We hypothesize that soft tissue volume loss, in the form of fat atrophy, contributes more significantly to the patterns of facial aging than is conventionally accepted.

The facial soft tissue of thirty women was evaluated using CT studies of the maxilla. They were grouped by age and race and matched for body mass index. The distance between the bony skeleton and the skin was measured at discrete areas of the face from the inferior orbital rim to the inferior portion of the maxilla.

We present a significant difference in soft tissue thickness between women aged 20 to 25 and women aged 40 to 45. With increasing age, there is a decrease in soft tissue thickness at the infraorbital and malar areas while there is an increase in soft tissue thickness at the inferior maxilla. This is consistent with our hypothesis that while gravitational forces on the deep tissues of the face result in their inferior displacement, there is associated overall fat atrophy with advancing age.

These results will improve facial rejuvenation surgery by providing an objective guide for volume augmentation and repositioning that optimally addresses the deep tissue changes in facial aging.