Aesthetic Plastic Surgery

, Volume 34, Issue 5, pp 603–611

Mechanotransduction: The Missing Link in the Facial Aging Puzzle?


  • Safa E. Sharabi
    • Division of Plastic SurgeryBaylor College of Medicine
  • Daniel A. Hatef
    • Division of Plastic SurgeryBaylor College of Medicine
  • John C. Koshy
    • Division of Plastic SurgeryBaylor College of Medicine
    • Division of Plastic SurgeryBaylor College of Medicine
  • Michael J. Yaremchuk
    • Division of Plastic SurgeryMassachusetts General Hospital
Original Article

DOI: 10.1007/s00266-010-9519-5

Cite this article as:
Sharabi, S.E., Hatef, D.A., Koshy, J.C. et al. Aesth Plast Surg (2010) 34: 603. doi:10.1007/s00266-010-9519-5



Craniofacial bony remodeling has been recognized as an important contributor to the facial aging process. Multiple studies have demonstrated significant craniofacial skeletal changes with age. However, no review has assembled this information in a concise, cogent fashion. Furthermore, the etiology of these skeletal changes has not been elucidated. This information is important for understanding the mechanisms of facial aging and for further development of facial rejuvenation.


A literature review of all articles discussing remodeling of the craniofacial skeleton with age was performed. Studies that used objective measurements of craniofacial skeletal parameters for different age groups were collected and analyzed.


The studies demonstrated consistent morphologic changes in the craniofacial skeleton with age. These changes included trends toward increased facial bony width in women; contour changes of the orbit, anterior maxilla, and mandibular body; and decreased dimensions of the glabellar, pyriform, and maxillary angles.


The craniofacial skeleton remodels with aging. Many of the observed changes in soft tissue contour and position reflect these skeletal changes. Changes in facial muscle function through the process of mechanotransduction may be responsible for these skeletal changes.


Craniofacial bony remodeling Craniofacial skeleton Facial aging Facial rejuvenation Mechanotransduction

Supplementary material

View video

A video demonstrating the changes in the bony orbit with age. Specifically, the orbit grows wider superior-medially and inferior-laterally (WMV 118 kb)

View video

A video demonstrating the changes in the profile of the facial skeleton with age. Specifically, the glabellar and maxillary angles become more acute (WMV 150 kb)

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2010