ABSTRACT
During the natural course of aging, the face undergoes a
series of predictable changes. The skin loses its elastic-
ity through a loss of integrity of both collagen and
elastin fibers in the dermis, resulting in visible static
rhytids and deeper furrows. Furthermore, a loss of adi-
pose tissue, most notably in the midface, leads to volu-
metric depletion of the underlying soft tissue support of
the facial skin. The result of these two changes is a
gravitational descent of the facial tissues that contributes
to hollowing of the cheeks, descent of the malar fat
pads, and deepening of the nasojugal, malar-palpebral,
and nasolabial folds.This can be further compounded by
the effects of exposure to ultraviolet radiation, which is
known to accelerate the aging process by promoting
elastolysis, collagenolysis, and dyschromia.
