Skip to main content

Advertisement

SpringerLink
Log in

Analysis and Assessment of Facial Aging

  • FACIAL PLASTICS: Facial Skin Rejuvenation (PJ Carniol and AE Brissett, Section Editors)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The goal of this review is to highlight the important clinical considerations that impact the facial aging process and discuss current assessment tools that are available to help guide the clinician on appropriate facial rejuvenation modalities.

Recent Findings

Extrinsic and intrinsic factors and their effects on facial aging continue to be studied. Ethnic and racial backgrounds play a critical role in the facial aging process. Gender’s impact on facial aging is explored. Several assessment tools have been developed to examine various subunits of the face, and other assessments have been created that account for the patient’s ethnic background.

Summary

Facial aging is a dynamic and complex process. Understanding facial aging requires understanding changes in all layers of facial tissues as well as extrinsic and intrinsic factors that can affect the process, along with ethnic differences. Using appropriate assessment tools can help guide the clinician toward optimal treatment modalities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Paskhover B, Durand D, Kamen E, Gordon NA. Patterns of change in facial skeletal aging. JAMA Facial Plast Surg. 2017;19(5):413–7.

    Article  Google Scholar 

  2. Mendelson B, Wong CH. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthetic Plast Surg. 2012;36(4):753–60.

    Article  Google Scholar 

  3. Shaw RB Jr, Kahn DM. Aging of the midface bony elements: a three-dimensional computed tomographic study. Plast Reconstr Surg. 2007;119(2):675–81; discussion 682–3.

  4. Sydney R. Coleman, MD, Rajiv Grover, BSc, MB BS, MD, FRCS (Plast), The anatomy of the aging face: volume loss and changes in 3-dimensional topography, Aesthetic Surgery Journal, Volume 26, Issue 1_Supplement. 2006, Pages S4–S9.

  5. Gosain AK, Klein MH, Sudhakar PV, Prost RW. A volumetric analysis of soft-tissue changes in the aging midface using high-resolution MRI: implications for facial rejuvenation. Plast Reconstr Surg. 2005;115(4):1143–52; discussion 1153–5.

  6. Guinot C, Malvy DJ, Ambroisine L, Latreille J, Mauger E, Tenenhaus M, Morizot F, Lopez S, Le Fur I, Tschachler E. Relative contribution of intrinsic vs extrinsic factors to skin aging as determined by a validated skin age score. Arch Dermatol. 2002;138(11):1454–60.

    Article  Google Scholar 

  7. Puizina-Ivić N. Skin aging. Acta Dermatovenerol Alp Pannonica Adriat. 2008;17(2):47–54.

    PubMed  Google Scholar 

  8. • Krutmann J, Schikowski T, Morita A, Berneburg M. Environmentally-induced (extrinsic) skin aging: exposomal factors and underlying mechanisms. J Invest Dermatol. 2021;141(4S):1096–1103. This study highlights the current body of literature regarding exposome-induced events that lead to extrinsic skin aging and reviews the macromolecular mechanism involved in these processes.

  9. •• Shome D, Vadera S, Khare S, et al. Aging and the Indian face: an analytical study of aging in the Asian Indian Face. Plast Reconstr Surg Glob Open. 2020;8(3):e2580. Published 2020;20. Findings from this study highlight the differences in facial aging patterns of Asian Indians from other races, as well as regional differences in facial aging patterns among Asian Indians.

  10. Adler E, Adler S, Carniol P. Hispanic facial plastic surgery. In: Carniol PJ, Monheit GD, editors. Aesthetic Rejuvenation Challenges and Solutions: A World Perspective (Series in Cosmetic and Laser Therapy). New York, NY: Informa UK Ltd.; 2009. p. 52–66.

    Chapter  Google Scholar 

  11. Vashi NA, de Castro Maymone MB, Kundu RV. Aging differences in ethnic skin. J Clin Aesthet Dermatol. 2016;9(1):31–8.

    PubMed  PubMed Central  Google Scholar 

  12. Burgess C. Cosmetic concerns and therapeutic considerations in ethnic skin. In: Carniol PJ, Monheit GD, editors. Aesthetic Rejuvenation Challenges and Solutions: A World Perspective (Series in Cosmetic and Laser Therapy). New York, NY: Informa UK Ltd.; 2009. p. 52–66.

    Google Scholar 

  13. Baumann L, Rodriguez D, Taylor SC, Wu J. Natural considerations for ethnic skin. Cutis. 2006;78(6 Suppl):2–19.

    PubMed  Google Scholar 

  14. Burgess C, Awosika O. Ethnic and gender considerations in the use of facial injectables: African-American Patients. Plast Reconstr Surg. 2015;136(5 Suppl):28S-31S.

    Article  CAS  Google Scholar 

  15. Porter JP, Olson KL. Anthropometric facial analysis of the African American woman. Arch Facial Plast Surg. 2001;3(3):191–7.

    Article  CAS  Google Scholar 

  16. Galzote C, Estanislao R, Suero MO, et al. Characterization of facial skin of various Asian populations through visual and noninvasive instrumental evaluations: influence of age and skincare habits. Skin Res Technol. 2013;19(4):454–65.

    PubMed  Google Scholar 

  17. Hamadah IR, Kim NA, Alam M. Aesthetic rejuvenation for patients of Middle Eastern descent. In: Carniol PJ, Monheit GD, editors. Aesthetic Rejuvenation Challenges and Solutions: A World Perspective (Series in Cosmetic and Laser Therapy). New York, NY: Informa UK Ltd.; 2009. p. 52–66.

    Google Scholar 

  18. Keaney TC. Aging in the male face: intrinsic and extrinsic factors. Dermatol Surg. 2016;42(7):797–803.

    Article  CAS  Google Scholar 

  19. Borras C, Gambini J, Gomez-Cabrera MC, Sastre J, et al. 17 betaoestradiol upregulates longevity related antioxidant enzyme expression via the ERK1 and ERK2[MAPK] ⁄ NF kappa B cascade. Aging Cell. 2005;4:113–8.

    Article  CAS  Google Scholar 

  20. Alves R. Androgenetic alopecia: a review and emerging treatment options. Clin Res Dermatol Open Access. 2017;4(4):1–13.

    Google Scholar 

  21. Adler SC, Adler ET, Carniol PJ. The aging face in a multiethnic world. In: Carniol PJ, Monheit GD, editors. Aesthetic Rejuvenation Challenges and Solutions: A World Perspective (Series in Cosmetic and Laser Therapy). New York, NY: Informa UK Ltd.; 2009. p. 52–66.

    Chapter  Google Scholar 

  22. Fitzpatrick RE, Goldman MP, Satur NM, Tope WD. Pulsed carbon dioxide laser resurfacing of photo-aged facial skin. Arch Dermatol. 1996;132:395–402.

    Article  CAS  Google Scholar 

  23. Glogau RG. Aesthetic and anatomic analysis of the aging skin. Semin Cutan Med Surg. 1996;15:134–8.

    Article  CAS  Google Scholar 

  24. Roberts WE. The Roberts Skin Type Classification System. J Drugs Dermatol. 2008;7(5):452–6.

    PubMed  Google Scholar 

  25. Rzany B, Carruthers A, Carruthers J, Flynn TC, Geister TL, Gortelmeyer R, Hardas B, Himmrich S, Jones D, de Maio M, et al. Validated composite assessment scales for the global face. Dermatol Surg. 2012;38:294–308.

    Article  CAS  Google Scholar 

  26. Vierkotter A, Ranft U, Kramer U, Sugiri D, Reimann V, Krutmann J. The SCINEXA: a novel, validated score to simultaneously assess and differentiate between intrinsic and extrinsic skin ageing. J Dermatol Sci. 2009;53:207–11.

    Article  Google Scholar 

  27. Guinot C, Malvy DJ, Ambroisine L, Latreille J, Mauger E, Tenenhaus M, Morizot F, Lopez S, Le Fur I, Tschachler E. Relative contribution of intrinsic vs extrinsic factors to skin aging as determined by a validated skin age score. Arch Dermatol. 2002;138:1454–60.

    Article  Google Scholar 

  28. Allerhand M, Ooi ET, Starr RJ, Alcorn M, Penke L, Drost E, MacNee W, Deary IJ, Starr JM. Skin ageing and oxidative stress in a narrow-age cohort of older adults. Eur Geriat Med. 2011;2(3):140–4.

    Article  Google Scholar 

  29. Bazin R, Flament F. Skin aging atlas. Asian type, vol. 2. Hannover: Med Com; 2010.

  30. Buranasirin P, Pongpirul K, Meephansan J. Development of a global subjective skin aging assessment score from the perspective of dermatologists. BMC Res Notes. 2019;12:364.

    Article  Google Scholar 

  31. Carruthers A, Carruthers J, Hardas B, Kaur M, Goertelmeyer R, Jones D, et al. A validated brow positioning grading scale. Dermatol Surg. 2008;34(suppl 2):S150–4.

    CAS  PubMed  Google Scholar 

  32. Carruthers A, Carruthers J, Hardas B, Kaur M, Goertelmeyer R, Jones D, et al. A validated grading scale for forehead lines. Dermatol Surg. 2008;34(suppl 2):S155–60.

    CAS  PubMed  Google Scholar 

  33. Carruthers A, Carruthers J, Hardas B, Kaur M, Goertelmeyer R, Jones D, et al. A validated grading scale for marionette lines. Dermatol Surg. 2008;34(suppl 2):S167–72.

    CAS  PubMed  Google Scholar 

  34. Carruthers A, Carruthers J, Hardas B, Kaur M, Goertelmeyer R, Jones D, et al. A validated grading scale for crow ’ s feet. Dermatol Surg. 2008;34(suppl 2):S173–8.

    CAS  PubMed  Google Scholar 

  35. Carruthers A, Carruthers J. A validated facial grading scale: the future of facial ageing measurement tools? J Cosmet Laser Ther. 2010;12(5):235–41.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology Head & Neck Surgery, Baylor College of Medicine, Houston, USA

    Caroline Hudson

  2. Department of Otolaryngology/Head and Neck Surgery, Houston Methodist Hospital, Houston, USA

    Anthony Brissett

  3. New Jersey Medical School, Newark, USA

    Paul Carniol

  4. Facial Plastic and Reconstructive Surgery, Houston Methodist Hospital, 6550 Fannin Suite 1703, Houston, TX, 77030, USA

    Anthony Brissett

Authors
  1. Caroline Hudson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anthony Brissett
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul Carniol
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anthony Brissett.

Ethics declarations

Research Involving Human and Animal Participants

This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This articleis part of Topical Collection on FACIAL PLASTICS: Facial Skin Rejuvenation

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hudson, C., Brissett, A. & Carniol, P. Analysis and Assessment of Facial Aging. Curr Otorhinolaryngol Rep 9, 415–421 (2021). https://doi.org/10.1007/s40136-021-00369-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40136-021-00369-z

Keywords

Search

Navigation