Analysis of the Anatomic Changes of the Aging Facial Skeleton Using Computer-Assisted Tomography
- 1 September 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Ophthalmic Plastic & Reconstructive Surgery
- Vol. 25 (5), 382-386
- https://doi.org/10.1097/iop.0b013e3181b2f766
Abstract
Purpose: The bony skeleton serves as the scaffolding for the soft tissues of the face; however, age-related changes of bony morphology are not well defined. This study sought to compare the anatomic relationships of the facial skeleton and soft tissue structures between young and old men and women. Methods: A retrospective review of CT scans of 100 consecutive patients imaged at Duke University Medical Center between 2004 and 2007 was performed using the Vitrea software package. The study population included 25 younger women (aged 18–30 years), 25 younger men, 25 older women (aged 55–65 years), and 25 older men. Using a standardized reference line, the distances from the anterior corneal plane to the superior orbital rim, lateral orbital rim, lower eyelid fat pad, inferior orbital rim, anterior cheek mass, and pyriform aperture were measured. Three-dimensional bony reconstructions were used to record the angular measurements of 4 bony regions: glabellar, orbital, maxillary, and pyriform aperture. Results: The glabellar (p = 0.02), orbital (p = 0.0007), maxillary (p = 0.0001), and pyriform (p = 0.008) angles all decreased with age. The maxillary pyriform (p = 0.003) and infraorbital rim (p = 0.02) regressed with age. Anterior cheek mass became less prominent with age (p = 0.001), but the lower eyelid fat pad migrated anteriorly over time (p = 0.007). Conclusions: The facial skeleton appears to remodel throughout adulthood. Relative to the globe, the facial skeleton appears to rotate such that the frontal bone moves anteriorly and inferiorly while the maxilla moves posteriorly and superiorly. This rotation causes bony angles to become more acute and likely has an effect on the position of overlying soft tissues. These changes appear to be more dramatic in women.Keywords
This publication has 12 references indexed in Scilit:
- The potential role of stereolithography in the study of facial agingAmerican Journal of Orthodontics and Dentofacial Orthopedics, 2001
- An Algorithm of Facial Aging: Verification of Lambros’s Theory by Three-Dimensional Stereolithography, with Reference to the Pathogenesis of Midfacial Aging, Scleral Show, and the Lateral Suborbital Trough DeformityPlastic & Reconstructive Surgery, 2000
- Relationship of the eye to the bony orbit, with clinical correlationsAustralian and New Zealand Journal of Ophthalmology, 1999
- Changes in ocular globe-to-orbital rim position with age: Implications for aesthetic blepharoplasty of the lower eyelidsAesthetic Plastic Surgery, 1999
- Frequent Face Lift Sequelae: Hollow Eyes and the Lateral Sweep: Cause and RepairPlastic & Reconstructive Surgery, 1998
- Relative Maxillary Retrusion as a Natural Consequence of Aging: Combining Skeletal and Soft-Tissue Changes into an Integrated Model of Midfacial AgingPlastic and Reconstructive Surgery, 1998
- The Role of Orbital Fat Preservation in Facial Aesthetic SurgeryClinics in Plastic Surgery, 1996
- Arcus Marginalis Release and Orbital Fat Preservation in Midface RejuvenationPlastic and Reconstructive Surgery, 1995
- Precision Planning In BlepharoplastyClinics in Plastic Surgery, 1993
- On Growth and FormPublished by Cambridge University Press (CUP) ,1992