The ageing process on the face is multifactorial and leads to damage to the dermis and epidermis; with decreased collagen, elastin, skin thickness, fatty layers, number of cells and extra cellular matrix. This, in turn, leads to changes in skin texture, firmness, radiance, volume, flexibility, and, ultimately, to the appearance of wrinkles.

But the ageing process is more than this — it is a complex interaction between varieties of facial elements, which occurs like a domino effect, and it happens in four main facial layers: skin, fat, muscles, and bones.

As the amount of fat in the face decreases with age, it causes a deflated effect, which leads to volume loss, and the hydrating and elastic functions of the skin no longer work as efficiently. The fibroblasts producing elastin, collagen and hyaluronic acid work better when they are under a degree of stretch. When the fat depletes, this stretch is decreased and the skin sags.

On the muscle front, it will be noted as part of the ageing process that some muscles get looser while other get tighter.

The bony facial skeleton changes — mainly the facial apertures. The nose and the eye sockets increase in size with age and the infra-orbital region physically moves backwards, so the holes are not only bigger but are also pushed back.
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