we age with a collapse toward the midline, sometimes described as an ‘internal rotation’. This shrinkage happens in three dimensions so that there is also a side or ‘lateral rotation’ which means that our forehead tends to move outward as the lower part of our face moves inward.

The aperture of the orbit of the eye widens as does that which supports the nose. As a result, the eyes become more sunken and the nose falls forward to look bigger. The soft tissues of the face, including  the ligaments, muscles, fat pads and skin also undergo their own ageing process. With the loss of the underlying bony support, these tend to droop and sag.

Therefore a comprehensive approach to facial rejuvenation has to restore from the bottom up to ensure a natural looking end result.