Anatomy of aging: in-depth analysis of facial zones

The aging process has a significant impact on the harmony and symmetry of facial features observed at a young age. An effective strategy for assessing morphological changes associated with aging is to divide the face into three key zones: the upper third (forehead and eyebrow area), the middle (central part and nose) and the lower third (chin, jaw line), as well as the neck. The analysis of aging processes is an important area of research in plastic surgery. The middle part of the face plays a crucial role in shaping a person's aesthetic perception, since attractiveness is often determined by the combination of eyes, nose, lips, and cheekbones that make up the so-called central facial triangle. When considering this area, it is necessary to apply a three-dimensional approach, since only such an analysis allows you to accurately assess age-related changes and recreate the youthful topography of the face. This paper presents a comprehensive analysis of current research on the etiology and mechanisms of facial aging by anatomical thirds. An in-depth study of the physiological changes occurring at each of these levels can greatly facilitate the understanding of aging processes and help improve correction strategies aimed at rejuvenating the face, which is very important for choosing a more effective method of surgical correction of age-related changes.

A search for publications on the topic of our research was conducted in open databases using search engines: PubMed, Web of Science, Scopus, Google Scholar, eLibrary, Cyberleninka. By keywords and their combinations: “aging”, “age-related facial changes”, “facial aging”, “neck aging”, “facial thirds” and “rejuvenation” 1,351 articles were identified. Articles devoted to age-related changes in the organs of vision, oral and nasal cavities were excluded from the analysis.; articles with a publication date of more than 25 years; articles that do not relate to aesthetic changes in the skin and functional changes in soft tissues and the facial skeleton; articles that dealt only with cosmetic procedures; publications that are outside the scope of the study of facial anatomy and physiology; articles that advertise medical non-certified drugs. As a result of applying these criteria, 211 articles were selected, from which the relevant full-text materials were extracted, analyzed and summarized based on information from the database. The anatomy of facial aging was analyzed in thirds for further research and development of effective corrective complex techniques.

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