How does aging affect facial symmetry and smile aesthetics?

Okay, so I’ve been noticing…things. I’m getting older (obviously) and I’m starting to see some changes in my face that I’m not super thrilled about. Mostly around my mouth, I think.

Specifically, I’m worried about how my face is becoming less symmetrical. Like, one side seems to be drooping more than the other. Is this a normal part of aging? And what about my smile? It doesn’t look quite as…youthful, I guess, as it used to. It feels like one side pulls up more than the other now too.

I’m wondering specifically about:

• Muscle tone: Does muscle loss in the face contribute to asymmetry as we age?
• Bone structure: Does the underlying bone structure change significantly enough to cause asymmetry?
• Skin elasticity: Obviously, skin sags with age, but how does that impact facial symmetry around the mouth and smile specifically?
• Fat pads: Do fat pads in the face shift or deflate, and if so, how does that contribute to asymmetry and a less aesthetically pleasing smile?
• Dental changes: Can changes in my teeth alignment or wear and tear on my teeth impact how my smile looks and contribute to perceived asymmetry?
• Anything I can do to slow it down or correct it? Are there exercises, treatments, or procedures that can address these issues?

I’m really trying to understand why this is happening and what my options are. I’m not necessarily looking for plastic surgery, but I’d be open to less invasive treatments if they actually work. Thanks!

Answer

Aging significantly impacts facial symmetry and smile aesthetics through a multitude of interconnected processes affecting both hard and soft tissues. These changes are gradual and multifaceted, leading to noticeable differences over time.

Skeletal Changes:

• Bone Resorption: Bone loss is a major contributor to age-related facial asymmetry. The maxilla (upper jaw) and mandible (lower jaw) undergo resorption, leading to a decrease in vertical height and overall volume. This bone loss is not uniform, and differences in resorption rates between the left and right sides can contribute to asymmetry. For example, the mandibular angle can become less defined and more obtuse, potentially affecting the perceived symmetry of the lower face. The alveolar bone, which supports the teeth, also resorbs, leading to tooth loss and further compromising facial support.
• Orbital Expansion: The bony orbit (eye socket) enlarges with age. This process, known as orbital remodeling, can lead to a sunken appearance of the eyes and a hollowing out of the tear trough area. Uneven expansion between the orbits can contribute to asymmetry in the upper face.
• Chin Changes: The chin may appear to recede or rotate slightly due to bone resorption in the mandible. This can affect the balance of the lower face and alter the perceived prominence of the chin.
• Nasal Changes: The nasal aperture widens, and the nasal tip droops due to the weakening of supporting ligaments and cartilage. This can change the overall shape and symmetry of the nose.

Soft Tissue Changes:

• Collagen and Elastin Loss: Collagen and elastin are structural proteins responsible for skin elasticity and firmness. As we age, their production decreases, leading to a loss of skin elasticity, thinning, and sagging. This sagging is not uniform across the face, contributing to asymmetrical folds and wrinkles.
• Fat Pad Atrophy: Subcutaneous fat pads, which provide volume and contour to the face, undergo atrophy with age. The loss of fat in the cheeks, temples, and around the eyes leads to a gaunt appearance and accentuates underlying bony structures. The differential atrophy of fat pads on either side of the face directly impacts facial symmetry. For instance, loss of volume in one cheek can make the other appear disproportionately larger.
• Muscle Changes: Facial muscles weaken and lose tone with age. This can contribute to drooping of the eyebrows, eyelids, and corners of the mouth. Muscle imbalances, where one side of the face is stronger or more active than the other, can further exacerbate asymmetry. For example, the depressor anguli oris muscle, which pulls down the corners of the mouth, can become more active on one side, leading to an asymmetrical downturned smile.
• Gravity’s Effect: Gravity constantly pulls down on the soft tissues of the face, contributing to sagging and drooping. This effect is more pronounced in areas with less underlying support, leading to jowls, deepening nasolabial folds (lines from the nose to the corners of the mouth), and marionette lines (lines from the corners of the mouth to the chin). The effects of gravity are rarely symmetrical, further impacting facial aesthetics.
• Changes in Skin Texture and Pigmentation: Sun exposure and other environmental factors can lead to uneven skin tone, pigmentation changes (such as age spots), and the development of fine lines and wrinkles. These changes can be more pronounced on one side of the face, leading to perceived asymmetry.

Dental Changes and their Impact on Smile Aesthetics:

• Tooth Wear and Loss: Teeth wear down over time due to attrition and erosion. This wear can be uneven, affecting the incisal edges (biting surfaces) and leading to discrepancies in tooth length. Tooth loss, particularly if not addressed with implants or other replacements, can cause alveolar bone resorption and further compromise facial support, affecting the symmetry and aesthetics of the smile.
• Gingival Recession: The gums can recede with age, exposing more of the tooth root. This can create an uneven gum line and make the teeth appear longer, particularly if recession is more pronounced on one side of the mouth.
• Tooth Position Changes: Teeth can shift and drift over time, particularly if there is tooth loss or periodontal disease. This can lead to crowding, spacing, and changes in the alignment of the teeth, affecting the symmetry of the smile arc and the overall appearance of the smile.
• Lip Support: The teeth and underlying alveolar bone provide support for the lips. As these structures change with age, the lips can lose their fullness and definition. The vermilion border (the edge of the lip) can become less defined, and wrinkles can develop around the mouth (perioral wrinkles). These changes can affect the shape and symmetry of the smile.
• Decreased Lip Elasticity: Lip elasticity decreases, affecting the dynamic movement of the lips during smiling. The upper lip may elevate less, exposing less of the upper teeth, leading to a less youthful appearance.
• Changes in Occlusal Plane: The occlusal plane (the plane formed by the biting surfaces of the teeth) can change with age due to tooth wear, tooth loss, and bone resorption. This can affect the angle of the smile and the overall balance of the face.

Interplay and Summary:

The effects of aging on facial symmetry and smile aesthetics are complex and interconnected. Skeletal changes provide the foundation for soft tissue changes, and dental changes directly impact lip support and smile appearance. Furthermore, lifestyle factors such as sun exposure, smoking, and diet can accelerate the aging process and exacerbate these changes. The interplay of bone resorption, fat atrophy, skin elasticity loss, muscle weakening, and gravity leads to a cumulative effect that can significantly alter facial symmetry and the aesthetics of the smile. The individual variations in these processes mean that the specific changes and their impact on facial symmetry and smile aesthetics will vary from person to person.