Bones, Fat & Muscles: The True Foundation of Facial Ageing
- assistant0102
- May 22
- 19 min read
Updated: Oct 24
As We Age, The Face Falls From Top To Bottom.
Why? Thinning skin, depleting muscle mass and fat loss make up the biggest portion of why our appearance changes as we mature!
As women age, the face undergoes significant transformations, primarily due to the loss and redistribution of facial fat. This process contributes to the development of fine lines, wrinkles, and sagging skin, often giving the appearance of accelerated aging.
In youth, facial fat is evenly distributed across various compartments, providing volume and contour to areas like the cheeks, forehead, and around the eyes and mouth. This distribution maintains the skin's smoothness and tightness. However, with age, this fat loses volume, clumps, and shifts downward, leading to sunken features and sagging skin.
At What Age Does Facial Fat Loss Begin?
Facial fat loss typically begins in the mid-30s, although the exact onset can vary based on genetics, lifestyle, and environmental factors. Initially, the changes are subtle, but over time, the cumulative effect becomes more pronounced, leading to noticeable alterations in facial structure and appearance.
The Process of Facial Fat Loss:
Volume Reduction: The deep fat compartments in the face diminish, leading to a loss of support for the overlying skin.
Fat Redistribution: Fat migrates from areas like the cheeks to the lower face, contributing to jowls and a heavier jawline.
Skin Elasticity Decline: With reduced collagen production, the skin becomes less elastic, exacerbating the effects of fat loss and leading to wrinkles and sagging.
Bone Structure Changes with Age:
Beyond fat loss, the facial skeleton also undergoes changes that affect appearance. As we age, bones such as the maxilla (upper jaw), mandible (lower jaw), and orbital bones (around the eyes) experience resorption, leading to a decrease in bone density and structural support . This bone loss contributes to a receding chin, sunken cheeks, and a more pronounced nasolabial fold.
The process of bone resorption, known as retrusion, results in the facial bones shrinking and shifting, further exacerbating the signs of aging.
The simultaneous loss of facial fat and bone density leads to a decrease in structural support and volume, causing the skin to sag and wrinkles to form. These changes are compounded by the natural decline in collagen and elastin production, essential proteins that maintain skin elasticity and firmness.
Additionally, repetitive facial expressions and muscle movements contribute to the formation of dynamic wrinkles, such as crow's feet and frown lines
The Role of Muscles in Ageing & Facial Support:
As we lose the puppy fat from youth, we must also work to keep the skin and muscles beneath lifted, toned, and sculpted to make up for the lost volume that once created a soft, full face.
Facial muscles act as scaffolding that holds up the skin. As we age, these muscles elongate and weaken, causing the skin to droop and contributing to deeper lines and folds. Without strong muscles, even the best skin treatments may not provide long-lasting lift or structure.
This is why addressing muscle tone is essential in any serious anti-aging plan. Strengthening facial muscles can lead to:
Improved facial contour and symmetry.
A lifted, firmer appearance.
Reduced puffiness and sagging.
A mature woman's face will usually be more sculpted and have sharper features than a younger woman's face. This is natural and it's why we need to keep the skin as thick, plump, and firm as possible, as well as care for the muscles underneath, which serve as the base for everything we see on the surface.
Understanding how fat and bone change as we age is only half the battle, addressing these changes with the right treatments is just as important.
Thankfully, advanced non-invasive technologies are now available that support the skin, muscles, and even bone health, helping to slow and reverse visible signs of aging.
Medical-grade Red and Near-Infrared LED Light therapy is one such innovation. When applied appropriately and regularly using the correct device, it has been shown to improve the health and integrity of the body's bones, muscles, and skin. These wavelengths penetrate deeply into the tissues, stimulating cellular repair and increasing circulation, which supports collagen production and bone metabolism.
References:
-A controlled trial to determine the efficacy of red and near-infrared light treatment in patient satisfaction, reduction of fine lines, wrinkles, skin roughness, and intradermal collagen density increase.
-Reverse skin aging signs by red light photobiomodulation
-Low intensity near-infrared light promotes bone regeneration via circadian clock protein cryptochrome 1
-Effects of photobiomodulation in the treatment of fractures: a systematic review and meta-analysis of randomized clinical trials.
-Effect of near-infrared light on in vitro cellular ATP production of osteoblasts and fibroblasts and on fracture healing with intramedullary fixation.
-Reverse skin aging signs by red light photobiomodulation
-Effects of photobiomodulation in the treatment of fractures: a systematic review and meta-analysis of randomized clinical trials.
Microcurrent muscle therapy is another powerful treatment that dramatically strengthens and restores the skin and muscles of the face.
However, it’s essential to differentiate between types: while many at-home devices only reach the skin’s surface, clinic-grade microcurrent muscle therapy —like that used in professional treatments—can penetrate deeply enough to affect both the skin and underlying facial muscles. These muscles serve as scaffolding for the face, so maintaining their strength and tone is critical for a lifted, youthful appearance.
Microcurrent muscle therapy is used by medical professionals to treat the damage caused by several forms of palsy and stroke within the nerve and muscle tissues.
Clinic-grade microcurrent muscle devices are designed to work in harmony with the body’s own bioelectrical system. Microcurrent therapy was developed to mimic the body’s natural electrical currents that flow through the nervous system, helping to stimulate repair and regeneration within the muscles and tissues.
Because each person’s natural electrical current varies, only clinical-grade devices are powerful and precise enough to effectively interact with these currents, allowing them to rebuild and strengthen the facial, neck, and chest muscles. For the treatment to be truly effective, the microcurrent must be able to penetrate and override the body’s existing electrical resistance.
References:
-Bioelectricity and microcurrent therapy for tissue healing-a narrative review.
-Electrical microcurrent stimulation therapy for wound healing: A meta-analysis of randomized clinical trials
-The science of electrical stimulation therapy for fracture healing
-Physiological effects of microcurrent and its application for maximising acute responses and chronic adaptations to exercise
-Short-term microcurrent electrical neuromuscular stimulation to improve muscle function in the elderly
-Investigating the therapeutic efficacy of microcurrent therapy: a narrative review
-Microcurrent Electrical Nerve Stimulation Facilitates Regrowth of Mouse Soleus Muscle
-Accelerated Bone Healing via Electrical Stimulation
-Effects of Acute Microcurrent Electrical Stimulation on Muscle Function and Subsequent Recovery Strategy
-Rewiring the Lesioned Brain: Electrical Stimulation for Post-Stroke Motor Restoration
-Effects of Electrical Stimulation on Facial Paralysis Recovery after Facial Nerve Injury: A Review on Preclinical and Clinical Studies
-A Randomized Clinical Trial of a Functional Electrical Stimulation Mimic to Gait Promotes Motor Recovery and Brain Remodeling in Acute Stroke
-Effects of Acute Microcurrent Electrical Stimulation on Muscle Function and Subsequent Recovery Strategy
At-home devices, such as the MyoLift, may not always have sufficient strength to do this. They can provide mild stimulation but may be too weak to break through the body’s natural current and therefore might not achieve the same level of muscle repair or lifting results.
In contrast, clinic-grade devices deliver a controlled current strong enough to synchronize with and enhance the body’s own signals—repairing, rebuilding, and re-educating the muscles for long-term improvement.
To further repair and rebuild aging skin, Radio Frequency (RF) technology has become a cornerstone of modern aesthetic treatments. Devices like Exilis Ultra 360 Monopolar RF stimulate dramatic collagen, elastin, and blood vessel growth. When used at the correct settings and intervals, this technology can effectively plump and firm the skin, restoring lost volume and reducing fine lines and laxity.
Reference:
Together, these therapies form a multi-layered approach to anti-aging, addressing not just surface concerns but the deeper structural changes that occur with time. By combining them into regular care routines or structured clinical programs, clients can maintain facial integrity and slow the visible effects of aging at every level.
Injectable therapies are not the solution. Let's take a deep dive into skincare, injectable therapies and why sometimes, even when you have lots of money and resources, it can all go VERY wrong!
There is a quick-fix treatment that is available everywhere.
Let's break it down!
Dermal Fillers:
Dermal Fillers are used to fill up lost volume caused by thinning skin and depleting muscle mass. Think of Dermal Fillers as a thick gel that works like putty or Polyfilla to fill up the gaps created in the skin from lost volume caused by diminishing strength and size of muscles and lost collagen, elastin, and blood vessel growth within the skin.
There are many different dermal fillers on the market to date. Some of the most commonly used are:
Juvederm Voluma – Both Juvederm and Juvederm Voluma are hyaluronic acid dermal fillers, but Juvederm is softer and thinner while Voluma is thicker and heavier.
Restylane Lyft – Both Restylane and Restylane Lyft are composed of hyaluronic acid. The primary difference between Restylane and Lyft is that the hyaluronic acid gel particles in Lyft are larger than those found in Restylane.
Restylane Silk – Both Restylane and Restylane Silk are composed of hyaluronic acid. The primary difference between the two products is that the hyaluronic acid particles in Silk are smaller, making it more suitable for use in the lip area.
The above-listed Dermal Fillers are made up of biodegradable hyaluronic acid.
Hyaluronic acid can bind with water molecules and hold up to 1000 times its weight in water. This is why it is advised to stay well hydrated after having hyaluronic acid-based Dermal Fillers. The more water molecules that are drawn towards the hyaluronic acid-based Filler injected into the layers of the skin, the more effective it is in making the skin look thicker.
The problem with these Fillers is that the skin is being filled up with hyaluronic acid and other chemical components (no injectable Filler is made up only of hyaluronic acid) and NOT replenished with new collagen, elastin, and blood vessel growth. Muscle mass depletion is also not being addressed, so these problems continue to worsen behind the scenes.
Think of a brick wall.
The mortar used to hold the wall together needs to be strong. A typical mortar mixture consists of 1 part cementitious material 2 1/4 - 3 1/2 parts sand by volume. Water is alsoo an integral ingredient that is added to the mortar mixture until it attains the right consistency for use.
Whilst water is an integral part of the mixture of mortar, if the mixture has too much water or is mainly water, then it will lack the integrity and strength to not only build the wall but also enable the wall to stand the test of time.
Think of our skin.
Collagen and elastin in the mesh hold the skin together and give it bulk, bounce, lift, strength, and integrity, much like the cementitious material used in mortar.
Whilst hydration, in the form of hyaluronic acid molecules, is an integral part of what makes up thick, strong, and healthy skin, filling the layers of thinning skin with hyaluronic acid-based Dermal Fillers is like using water balloons as mortar in a brick wall.
Whilst continuously using Fillers may make the skin look thicker and firmer, more and more will be needed in more and more areas due to the natural ageing process. It is important to remember that whilst hyaluronic acid-based Dermal Fillers work to make the skin look better, they do nothing to make it better and correct the underlying problem of thinning skin.
The Dermal Filler called Radiesse is made up of Calcium Hydroxylapatite.
Calcium Hydroxylapatite is a substance found naturally in teeth and bones. When used in a Dermal Filler known as Radiesse, calcium hydroxylapatite helps to create volume lost due to thinning skin and can be used in larger areas of the face like the cheeks or jawline. Radiesse is used to gain longer-lasting results than other hyaluronic acid-based Fillers.
The Dermal Filler called Sculptra is made up of Poly-L-Lactic Acid (PLLA).
PLLA particles are made up of repeating units of lactic acid, which is produced by the fermentation of sugars found in renewable resources like corn starch, sugarcane, or other plant-based materials. Since its source is biological (plants), it is categorised as a biopolymer.
Once injected, the tiny PLLA particles are spread throughout the deeper layers of the skin (the dermis). The body recognises these PLLA particles as foreign, which prompts a mild, controlled inflammatory response.
As part of this response, fibroblasts (the cells responsible for producing collagen) are activated, leading to the gradual production of new collagen fibres around the PLLA particles. Over time, the PLLA is broken down naturally by the body, but the collagen it has stimulated remains, providing long-term volume, firmness, and smoothness to the skin.
To gain the full effect of Sculptra, 2-4 treatments are spaced about a month apart, and the full effects of Sculptra can take up to 9 months to develop.
The Dermal Filler called Bellafill is made up of Poly(methyl methacrylate).
Bellafill is a long-lasting Dermal Filler that contains bovine collagen (collagen harvested from cows) and tiny Poly(methyl methacrylate) beads (a transparent thermoplastic). The collagen provides immediate volume and lift, while the Poly(methyl methacrylate) remains in place and works to create a base that provides structural support to the skin. Think of the bovine collagen replacing your own lost collagen instantly, and the Poly(methyl methacrylate), which is basically specially formulated plastic, working to create more support to the collapsing skin.
There can be many side effects caused by Dermal Fillers.
Most people can have them with no or only short-term side effects such as bruising, redness, and/or swelling.
In rare cases, longer-lasting side effects can develop, resulting in the need for antibiotics, steroids, and/or surgical intervention, and in the very rarest cases, cause long-term scarring or disfigurement.
Some side effects are Granulomas, Injection site ulcers, Erythematous papulocystic nodules, and Delayed Onset Nodules.
The pictures shared are of a Jessica t Medi-Spa client who suffered from Delayed Onset Nodules.
Our client chose to have some Fillers due to her going on a lengthy trip and not being able to come for treatments for a long period. She had Dermal Fillers in her tear trough area, upper cheeks, and nasolabial folds (smile lines). After approximately 8 months, the first of many nodules appeared at the sides of her mouth. These cyst-like growths continued to pop up on both sides of her face and included ones around her eye area that were visibly noticeable at around the 14-month mark after the Fillers had been done.
Our client was very lucky as the clinic (whose practitioners had done NOTHING wrong) where she had the treatment done helped her to resolve this problem, first by recommending and providing two courses of steroids which successfully shrunk the nodules but did not completely get rid of them, and then dissolving the nodules manually with other injectable substances throughout 2 treatment sessions in the hospital.
This is why it is very important to only have injectable therapies from a provider who guarantees they will support you if anything goes wrong after treatments are provided.
What About Thread Lifts?
Thread lifts are often marketed as a quick fix for sagging skin, promising a lifted, more youthful look without surgery. They involve inserting dissolvable threads under the skin to pull and anchor areas like the cheeks, jowls, or neck. While the idea sounds appealing, with minimal downtime, fast results, it’s important to understand the potential trade-offs.
Many clients come to us after having threads, especially once the temporary “lift” fades and they’re left with skin changes they didn’t expect. The threads dissolve, but sometimes leave behind uneven texture, puckering, scar tissue, or in some cases, visible marks. The results can also wear off surprisingly quickly, especially if the underlying skin and muscle weren’t strong to begin with.
What’s also important to know is that certain treatments we provide, such as radiofrequency (RF) or RF microneedling, can’t be safely done over areas where threads have been placed. The heat can interfere with the threads, potentially melting them unevenly or causing internal damage. This limits our ability to rebuild the skin naturally if you've had threads inserted, which can delay your progress and reduce treatment options.
Like many injectables, thread lifts focus on creating the appearance of firmness rather than rebuilding the skin's deeper structure. They can create tension, but not true strength. At best, they are temporary, and at worst, they may leave the skin less resilient over time.
We believe in strengthening your skin from the inside out, working on the real causes of sagging, like loss of collagen, elastin, and muscle tone. This is why our treatments focus on repairing and rebuilding what’s been lost, gently and gradually, with results that keep improving, not fading.
Fat Transfer – a more natural alternative to synthetic Dermal Fillers.
While Fat Transfer (also called Fat grafting) cannot technically be called a Dermal Filler, autologous Fat Transfer is another way to reverse the visual signs of thinning skin. This procedure is a two-step process that begins with the removal of fat deposits using Liposuction from an area like the midsection or thighs. The fat cells are then harvested and prepared for injection similar to a Dermal Filler. The difference is that the patient’s own cells are used to produce the most natural result, and the results are permanent for most patients. Make sure you do your research and see highly qualified and experienced plastic surgeons (not cosmetic surgeons) like Dr. Quinn to get more info about Fat Transfer procedures.
Jessicat believes only after creating thicker, stronger skin by targeting the problem of depleting muscle mass should you look at having Fat Transfer procedures to perfect your overall results.
There are two main problems with Injectable therapies:
One: They are a quick-fix and addictive way to hide the effects of thinning skin, which can get us into the bad habit of thinking we can simply inject the ageing process away. They do nothing to fix the underlying problem of thinning skin, so the problem goes on unchecked and is allowed to get worse and worse until the skin is so thin, fragile, and damaged that the injectable therapies cannot gain the same effect as they once did.
Two: Over time, as more and more injectable therapies are used, the individual contours that make our faces look like us can be lost, and we can become more mannequin-like in appearance, or worse, our faces can become misshapen and gain a look we do not want.
Sometimes, people do not notice this happening and get lost in trying to freeze or plump away individual imperfections, causing them to lose sight of the overall picture.
Think it can’t happen to you? Let’s look at some examples of injectable therapies that were used well, overused, and when things go terribly wrong!
Used well, or overused? In this case, it's all in the eye of the beholder due to Trinny looking amazing at 56 years of age!
Trinny Woodall is a beautiful woman and is well known for co-presenting BBC television series What Not to Wear with Susannah Constantine.
She is also well known for her honesty about using Botox, Dermal Fillers and Laser resurfacing treatments.
Trinny has said; ‘I’d never have a facelift, as I’ve never seen anyone who has had one that looks good.’
Due to Trinny having more and more Dermal Filler under her eyes (possibly temples) and in her upper cheeks, her eyes are looking much smaller, and her mouth is being pulled wider, making it appear like she has had fillers in her lips, which she denies.
It should be considered that Trinny has a lot of Botox (watch this video of Trinny having a treatment with Dr. Sebagh) very regularly. It is logical that paralysing her muscles over the last 15 years or so has affected the muscles’ size and strength. This means that more and more filler will be needed to fill up both thinning skin and space caused by lost muscle mass, which is why her smile is now beginning to look much wider and more stretched.
This is what can happen when we work to spot and treat problem areas and end up losing sight of the bigger picture!
When it comes to injectable fillers, Christie Brinkley has been quoted saying: “fill but don’t stuff!”
Courteney Cox is iconic for her fresh, energetic, and carefree style of beauty. She is famed for looking much younger than she is and is well known for regularly having treatments, including injectable therapies like Botox and Filler, to keep herself looking youthful.
The pictures shown are an example of what too much Filler can look like. After seeing pictures of herself, Courteney had the Fillers in her skin dissolved and publicly spoke out about how easy it was to lose sight of how she actually looked and how easy it was to go too far with injectable therapies.
As you can see from the pictures below, after having the Fillers dissolved, Courteney is looking much more like her radiant self.
The text accompanying the photo below is an excerpt from an article featured in New Beauty, where Cortney Pelletteri interviewed Courteney Cox on June 22, 2017. Follow this link to read the full article: https://www.newbeauty.com/courteney-cox-beauty/
This is what we may want to avoid!
All the women shown are beautiful women in their own right, in both the before and after pictures shown below.
Beauty is in the eye of the beholder, so whilst some of us may view these pictures and feel too many injectable therapies (and or surgery) have been used, others will like the effects. This blog was written with the hope that the information contained in it will better enable you to attain the look you desire and avoid a look that you do not want.
Whilst I dislike criticising other women’s appearance, to make my point it is unavoidable due to our needing to see examples of faces before and after injectable therapies have been used.
It needs to be said here that it is all a case of degrees, and everyone needs to find their own balance. Knowledge is power, and reading this blog is enabling you to take the power of knowledge into your hands so that you can go on to make better-informed decisions for your individual needs!
What About Botox?
For many women, Botox is one of the first medical-grade aesthetic treatments they use to try and hide fine lines, wrinkles, and or sagging skin due to the natural aging process causing their skin to thin/collapse.
Botox is a brand name and is an abbreviation of the name Botulinum toxin. Botulinum toxin B is marketed under the brand name Myobloc and is a type of muscle relaxant.
Muscle relaxants like Botox work to paralyze the muscles and stop the skin from moving when expressions are made. This works to hide the problem of thinning skin but does NOTHING to help improve the problem.
It also needs to be considered that over time, as the muscles are paralyzed over and over again, they can lose size and strength and eventually sag much faster than the natural aging process would cause.
Injectable muscle relaxants like Botox work to hide one problem but do nothing to address the problem of thinning skin that causes fine lines, wrinkles, and sagging skin, which means more and more Botox will be needed over time to hide the problem as it continues to get worse.
As more and more Botox is used to hide the problem of thinning skin, the muscles can become weaker and smaller, which can cause hollows within the facial features and feed into the problem of fine lines, wrinkles, and sagging skin. To address this, doctors and other providers of injectable therapies will most often advise the use of Fillers in order to try and make up for the lost volume caused by depleted muscle mass, which is a result of using Botox regularly. As more and more Fillers are used, the shape of the face can become more and more swollen, and the gentle contours that make up an individual's face can be lost, causing women who rely on injectable fillers to often look very similar to one another.
So how do stars like Jennifer Lopez do it?
They have treatments like the ones we provide that include the use of state-of-the-art technologies that work to repair, rebuild, and improve the cellular function of the skin. Many of them are smart enough to address depleting muscle mass as well in order to keep a strong, full, and lifted scaffolding for the skin to sit upon. Jennifer Lopez is said to own one CACI Microcurrent device (I am sure she does not do her own treatments, though).
Stars like Jennifer Lopez’s team of beauty professionals work to keep their client’s skin thick, full, and lifted, the muscles strong and full (this step is still left out by so many amazing beauty professionals, but awareness is slowly building), and use injectable therapies, and/or procedures like fat transfer and surgical procedures minimally to fine-tune their look.
THEY DO NOT RELY SOLELY ON INJECTABLE THERAPIES TO CREATE THE FOUNDATION OF THE LOOK!
We have put a man on the moon; of course, we can do better than using toxic creams that work only to melt away dead skin cells and cause us to be even more prone to damage from the sun, and quick-fix injectable therapies that work only to hide the signs of ageing and do nothing to address the underlying issues that cause our appearance to change as we mature and can actually make these issues worse.
Injectable therapies have their place, but this place should be to finish off a look, and not to create it!!
Let's work to solve the underlying problem of thinning skin and depleting muscle mass, opt for procedures like using our own fat in place of Injectable Fillers if possible (using fat transfer procedures provided by an experienced and highly qualified plastic surgeon), and use injectable therapies minimally, or not at all.
Interested in knowing what it takes to look timelessly youthful? Check out our blog:
I hope you find the info shared interesting and that it enables you to find the right treatments and devices to help you gain and maintain a timeless and youthful look. Jessicat.
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References:
-Clinical Trials Involving Biphasic Pulsed Current, MicroCurrent, and/or Low-Intensity Direct Current
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