Three-Dimensional Approach of Cosmetic Patient: Aging Gracefully

Aging is a complex process that involves intrinsic and extrinsic factors and result in modifications in all tissues of the body. The aging of the face comprise a set of changes in bone support along with atrophy and flexibility of soft tissues such as skin, muscles, fat, and ligaments. Anatomically, the face can be divided in two regions: anterior and lateral. In the anterior part, there is predominance of the structures related to facial expression, while in the lateral region muscles related to mastication stand out. Another way to divide the facial components is related to general stratification in five basic layers joined by a system of facial retention ligaments. To promote the mobility required for facial expression independent of the basic functions of the face, particularly chewing, a number of soft tissue spaces are incorporated into the face architecture. This arrangement, most clearly seen on the scalp, also exists on the rest of the face, although with significant modifications. Understanding the anatomy of the aging process, in other words, the impact of facial skeletal aging and its correlations with soft tissue changes, will lead to an understanding of the current perspective of a three-dimensional approach to injectable procedures that are much more effective in preventing and treating the signs of aging.