The face ages in every layer at once: the skin thins and loses elasticity, the fat compartments shrink and slide downwards, the supporting ligaments loosen, and the bones of the eye socket, cheek and jaw slowly remodel. Together these changes turn the full, heart-shaped face of youth into a squarer, heavier lower face with hollows higher up. Understanding which layer has changed guides the choice of treatment.
Skin: the outer layer
From the mid-twenties, the skin produces less collagen and elastin each year. It becomes thinner, drier and less able to spring back. Fine lines appear first around the eyes and forehead, where muscles move most often. Sun exposure is the biggest external factor, causing uneven pigmentation, broken veins and deeper wrinkles; smoking, pollution and poor sleep add to the damage. Skin changes are best addressed with sun protection, a sensible skin care routine and, where appropriate, non-surgical treatments.
Fat: deflation and descent
The face contains several separate pockets of fat rather than one continuous layer. With time, some of them, particularly those deep in the cheek and around the eyes, lose volume, while others become relatively heavier or slide lower. This is why hollows develop under the eyes and cheekbones at the same time as fullness gathers along the jawline as jowls. It explains why simply adding volume, or simply tightening skin, rarely gives a natural result on its own.
Ligaments and muscle
Retaining ligaments act like anchors, tethering the skin and fat to the underlying bone. As they stretch, the tissues they hold move downward, and the points where they remain firmer create creases such as the nasolabial folds and marionette lines. The platysma muscle in the neck can separate into visible vertical bands, and the muscular layer of the face, the SMAS, loses tone. Repeated expressions etch dynamic lines into the skin, which eventually remain visible at rest.
Bone: the hidden change
The facial skeleton is not fixed. Over decades, the eye sockets widen, the cheekbones and upper jaw lose some projection, and the jawline becomes less defined, especially if teeth are lost. With less scaffolding underneath, the soft tissues above have less to hang on to, contributing to sagging and a more tired appearance. This bony change is one reason the lower eyelid can look longer and the chin less prominent with age.
A typical timeline
- Thirties: early lines around the eyes and forehead, slight tear trough hollowing and the first loss of skin brightness.
- Forties: deepening nose-to-mouth folds, early jowls, hooding of the upper eyelids and some volume loss in the cheeks.
- Fifties: more obvious jowls, marionette lines, loosening neck skin and bags under the eyes, often accelerated around the menopause.
- Sixties and beyond: neck bands, thinner skin, deeper folds and more noticeable changes to the jaw and lip area.
Genetics, sun exposure, smoking and weight changes mean people age at very different rates, so these are broad patterns rather than rules.
Matching treatment to the layer
Because ageing affects several layers, a good plan targets the ones that have changed most. Skin quality responds to sun protection and skin treatments. Lost volume may be restored with dermal filler or fat grafting. Dynamic lines can be softened with anti-wrinkle injections. Sagging of the deeper tissues is best addressed surgically, for example with a facelift, deep plane facelift or neck lift, while blepharoplasty treats excess eyelid skin and bags. Mr Nassab will assess each layer before suggesting what, if anything, is likely to help.
Slowing the process
Nothing stops ageing, but some habits make a real difference: daily broad-spectrum sunscreen, not smoking, a stable weight, good sleep and a balanced diet. Avoiding large fluctuations in weight also protects the skin’s elasticity. These measures also help any treatment you do choose to last longer. Surgery is for adults aged 18 and over; the £150 consultation fee is separate from any treatment cost.
Frequently Asked Questions
At what age does the face start ageing?
Subtle changes in skin collagen start in the mid-twenties, but visible signs usually appear in the thirties and forties, depending on genetics and lifestyle.
Why do jowls form?
Jowls form as the fat and tissues of the cheek slide down and the ligaments that hold them loosen, while the jawline loses some bony support.
Does the menopause affect facial ageing?
Yes. Falling oestrogen levels around the menopause reduce collagen and can speed up skin thinning and laxity.
Can skin care stop my face ageing?
Skin care, especially sunscreen, protects skin quality, but it cannot prevent the deeper changes in fat, ligaments and bone.
Is facial ageing the same on both sides?
Not always. Sun exposure, sleeping position and natural asymmetry can make one side look older than the other.
