The battle between science and marketing
Dr Daniel Sister makes the case for science
Below is the introduction to the article which will appear in full in our sister print publication B BEYOND Magazine.
On facial ageing
The ageing process is a complex interaction between a variety of facial elements, which occurs like a domino effect. The process can be described as a cascade effect, which happens in four main facial layers – the bone, muscle, fat and skin.
This domino effect occurs both from the outside skin layer inward towards the bone, and also from the bone outwards to the skin – in both directions, simultaneously. The changes that occurs, in one layer affects the next to slowly create the visual effects we recognise as age.
The most significant change in the first layer, the bony facial skeleton, occurs in the facial apertures, or ‘holes’ of the face. ‘The holes in the face – that is, the nose and the eyes – actually increase by 20 percent in size with age. The orbital apertures, or eye sockets, enlarge as time goes by and the bone of the infra-orbital region just under the eye physically moves backwards with age, so the holes not only get bigger but are also pushed back. This contributes to the lower, sunken-looking lower eye area.
Because of this, the muscle, fat and skin tissues start to descend and essentially start to slip off the surface of the receding bone. There is an assumption that gravity is the cause of this effect, which is partly true, but it’s very much in combination with the changes in the facial skeleton. Similarly, the nasal opening becomes larger, impacting the ligaments that support the nose; the nose gets larger as we age because of an enlargement of the sebaceous glands, but the change in ligaments also causes the nose to droop.
The changes that occur in the next layer up, the musculature of the face, also participate in the cascade effect, but not in the way patients might think. Despite common belief, the facial muscles actually tighten with age, not loosen. The most obvious signs of this can be seen in the platysma bands of the neck, which stretch from the chin to the collar bone area and become more pronounced with age. This effect can also come about in the form of permanent crow’s feet and deep-set glabella lines between the eyes.
Above the muscles, the amount of fat that decreases with age causes a deflated effect, which not only means volume loss but also that the hydrating and elastic functions of the skin don’t work as efficiently. The fibroblast cells in the skin that produce elastin, collagen and hyaluronic acid (HA) work best when they’re under a degree of stretch. When the fat depletes, this stretch is lessened and the skin isn’t functioning as well, which causes it to sag.
The most common manifestation of this process is a tired, weathered look with slightly sagging skin, flatter cheeks, jowling that disrupts the smoothness of the jawline, neck laxity and protruding platysma bands along the neck. This domino effect moves through the layers of the face in both directions, from bottom to top and top to bottom. It’s a complex cascade effect with each facial element affecting and interacting with the other.
How could any face cream prevent bone loss?
How could a cream that does not penetrate deeper than the very first layer of the skin work on muscles?