Why does our face look older when we age?

As we age, the skin of our face becomes rougher, thinner, and loses elasticity, giving it a hanging and fragile appearance. This is due to the loss of elastin, the elastic tissue of the skin, as well as to the thinning of the epidermis, the surface layer of our skin. There is also a loss of fat below the skin, bone loss, and cartilage loss, which contribute to the “skeletal” appearance we develop when we age: loose skin, sunken eyes, puckering of the skin around the mouth, and accentuation of the bony structures in the nose.

Why do some people’s faces age quicker than others?

This natural aging process can be worsened by external factors, such as the sun, harsh weather, and bad habits. For instance, smoking produces an excess of free radicals, which can lead to premature wrinkles, among other health issues. Exposure to sunlight is also one of the most important causes of early skin aging, because of the damage that ultraviolet (UV) light causes on the elastin fibers of the skin, which break down under the effect of UVs, causing the skin to lose its natural elasticity, becoming saggy and easily bruised. Also, other factors contribute to aging of the skin, including stress, obesity, or even gravity, daily facial movement, and sleep position. Gravity causes drooping of the eyelids and eyebrows, longer earlobes, and “double chins”, facial movement lines become more visible, and sleep creases appear on the side of the forehead, depending on sleep position.

Is there anything that can be done about facial skin aging?

In the recent past, plastic surgery has evolved considerably to slow down the effects, or at least the aesthetical consequences, of skin aging. Technically known as rhytidectomies (from ancient Greek rhytis, or wrinkle, and ektome, or excision), which literally means surgical removal of wrinkles, a facelift does just that; it is a cosmetic surgery that removes wrinkles and gives a more youthful facial appearance. There are several techniques to do a facelift, but the most frequent one is the removal of excess skin, followed by the tightening of the tissues that are under the skin, and fat grafting, where fat is inserted under the skin to make it look fuller. Regardless of technique though, the final objective is always the same: to rejuvenate the appearance of the face.

How about stem cells?

Today, exciting new techniques, notably the use of stem cells, are being tested to improve the outcome of facelifts. Stem cells help the skin and underlying tissues renew themselves and become younger, enhancing the effects of a facelift. Most of the studies related to the use of stem cells for facial skin aging focus on autologous adipose-derived stem cells, or stem cells that have been collected from the fat tissues of the patient. Some also use fat enriched with Stromal Vascular Fraction (SVF), which is obtained from liposuction and contains several types of cells, including mesenchymal stem cells and adipose-derived regenerative cells, or ADRCs, which also have the capacity of multilineage differentiation.

Recently, a joint study from universities and health institutes of Italy and Brazil showed that both the injection of adipose-derived stem cells or SVF-enriched fat cells effectively reduced elastosis, the degeneration of the skin’s elastic fiber network, and encouraged the development of younger elastic fibers. This and other studies show that the use of stem cells could open a promising new chapter for facial anti-aging procedures.



Luiz Charles-de-Sá, Natale Ferreira Gontijo-de-Amorim, Christina Maeda Takiya, Radovan Borojevic, Donatella Benati, Paolo Bernardi, Andrea Sbarbati, Gino Rigotti.2015. Antiaging Treatment of the Facial Skin by Fat Graft and Adipose-Derived Stem Cells. Plastic and Reconstructive Surgery, 135 (4): 999

Gino Rigotti, Luiz Charles-de-Sá, Natale Ferreira Gontijo-de-Amorim, Christina Maeda Takiya, Paola Romina Amable, Radovan Borojevic, Donatella Benati, Paolo Bernardi, Andrea Sbarbati. 2016. Expanded Stem Cells, Stromal-Vascular Fraction, and Platelet-Rich Plasma Enriched Fat: Comparing Results of Different Facial Rejuvenation Approaches in a Clinical Trial. Aesthetic Surgery Journal, Volume 36, Issue 3, 1 March, Pages 261–270

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