As we age, the organized groups of fat in the face (known as fat pads) begin to shrink and fall. This causes the fat pads to shift around, and make bony features, lines, and wrinkles more visible. This is most commonly observed under the eyes as “bags” begin to form with age. The formation involves not just fat pad changes, but also bone resorption in the orbital rim, weakening of supporting ligaments, and changes in skin quality.
As our fat pads begin to fall, our skull is also changing shape. The craniofacial skeleton changes because of bone expansion and bone resorption. The resorption of bone causes it to thin, removing structural support for the overlying tissues. This loss of support is characterized by sagging and droopy skin. This is commonly observed around the eyes, as the bone shape transforms from oval to square, or in the jawline as it elongates and loses its prominence.
Facial aging is a complex process involving multiple factors, including changes in skin, fat, muscle, and bone. The exact patterns and extent of these changes can vary between individuals and are influenced by factors such as genetics, lifestyle, and environmental exposures[1][7].
Citations:
[1] https://www.meliorclinics.co.uk/blog/2019/05/13/facial-fat-pads-and-their-link-to-ageing/
[2] https://www.changesplasticsurgery.com/blog/sag-bone-whats-really-behind-an-aging-face/
[3] https://www.myplasticsurgeon.ca/cosmetic-procedures/surgery/facelift/facial-aging.html
[4] https://aesthetic-solutions.com/uncontrollable-aging-factors/
[5] https://traceybell.co.uk/bone-loss-and-facial-ageing-what-happens-and-what-are-my-thoughts/
[6] http://www.newagecosmetics.com.au/changes-in-facial-fat-pads-as-we-age/
[7] https://drtimpearce.com/2022/12/08/fat-pad-anatomy-why-are-superficial-fat-pads-key-to-aesthetics/
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438644/