Facial Aging: When the Triangle of Youth Becomes Inverted

A youthful face is more than just about the absence of visible lines and wrinkles. It has three unique features, which include high cheekbones, full (volume in the) cheeks, and a well-defined jawline. This is also referred to as the “triangle of youth”, with the chin being the point of the triangle and the cheeks as the base. 

The triangle of youth, however, slowly becomes inverted with age. You then notice flattened cheeks, nasolabial folds, and jowls with lax skin gathering under the chin and along the jaw. The jawline area then becomes the widest part of the face, with the cheekbones narrowing and the cheeks looking deflated. This is referred to as the “pyramid of age”.

How the face changes over time

The concept of the facial triangle (triangle of youth)  can help both aesthetic doctors and patients understand the youthful face and how the aging process changes it. As the face starts to lose volume, the skin appears thinner and sunken. The facial bone changes in structure and we lose volume in the fatty components of the face.

• Shifting of facial pads – Facial fat pads move and decrease, commonly gathering on the side of the lower jaw, as well as the neck. This can make existing lines and wrinkles more prominent and create a baggy appearance around the lower part of the face.
• Weakening of facial muscles – Over time, our muscles get weaker, as they are always in (repetitive) motion as we talk, eat, smile, or make any other facial expression. This, along with gravity and loss of facial fat can lead to wrinkles in different areas of the face. The thinning skin and loss of muscle tone can also lead to a sagging appearance with a less defined jawline or facial profile.
• Changes in bone structure and bone loss – These can alter the contour and dimensions of the face. With bone loss or changes in bones, the area around the eye gets bigger and you might notice a reduction in the angles of the brow. These can give the eyes a sunken appearance, along with droopy eyelids, frown lines, and crow’s feet. The jawline area also looks less defined or sculpted.
• Loss or decline in collagen – The production of essential skin proteins like collagen and elastin naturally reduces over time. This can make the skin drier, thinner, and less elastic. It can cause sagging skin and the appearance of wrinkles and fine lines.

Addressing the signs of aging

With facial volume loss affecting most parts of the face, dermal fillers prove to be helpful. These injectable gels are used for adding or restoring volume, as well as filling in lines, folds, and creases. They can help add volume to the cheeks and other areas of the face, augment facial structure, and even improve weak jawlines.

Dermal fillers at Cutis

In our clinic, we have two types of fillers made with hyaluronic acid or HA (Juvéderm) and calcium hydroxylapatite or CaHa (Radiesse). Both are naturally-occurring substances in the body and are biosynthetically produced when used in fillers. They are also biocompatible with the skin and eventually absorbed and metabolized by the body over time.

Juvéderm comes in various types and is mainly used for adding volume to the face. These fillers can also shape and hydrate facial skin, as well as plump up the lips, soften folds and creases, sculpt the lower face, and even address acne and some facial scars. Certain Juvéderm fillers can also help stimulate collagen over a significant period. 

HA fillers are longer-lasting but they are not permanent. The results can last for 6 to 18 months, and depending on the person, they can last a bit shorter or longer. One great thing about such fillers is that they can be removed if you don’t like the results. This is done by injecting hyaluronidase, an enzyme that breaks down HA, into the treated area. 

Radiesse is used for restoring or adding volume to the face, as well as smoothing mild to severe lines, folds, and wrinkles. It can also replenish volume loss in the cheeks, and strengthen weak chin and jawline. Radiesse, furthermore, integrates well with cheekbones, as it is made of CaHa, a naturally-occurring substance found in bones.

This filler works as a bio-stimulator, which helps stimulate the body’s own processes to produce collagen. Radiesse also has the ability to act as a scaffold under the skin, which then provides structure. The effects can last for 18 to 24 months, providing lasting rejuvenation and volume correction in the treated area. 

Strategic dermal filler placement can help balance your facial profile for a more rejuvenated or youthful look. Fillers can add fullness to the cheeks and cheekbone area and help flip the pyramid of age. They can also be injected into the chin to make the area more defined and emphasize the apex or the tip of the triangle of youth. 

Combining fillers with other aesthetic procedures

Since the aging process affects not just the skin, additional aesthetic treatments may be recommended. In the case of thinning or sagging skin, non-invasive skin lifting procedures like Ultherapy can be helpful. Ultherapy is US FDA-approved for lifting and tightening the skin on the face, brow, neck, and under the chin.

This non-invasive procedure can treat/improve general skin laxity, lift and tighten the jawline, as well as reduce lines and wrinkles on décolletage. It uses micro-focused ultrasound energy, which penetrates the skin’s deeper layers and triggers the production of new collagen. This then enables the skin to achieve a visible yet gentle lift over time.

One unique thing about Ultherapy is that it uses real-time visualization technology. This lets providers/aesthetic doctors see and evaluate skin structure and anatomy and deliver the energy to where it will be most beneficial. This also allows a hyper-personal lifting solution, involving the See, Plan, Treat, or SPT Protocol. 

You may be able to see initial improvements after two weeks, with significant  changes appearing over two to three months. The results can last for a year or two and can be done as an annual treatment. When paired with fillers, Ultherapy is usually done first, followed by the injectables after a few weeks. 

Read our previous post to learn more about this anti-aging and skin rejuvenation combination. 

Are you looking to improve signs of aging or restore the triangle of youth without surgery? Contact Cutis Medical Laser Clinics in Singapore today and schedule a consultation with our aesthetic doctor to find out how we can help.