Lambros Val
Newport Beach, Calif. From the Department of Plastic Surgery, University of California, Irvine.
Plast Reconstr Surg. 2007 Oct;120(5):1367-1376. doi: 10.1097/01.prs.0000279348.09156.c3.
Many of the anatomical changes of facial aging are still poorly understood. This study looked at the aging process in individuals linearly over time, focusing on aspects of periorbital aging and the upper midface.
The author compared photographs of patients' friends and relatives taken 10 to 50 years before with closely matched recent follow-up pictures. The best-matching old and recent pictures were equally sized and superimposed in the computer. The images were then assembled into GIF animations, which automate the fading of one image into the other and back again indefinitely.
The following findings were new to the author: (1) the border of the pigmented lid skin and thicker cheek skin (the lid-cheek junction) is remarkably stable in position over time, becoming more visible by contrast, not by vertical descent as is commonly assumed. (2) Orbicularis wrinkles on the cheek and moles and other markers on the upper midface were also stable over decades. (3) With aging, there can be a distinct change in the shape of the upper eyelid. The young upper lid frequently has a medially biased peak. The upper lid peak becomes more central in the older lid. This article addresses these three issues. No evidence was seen here for descent of the globe in the orbit.
There seems to be very little ptosis (inferior descent) of the lid-cheek junction or of the upper midface. These findings suggest that vertical descent of skin, and by association, subcutaneous tissue, is not necessarily a major component of aging in those areas. In addition, the arc of the upper lid changes shape in a characteristic way in some patients. Other known changes of the periorbital area are visualized.
面部衰老的许多解剖学变化仍未得到充分理解。本研究对个体随时间的衰老过程进行了线性观察，重点关注眶周衰老和中上面部的情况。
作者将患者10至50年前与其朋友和亲属的照片与近期紧密匹配的随访照片进行比较。最佳匹配的旧照片和近期照片尺寸相同，并在计算机中进行叠加。然后将这些图像组装成GIF动画，可使一幅图像无限期地淡入另一幅图像，再淡回原图像。
以下发现是作者首次观察到的：（1）色素沉着的眼睑皮肤与较厚的脸颊皮肤的边界（睑颊交界处）随着时间推移位置非常稳定，相比之下变得更加明显，并非如通常所认为的那样是垂直下降。（2）脸颊上的眼轮匝肌皱纹以及中上面部的痣和其他标记在数十年间也很稳定。（3）随着年龄增长，上睑形状会有明显变化。年轻的上睑通常在内侧有一个偏向的峰值。上睑峰值在老年上睑中变得更加居中。本文探讨了这三个问题。在此未发现眼球在眼眶内下降的证据。
睑颊交界处或中上面部似乎几乎没有上睑下垂（向下移位）。这些发现表明，皮肤以及与之相关的皮下组织的垂直下降不一定是这些区域衰老的主要组成部分。此外，部分患者上睑的弧度会以一种特征性方式改变。眶周区域的其他已知变化也得以显现。
