Age-related changes in the lower third of the face considering anatomical and physiological aspects and morphotypes of skin aging
All areas and tissues of the face will go through age-related changes; however, aging occurs at a faster rate in the lower third of the face than in other areas. This study presents the anatomical and physiological aspects of age-related changes in all areas and tissues of the face, mainly in the lower third, such as the skin, subcutaneous fat, muscular-aponeurotic system, deep layers of adipose tissue, and bone structures of the face. Involutional changes were differentiated by taking into account the constitutional and architectonic features of the face. Heterochronous and heterotopic characteristics of age-related changes, cutaneous, and treatment components of facial aging were identified. The most commonly used visual scales to assess cosmetic effects and determine chronological aging included global aesthetic improvement scale, Glogau scale, Fitzpatrick wrinkle classification, and Merz visual 5-point aging scale. According to the classification of age-related changes proposed by Kolgunenko, five morphotypes of aging are distinguished: tired, wrinkled, deformation, mixed, and muscular. Understanding the pathogenesis of involutional changes in the lower third of the face in patients with different morphotypes of aging allows for an objective and individualized choice of optimal therapy methods.