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  • Dr Marcus Mehta

What happens to our face as we age?

Updated: Jul 18, 2019

Ever wondered why we age the way we do? Understanding this helps put together treatment options that treat the the face in a way that looks very natural




Throughout our life the face is always changing and for me as a cosmetic doctor it is vital to understand so when I treat it can be done in the most natural and age appropriate way. Here I talk about the changes that occur with age in skin, bone and fat.

In our 20’s we have high levels of key elements in our skin that keep us looking young. These are collagen, elastin and glycosaminoglycans- the most abundant of which you will have heard of - Hyaluronic acid. Collagen & elastin are responsible for our skin being supple, elastic and strong. Hyaluronic acid gives skin its hydrated and plump appearance. As we age we lose all 3 elements of these in our skin which results in the aged appearance of skin in our 50’s.


Interestingly our bony skull also changes as we age for example the bony orbits (eye sockets) enlarge as we age and the facial bones in our cheek area slowly shrink. The angles of the brow, nose, and upper jaw bones also reduce. Unfortunately for my female clients researchers have found that many of these changes occurred earlier in women between young and middle age. In men, most of the changes occurred between middle age and old age.


We have deep and superficial fat pads in the face and as we age the majority of these shrink and descend giving rise to key features my clients tell me make them look old. These are the nose-mouth lines (nasolabial folds), the downturning of the mouth (marionette lines) and loss of jawline or jowl formation.


I like to break treatments down to skin based ones and one associated with volume loss. Regularly looking after your skin is the best way to keep on top of the ageing process, good topical skincare including a medical grade physical sunscreen in combination with a retinol (0.5%-1%) are my key recommendations. As for the volume loss experienced as we age this is best treated using a like-for-like replacement in the areas we lose it from and the best example of this is a hyaluronic acid filler. For example a thicker filler designed to emulate bony loss vs a softer filler for fat pad loss. If done well filler treatment should be painless, injection sites virtually undetectable and most importantly results that are natural. I am a big believer of not changing your look but enhancing and redefining key areas to harmonise the whole face. The result should be one that make you feel refreshed and well slept rather than completely different.

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