What Happens when We Age in Our Twenties? (photo)

These pictures illustrate the changes that occur in nearly everyone as we age.  The facial fat begins to descend from the high cheek area into the midface and the bones of the cheek/lower eye socket become more prominent.  The current thinking in facial plastic surgery centers on volume restoration to restore a youthful appearance.  Injectable fillers and fat grafting or repositioning are used to regain some of the youthful appearance.  See an oculoplastic surgeon familiar with the delicate anatomy of the lower eyelid and tear trough area.  Injections over the cheeks and in the tear trough, when properly placed, can dramatically improve the appearance in this area.

You are very observant to recognize the change of volume in the face with aging! This is actually how we are attempting to restore a youthful appearance compared to pulling and tightening from the past.

Gravity effects the tissue by pulling it down and we lose the high cheek volume while leaving a tear trough between the lower eyelid and cheek junction. We also lose overall volume of fat and skin thickness as we age. We now commonly add volume with fillers (Restylane/Juvederm/Radiesse etc and sometimes your own fat) to fill these areas of depletion to give a more youthful appearance.

Make sure your surgeon has experience with injections around the eyes and tear troughs as this is a very delicate area. 

This Scarlett Johansson in her early 20s shows fullness in her face when she was younger as opposed to Scarlett Johannson now, which she looks a bit more gaunt. Yes, natural effects of aging are inevitable as one gets older, but as an actress and celebrity her choices may also reflect how she wants to be perceived, which may be to have older and more mature image. The appearance of looking older can occur ironically by genetic trait or even by being athletic and having lower body fat. It is possible to enhance the appearance of the face to look more youthful by restoring volume in the cheek or submalar area as well as the under eye hollows. In my practice, I use materials such as Radiesse, Restylane as well as a technique called The Vampire Facelift (combining platelet rich fibrin matrix with hyaluronic acid filler) to treat these areas. I have attached a video of the Vampire Facelift I perform at my practice in New York to demonstrate.