Facial aging is a multidimensional process that involves far more than the appearance of wrinkles. To truly understand why our faces change over time — and how modern treatments can address those changes — we need to look beneath the surface at the structural, volumetric, and cellular transformations that occur across every layer of facial tissue. As a facial plastic surgeon, Dr. Jordan Licata approaches aging with this comprehensive understanding, which is why our treatment plans at Integrated Facial Aesthetics are designed to address the full picture, not just the surface symptoms.
The process begins with the skeleton itself. Starting in our late twenties, the facial bones undergo a gradual process called resorption, where bone density decreases and the overall structure of the face subtly shifts. The eye sockets enlarge, the midface recedes, and the jawline loses definition. These skeletal changes alter the framework upon which all other facial tissues rest, contributing to the hollowing and sagging that we associate with an aged appearance. This is one reason why volume restoration — through fillers or fat transfer — can produce such dramatic rejuvenation: it addresses the structural loss that sits at the root of visible aging.
Above the bone, the fat compartments of the face undergo their own transformation. In youth, facial fat is distributed evenly in discrete compartments that give the face a smooth, contoured appearance. As we age, some of these compartments shrink and descend while others expand, creating a cascade effect: the cheeks flatten, the nasolabial folds deepen, jowls emerge along the jawline, and under-eye hollows become more pronounced. Understanding the anatomy of these fat compartments is essential for any provider performing facial rejuvenation, because treating the wrong area — or ignoring the underlying cause of a concern — can produce unnatural results.
Finally, the skin itself undergoes significant changes. Collagen production declines by roughly one percent per year after age twenty, and the remaining collagen fibers become fragmented and disorganized. Elastin — the protein responsible for skin's ability to snap back — degrades and is not effectively replaced. Combined with the effects of cumulative UV exposure, environmental stressors, and hormonal shifts, these changes result in thinner, less resilient skin with visible texture irregularities, pigmentation changes, and the formation of both fine lines and deeper wrinkles. Addressing facial aging comprehensively means treating all of these layers — bone, fat, muscle, and skin — in a coordinated, strategic manner. That is the philosophy that guides every treatment plan we create at Integrated Facial Aesthetics.