As If Aging Wasn't Enough

As if getting older didn't already come with its share of challenges, new research published in a recent issue of Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons, reveals that facial asymmetry increases as we get older.

Not only does facial asymmetry worsen with age, but it can also cause complications for facial reconstruction, skin rejuvenation and other anti-aging procedures.

Does Facial Asymmetry Matter?

If you're getting a face-lift or other face procedure, it does.

"Knowing that facial asymmetry increases over time can be helpful in making sure that cosmetic changes to the face adjust for those differences," said Dr. Mona Alqulali.

Alqulali is a Bettendorf, Iowa, cosmetic surgeon and OB-GYN.

To analyze how facial asymmetry changes over time, the researchers used a technology known as 3D photogrammetry. Using this technology, they scanned the facial surface in 191 study participants between the ages of 4 months and 88 years.

Once participants were scanned, the researchers then calculated the "root mean square deviation" (RMSD) to gauge the degree of difference between each side of the face.

By employing 3D photogrammetry, they were able to measure down to the smallest level of asymmetry: a fraction of a millimeter.

After scanning and measuring participants, the researchers took their calculations and evaluated them regarding participants' age. They also used their calculation to analyze the different regions of the face: upper, middle and lower.

The range of facial symmetry spanned from 0.4 and 1.3 millimeters across all ages.

The study connected an increase in facial asymmetry and age; on average, the difference between both sides of the face increased by 0.06 mm for every 10 years of aging.

They also found that the changes in facial asymmetry were not affected by race or sex.

The most significant area of facial asymmetry occurred in the lower two-thirds of the face, the space between the eyebrows and the nose and from the nose to the chin.

The upper third region, between the eyebrows and the hairline, had the least change among all participants.

Regaining Symmetry

Facial asymmetry is natural, but making things symmetrical is a goal of cosmetic surgery and procedures.

"We are all born with something that may not be the same on the other side of the body, whether it is an ear slightly higher, an eye is a smidge lower or a breast is slightly bigger," Alqulali said.

In the past, cosmetic surgeons have taken manual measurements of each side of the face, a process known as anthropometry.

The researchers believe that using anthropometry was a less reliable way to measure than their digital scans produced by 3D photogrammetry.

While the research team does not yet know why facial asymmetry increases with age, they hope to hope to develop an approach to target increasing facial asymmetry.

One way that facial asymmetry is being treated currently is through the use of dermal fillers and fat transfers.

"Using fillers and fat can help to create symmetry where there is unevenness caused by a loss of facial fat volume," Alqulali said.

Facial fat volume decreases as a natural consequence of the aging process.

"The peak of facial fat is between ages 18 and 22. After that, fat volume slowly decreases over time," Alqulali said.

Fat transfers to the face and other body areas have increased significantly in popularity over the last few years.

"Fat transfers are increasing in popularity because it is a minimally invasive way to get the look you want," Alqulali said.

During a fat transfer, fat is taken from one body area through a specialized form of liposuction. After collection, the fat is then injected into another area, such as the face, in the facial fat transfer procedure, the buttocks as part of the Brazillian Butt-Lift or the breasts during the natural breast-augmentation procedure.

An added benefit of fat transfers is that their results last for many years.



ASPS. Facial Asymmetry Increases with Age. 31 October 2018.


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