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Adult Facial Growth: Applications to Aesthetic Surgery

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Abstract

Background: Reshaping of the face with age is a result of volume change and loss of support. It is not well understood which tissues are involved in this process. Recent publications suggest that adult bone growth may have a significant role. Objective: We report a longitudinal cephalometric analysis of midfacial growth in adults to determine the role of bone in facial aging. Methods: The Behrents modification of the Bolton Cephalometric study in patients up to age 83 was reviewed. A trigonometric analysis targeted orbital and anterior maxillary growth. Results: Facial bone growth is shown to continue throughout adulthood. Anterior descent creates increased bone projection. Conclusions: The appearance of facial aging is caused by attrition of soft tissue volume and loss of support. The deficiency of maxillary bone projection seen in some patients, with tear trough depression and negative vector eyelid (polar bear), preexists adulthood and is unmasked with age.

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References

  1. A Barnett L Whitaker (1986) ArticleTitleFacial form analysis of the lower and middle face. Plast Reconstr Surg 78 158–165

    Google Scholar 

  2. SP Barlett R Grossman L Whitaker (1992) ArticleTitleAge-related changes of the craniofacial skeleton: An anthropometric and histological analysis. Plast Reconstr Surg 90 592–600

    Google Scholar 

  3. R Behrents (1985) An atlas of growth in the aging cranio facial skeleton. Center for Human Growth, University of Michigan Ann Arbor, Michigan

    Google Scholar 

  4. R Behrents (1985) Growth in the aging craniofacial skeleton. Center for Human Growth University of Michigan Ann Arbor, Michigan

    Google Scholar 

  5. Behrents R: Personal communication, 2002

  6. W Binder L Shoenrock E Terino (1994) ArticleTitleAugmentation of the malar and submalar midface. Facial Plast Surg Clin N Am 2 265–283

    Google Scholar 

  7. S Bishara T Hession L Pederson (1985) ArticleTitleLongitudinaL soft tissue profile changes: A study of three analyses. Am J Orthod 88 209–223 Occurrence Handle1:STN:280:BiqA3cvjs1E%3D Occurrence Handle3862344

    CAS  PubMed  Google Scholar 

  8. TR Broadbent (1957) ArticleTitleArtistic relationships in surface anatomy of the face: Application to reconstructive surgery. Plast Reconstr Surg 20 1 Occurrence Handle1:STN:280:CyeD38jhvVI%3D Occurrence Handle13484491

    CAS  PubMed  Google Scholar 

  9. TR Broadbent . Bolton (1975) Standards of dentofacial developmental growth. Mosby St. Louis

    Google Scholar 

  10. DH Enlow (1975) Handbook of facial growth. W.B. Saunders Philadelphia

    Google Scholar 

  11. DH Enlow (1977) ArticleTitleResearch on control of craniofacial morphogenesis: NIVR state of the art workshop. Am J Orthod 71 509–529 Occurrence Handle1:STN:280:CSiC2sbjvFw%3D Occurrence Handle266364

    CAS  PubMed  Google Scholar 

  12. DH Enlow MG Hans L McGrew (1996) Essentials of facial growth. WB Saunders Philadelphia

    Google Scholar 

  13. LG Farkas IR Munio (1987) Arthropometric facial proportions in medicine. Charles C. Thomas Springfield, Illinois

    Google Scholar 

  14. S Hamra (1995) ArticleTitleArcus marginalis release and orbital fat preservation in midface rejuvenation. Plast Reconstr Surg 96 354–362 Occurrence Handle1:STN:280:BieD3czisVA%3D Occurrence Handle3652607

    CAS  PubMed  Google Scholar 

  15. H Israel (1973) ArticleTitleRecent knowledge concerning craniofacial aging. Angle Orthod 43 176–184 Occurrence Handle1:STN:280:CSyC2cfpvVA%3D Occurrence Handle4511996

    CAS  PubMed  Google Scholar 

  16. W Kerr (1979) ArticleTitleA longitudinal cephalometric study of dental facial growth on five to fifth years. Br J Orthod 6 115–121 Occurrence Handle1:STN:280:Bi%2BB2c3kslE%3D Occurrence Handle297456

    CAS  PubMed  Google Scholar 

  17. ML Moss (1969) ArticleTitleThe primary role of functional matrices in facial growth. Am J Orthod 55 566–577 Occurrence Handle1:STN:280:CCaC1MzktlA%3D Occurrence Handle5253955

    CAS  PubMed  Google Scholar 

  18. JB Mulliken S Godwin N Pracharktam D Altobelli (1996) ArticleTitleThe concept of saggital orbital-globe relationship in craniofacial surgery. Plast Reconstr Surg 97 700–706

    Google Scholar 

  19. J Pessa (1999) ArticleTitleConcertina effect and facial aging: Non-linear aspects of youthfulness and skeletal remodeling and why, perhaps infants have jowls. Plast Reconstr Surg 103 635–644

    Google Scholar 

  20. J Pessa (2000) ArticleTitleAn algorithm of facial aging verification of lambros’ theory by three dimensional stereolithography with reference to the pathogenesis of midfacial aging, scleral show and the lateral suborbital trough deformity. Plast Reconstr Surg 106 479–488

    Google Scholar 

  21. E Terino R Flowers (2000) The art of alloplastic facial contouring. Mosby St. Louis

    Google Scholar 

  22. L Whitaker (1987) ArticleTitleAesthetic augmentation of the malar-midface structures. Plast Reconstr Surg 80 337–346

    Google Scholar 

  23. M Yarenchuk (2001) ArticleTitleInfraorbital rim augmentation. Plast Reconstr Surg 107 1585–1595

    Google Scholar 

  24. V Zadoo J Pessa (2000) ArticleTitleChanges to the curvilinear form of the aging maxilla. Plast Reconstr Surg 106 460–467

    Google Scholar 

  25. B Zide B Grayson J McCarthy (1981) ArticleTitleCephalometric analysis for upper and lower midface surgery, part II. Plast Reconstr Surg 68 961–968

    Google Scholar 

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Correspondence to Richard A. Levine.

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Levine, R.A., Garza, J.R., Wang, P.T. et al. Adult Facial Growth: Applications to Aesthetic Surgery . Aesth. Plast. Surg. 27, 265–268 (2003). https://doi.org/10.1007/s00266-003-2112-4

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