When we are young and pre-puberty, our faces are quite round. The skin is thick and very well hydrated and there are rarely any blemishes or wrinkles.

As we go through puberty, the face elongates therefore it appears to become thinner and longer. This happens because the sex hormones stimulate growth of the bone in the mid face (the maxilla) as well as the jaw. These hormones are oestrogen and progesterone in the female and testosterone in the male.

In the young adult, however, although the shape of the face has changed, there are usually high cheek bones with a gradual inward sloping of the cheek down to the chin. The skin is quite flattened with little in the way of blemishes or wrinkles usually and the lips are hydrated and usually quite full.

As we age, several factors come into play. Things that are very bad for the skin are cigarette smoke, over-exposure to ultraviolet light or sunlight, exposure to other chemicals or pollution in the atmosphere as well as medicines and different hormone disturbances in the body itself. There are obviously other factors as well but this list is just to show there are external influences as well as internal influences. Without doubt there is also a very strong genetic or familial influence. Some people come from families that always look young whereas others come from families that show age much quicker. Not everything in life is fair!

As the skin ages it becomes less well hydrated and thinner. As such, wrinkles start to appear in it. These usually start appearing between the edges of the nose and the corners of the mouth – the “nasolabial folds.” In addition people start to show wrinkles between their eyebrows (glabellar lines,) wrinkles across their foreheads, “laughter lines” or lines from the corners of their eyes backwards towards the hairline as well as other less common lines.

In addition the shape of the face slowly changes as the tissue over the cheek bones starts to reduce leaving them more sunken, the lips being less full and becoming thinner as well as the cheek starting to droop giving the appearance of a “jowl.”

To combat these signs of ageing, it is necessary to correct whichever combination of such signs one has. Traditionally a face lift was the usual way forward but with the improved technologies today, similar effects can be obtained by the use of other techniques. At the forefront of these are facial fillers.