Facial Muscles

The muscles of the face have several functions:

• Moving the jaw when we chew food
• Closing and opening the eyes
• Facial expressions and social communication

When we communicate with others, our feelings are reflected in our facial expressions. So for example, when we are surprised we raise our eyebrows. The muscle involved in this movement is the frontalis, which spreads across the forehead, this muscle attaches the bone underneath to the skin above. When this muscle contracts, it pulls the eyebrows upwards, and as this gets shorter the skin-attached creates wrinkles. As the frontalis relaxes the wrinkles disappear. However, as we age, our skin gradually loses its elasticity, so when the frontalis relaxes, the skin lacks the elasticity to return to its natural, smooth state and we develop forehead wrinkles.

Dermal fillers are of no use here as they are designed to replace lost volume, such as fine lines and wrinkles. They cannot smooth out forehead lines which are caused by dynamic muscle movement. The only option is to isolate the muscle and prevent it from contacting. This is where Botulinum toxin comes in.

Loss of skeletal bone, or resorption, is another consequence of ageing. As the upper jaw (maxilla) decreases in size it compounds the displacement with the malar fat pad and accentuates the nasolabial fold.

Facial Fat Pads and Ageing

Facial fat pads determine the contours and fullness of our face, but as we age two things happen. We lose volume from our facial fat deposits, and the ligaments that hold them in place begin to slacken, leaving gravity to do the rest.

The diagram shows the results of volume loss. and migration of facial fat pads over approximately 20 years. Underneath the eye, the malar fat pad (which is triangular) has descended leaving a ‘malar split’. Lower down, the malar fat pad descent has bulged against the ‘nasolabial crease’ making the nasal fold more prominent and creating a heavier pre-jowl. Loss of volume and fat pad migration can both be corrected by dermal filler (hyaluronic acid).

Skin Ageing

Skin wrinkling occurs at some sites (particularly around the eyes) due to the repeated underlying muscle action. The lines caused by muscle contraction or dynamic rhytids (wrinkles), begin to develop into static rhytids as the skin loses its skin elasticity over the years. In other words, the wrinkles become permanent. Jowls and nasolabial folds are also adversely affected by excess skin.

In addition to a loss of elasticity, ageing skin also loses its strength and volume, due solely to a lack of fibroblast activity in the dermal layer. Fibroblasts are responsible for the production of hyaluronic acid, collagen, and elastin. These 3 components of the dermal layer give the skin its volume, strength, and elasticity, respectively. When the skin is traumatised the natural healing response ‘awakens’ fibroblasts which respond with an increased output of HA, collagen, and elastin. This explains the dramatic results of certain aesthetic procedures, such RF micro-needling, and peels.

Regular hydration of the lips is, therefore, a vital part of any skincare regime, and for those exposed regularly to direct sunlight, an SPF should be included.

Lip Anatomy

The skin of the lips has no hair follicles. Nor does it have any sweat or sebaceous glands. This explains why the skin of the lips is prone to drying out. Without the oily sebum from the sebaceous glands which make skin waterproof,  the skin of the lips becomes dehydrated after constant exposure to environmental aggressions such as wind, heat, and UV radiation.

The outer layer of cells in the skin of the lips (stratum corneum) is much thinner than normal skin, as a result, you can see the blood vessels that lie beneath the skin making them appear red.

The skin of the lips also lacks melanocytes, the cells responsible for making melanin which protects the delicate, deeper layers of skin by absorbing harmful UV light.