Bony Elements in the Mid-Face Change Over Time

Three-dimensional computed tomographic study finds significant contraction and deterioration

TUESDAY, Feb. 27 (HealthDay News) -- As people age, the bony elements of the mid-face change dramatically, primarily because of contraction and deterioration and not expansion, according to study findings published in the February issue of Plastic and Reconstructive Surgery.

Robert B. Shaw, Jr., M.D., of the Stanford University School of Medicine in Palo Alto, Calif., and a colleague conducted computed tomographic facial bone scans on 60 white patients (30 women and 30 men). The study group consisted of 20 patients aged 25 to 44, 20 patients aged 45 to 64, and 20 patients aged 65 and above. The researchers performed three-dimensional reconstruction on each computed tomographic scan.

The investigators found an age-associated decrease in the glabellar and maxillary angle in both the male and female subjects but found no change between age groups in the pyriform angle. They also observed an age-associated increase in the pyriform aperture area.

"Thus, we feel the most effective approach to facial rejuvenation should be twofold: restoring volume to compensate for the loss of bony volume, and lifting and reducing the aged and less elastic soft-tissue envelope," the authors conclude. "As there is a continuing dynamic of bony changes with increasing age, soft-tissue augmentation may be a better approach compared with bony augmentation, as the platform underneath the bony implant may deteriorate over time."

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