Adult Facial Growth: Applications to Aesthetic Surgery (original) (raw)
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Age-Related Changes of the Orbit and Midcheek and the Implications for Facial Rejuvenation
Aesthetic Plastic Surgery, 2007
Background:Aging of the midface is complex and poorly understood. Changes occur not only in the facial soft tissues, but also in the underlying bony structure. Computed tomography (CT) imaging was used for investigating characteristics of the bony orbit and the anterior wall of the maxilla in patients of different ages and genders. Methods: Facial CT scans were performed for 62 patients ranging in age from 21 to 70 years, who were divided into three age groups: 21À30 years, 41À50 years, and 61À70 years. Patients also were grouped by gender. The lengths of the orbital roof and floor and the angle of the anterior wall of the maxilla were recorded on parasagittal images through the midline of the orbit for each patient. Results: The lengths of the orbital roof and floor at their midpoints showed no significant differences between the age groups. When grouped by gender, the lengths were found to be statistically longer for males than for females. The angle between the anterior maxillary wall and the orbital floor was found to have a statistically significant decrease with advancing age among both sexes. Conclusion: Bony changes occur in the skeleton of the midcheek with advancing age for both males and females. The anterior maxillary wall retrudes in relation to the bony orbit, which maintains a fixed anteroposterior dimension at its midpoint. These changes should be considered in addressing the aging midface.
Anthropometric vs. Dental Variables of the Ageing Face: A Clinical Study
Applied Sciences
Background: Biological ageing and pathological changes of teeth impact the appearance and may hinder the effectiveness of facial aesthetic treatments. The present cross-sectional study in Caucasian dentate individuals aimed to measure facial features of the lower and middle parts of the face across different ages and to identify any significant impacts of age, sex and dental variables on facial aesthetics. Methods: Fifty-eight adults (ranging from 26 to 79 years of age) participated in the study. Facial measurements were collected via digital two-dimensional photography, and intraoral variables were recorded. The data were digitally analysed using ImageJ software and statistically analysed using SPSS Software. Results: The lower and middle third of the face revealed statistically significant changes across the age span tested, with the middle third presenting higher values in females and the lower appearing more prominent in males. A negative correlation with age was revealed for th...
Aesthetic Plastic Surgery, 2012
In principle, to achieve the most natural and harmonious rejuvenation of the face, all changes that result from the aging process should be corrected. Traditionally, soft tissue lifting and redraping have constituted the cornerstone of most facial rejuvenation procedures. Changes in the facial skeleton that occur with aging and their impact on facial appearance have not been well appreciated. Accordingly, failure to address changes in the skeletal foundation of the face may limit the potential benefit of any rejuvenation procedure. Correction of the skeletal framework is increasingly viewed as the new frontier in facial rejuvenation. It currently is clear that certain areas of the facial skeleton undergo resorption with aging. Areas with a strong predisposition to resorption include the midface skeleton, particularly the maxilla including the pyriform region of the nose, the superomedial and inferolateral aspects of the orbital rim, and the prejowl area of the mandible. These areas resorb in a specific and predictable manner with aging. The resultant deficiencies of the skeletal foundation contribute to the stigmata of the aging face. In patients with a congenitally weak skeletal structure, the skeleton may be the primary cause for the manifestations of premature aging. These areas should be specifically examined in patients undergoing facial rejuvenation and addressed to obtain superior aesthetic results.
Regional shape change in adult facial bone curvature with age
American Journal of Physical Anthropology, 2010
Life expectancies have increased dramatically over the last 100 years, affording greater opportunities to study the impact of age on adult craniofacial morphology. This article employs a novel application of established geometric morphometric methods to examine shape differences in adult regional facial bone curvature with age. Three-dimensional semilandmarks representing the curvature of the orbits, zygomatic arches, nasal aperture, and maxillary alveolar process were collected from a cross-sectional cranial sample of mixed sex and ancestry (male and female; African-and European-American), partitioned into three age groups (young adult 5 18-39; middle-aged 5 40-59 years; and elderly 5 601 years). Each facial region's semilandmarks were aligned into a common coordinate system via generalized Procrustes superim-position. Regional variation in shape was then explored via a battery of multivariate statistical techniques. Agerelated shape differences were detected in the orbits, zygomatic arches, and maxillary alveolar process. Interactions between age, sex, and ancestry were also identified. Vector plots revealed patterns of superoinferior compression, lateral expansion, and posterior recession depending on the population/subpopulation, location, and age groups examined. These findings indicate that adult craniofacial curvature shape is not static throughout human life. Instead, age-related spatial modifications occur in various regions of the craniofacial skeleton. Moreover, these regional alterations vary not only through time, but across human populations and the sexes.
Longitudinal study of facial skeletal growth completion in 3 dimensions
American Journal of Orthodontics and Dentofacial Orthopedics, 2007
Introduction: Previous authors have suggested that transverse facial skeletal growth is completed before either anteroposterior or vertical growth and that anteroposterior growth is completed before vertical growth. Our purpose in this study was to examine this concept. Methods: Twenty-four subjects (11 male, 13 female) who had annual lateral and posteroanterior cephalograms up to and including age 17 or 18 and again at age 25 or older were identified from the Iowa Facial Growth Study. Transverse, anteroposterior, and vertical facial dimensions were measured longitudinally into adulthood by using key skeletal landmarks. Descriptive statistics were calculated, and nonparametric Wilcoxon signed rank tests were performed separately for the sexes to determine the age at which each anteroposterior, vertical, and transverse growth variable reached adult size. Results: For both sexes, an overlap exists at any age in the amount of growth completed for the various measurements in the transverse, anteroposterior, and vertical dimensions. Although some transverse measures (cranial width and interjugal width) attain adult size before any anteroposterior or vertical ones, there is evidence of continued growth for other transverse parameters (interzygomatic width and intergonial width). A similar overlap is seen in the anteroposterior and vertical dimensions. Conclusions: A distinct separation, by time and dimension, is not seen in the amount of facial growth completed during development. Instead, a dramatic spread and an overlap of growth curves are observed throughout the developing years.
Comparison of skeletal maturation of subjects with horizontal and vertical facial growth patterns
Acta stomatologica Croatica, 2019
Aim: Establishing skeletal maturity in orthodontics is an important part in clinical and scientific research. Facial growth occurs in vertical and horizontal dimensions. Depending on the dominance of one of the components, three basic growth patterns are known; neutral, vertical and horizontal. The purpose of the study was to determine whether there is a difference between skeletal and chronological age in subjects with different facial growth patterns. Materials and methods: The study was conducted on a total of 146 subjects (48 with horizontal, 48 with vertical and 50 with neutral growth patterns) aged 12 to 18 years. Determination of facial growth pattern was done by cephalometric analysis (Zagreb 82 MOD), using the Dolphin 10.5 software and 8 variables were measured on each cephalogram. Skeletal maturity estimation was performed according to CVMS tables. Results: Statistically significant differences (p <0.001) were found between subjects with horizontal and vertical growth p...
Aesthetic Plastic Surgery, 1999
Changes in the relationship of the anterior globe to the orbital rim, orbital fat, and cheek mass are examined in the present study. Two groups of individuals (N = 28) were studied, young versus old, using three-dimensional computer tomography. A computer-derived soft tissue reformat of the data allowed the anterior-posterior changes to be evaluated at the midpupillary plane. Analysis of the data brings to light two important changes which occur with aging. First, the orbital rim moves posteriorly relative to the anterior cornea with age (p = 0.0007). This is important because overresection of orbital fat during lower blepharoplasty accentuates the proptotic appearance of the eye which occurs naturally with age due to orbital remodeling. A second finding is that there is a tendency for the cheek mass to move posteriorly with age relative to the anterior cornea (p = 0.0038). The negative vector, a warning sign for lower blepharoplasty, becomes more common with advancing age. It is suggested that the presence of a negative vector is a sign of generalized maxillary hypoplasia. Certain individuals with a negative vector can be further identified preoperatively by the clinical triad of scleral show, prominent medial fat, and a prominent nasojugal crease. These individuals likewise exhibit maxillary hypoplasia and may be more prone to complications after blepharoplasty. Lastly, a summated model of skeletal remodeling is presented. The significant points are as follows: (1) contrary to previous work, the craniofacial skeleton remodels throughout adulthood, (2) changes in the skeletal architecture impart their effects on the overlying soft tissues, and (3) facial aging is a summation of both hard and soft tissue changes which occur throughout life.
Changes in facial shape with age: an analysis with three-dimensional imaging
European Journal of Plastic Surgery, 2011
The appearance of the aged face has traditionally been attributed to soft tissue changes with surgical treatments targeting ptosis of skin, SMAS, and fat. However, true facial aging is recognized as a combination of soft tissue and skeletal changes, which continue to be integrated into a model for facial aging. With a greater understanding of these changes, techniques in facial rejuvenation will continue to evolve. Three-dimensional imaging technology was used in this study. Measurements correlating with mid- and lower-face changes were compared for each three-dimensional facial image of 31 mother–daughter matched controls. Each mother image was superimposed on the corresponding daughter, using registration of the upper face to visualize mid-face differences between pairs. Also, measurements of women in four age groups were compared using a one-way ANOVA. The ratios of Po-A:Po-N were significantly greater in daughters in comparison to their mothers (p = 0.0073), with the majority of mother subjects showing a more acute Po-N-A angle (p < 0.042). An investigation between age groups exhibited significant difference between the youngest (18–29) and oldest (60+) groups for Po-A:Po-N length ratio, Po-B:Po-N length ratio, Po-N-A angle, and Po-N-B angle. Differences between the 30–44 and 60+ age groups were also significant for the Po-A:Po-N and Po-B:Po-N length ratios. The results from this study suggest a posterior movement of the mid and lower face with age. This multi-factorial process makes facial rejuvenation more complex than initially perceived, and recognizing it will facilitate better rejuvenation strategies in the future.
Assessment of the type of facial growth
Medicinski casopis, 2011
The viscerocranium to neurocranium ratio is 1:8 in infants, while in adults, when growth has been completed, it reduces to 1:3. For orthodontists, it is important to determine the way the face or each jaw grows and thus predict further growth so that the right therapy can be chosen or an anomaly corrected. Therefore, it is necessary to make a head profile radiograph i.e. cephalometric radiograph of the patient's head. The aim of this study is to present the most frequently used methods for analysis of the cephalograms in order to determine the type of facial growth. Today, it is known that growth persists throughout adulthood, although at a slow rate.