Anatomy of the Male Aging Face

Facial aging is a process that differs among individuals but has several common underpinnings. Age-related changes occur at the cellular and subcellular levels, resulting in modifications of all tissues, including the facial bones, connective tissue, fat compartments, skin, and skin appendages. There is an overall volume loss of the face with descent of the soft tissues, giving the face a squared shape. Different zones of the face, however, age differently. Age-related alterations can be related to both intrinsic and extrinsic factors such as sun exposure, smoking, topical medications, and scarring. In this chapter, we will review the various tissue changes that occur with aging in the face and describe the anatomic changes according to the facial subunit. In-depth knowledge and detailed understanding of the changes associated with aging are essential to the plastic surgeon and further facilitate natural-appearing and effective surgical facial rejuvenation.