What causes facial ageing?

Here, Dr Cherie Wong, a registered cosmetic doctor, explains the 4 processes that contribute to facial ageing

What causes facial ageing?

When thinking about facial ageing, we often only focus on the skin. However, to truly understand what causes the visible signs of ageing, we need to go further than skin-deep.

The way I think about facial ageing is to divide the face into four main layers, each contributing to the process:



The skull is the structural base of the face, giving us definition and contour. However, as we age, our facial skeletons actually change shape. Our facial bones start to lose volume and recedes backwards, meaning changes to how our features will look. Our eye sockets widen and deepen, leading to hollowness. There is blunting of the angles of the brows, nose and upper jaw bones, meaning formation of frown lines and crow’s feet, hooded eyelids, disappearance of cheekbones and a drooping nose. The length and height of our lower jaw also decreases, leading to formation of a jowl and a less defined chin.


2. FAT

Body fat is often scorned and demonised, but you definitely want some baby fat in your face! When we’re young, we have distinct pockets of fat pads in the face that are evenly distributed to plump up the forehead, temples, cheeks, around the eyes and around the mouth.

Unfortunately, as we age, these fat pads not only reduce in volume, but also shift downwards, thanks to gravity. This causes hollowing of the upper face, whilst the lower face appears heavy with no definition. The overlying skin also becomes loose and sags, as there is no longer underlying fat to plump it up. The redistribution of fat pads also creates deep lines and folds, as the fat sags against our facial ligaments. This is mainly seen just under the eyes, at the nose-to-mouth lines and at the corners of the mouth.



Our facial muscles are important for speech, facial expressions and for chewing. Overly strong or hyperactive muscles will repeatedly tug and crease the overlying skin, creating forehead lines, frowns lines and crow’s feet around the eyes on facial expression. If the skin is not strong and elastic enough, resting lines and wrinkles will form.



Collagen is an important protein in the skin. It is the framework that holds the skin together, making the skin strong, thick, smooth and elastic. Collagen production is abundant in our youth, but by our mid-20’s, its production starts to slow down. By age 30, the amount of collagen in our skin decreases by 1-2% each year. In addition, many external factors also speed up the process of collagen loss, namely sun exposure, environmental pollution and oxidative stress, smoking, a high sugar diet and chronic inflammation. The loss of collagen makes our skin become weaker, thinner, looser and less elastic, therefore prone to wrinkles and sagging.

Growing older also slows down our metabolism, which delays natural skin renewal and repair. Old and dead skin cells build up on the surface of the skin, leading to dullness, sallowness and uneven skin tone.


If you’ve read up to here and are starting to feel depressed, don’t despair! There are many treatments nowadays, both preventative and curative, to tackle the signs of aging. Speaking to an aesthetic doctor may be a good first step to find out more.

If you are interested in a treatment from Dr Cherie, please visit her clinic website