Facial aging trajectories: A common shape pattern in male and female faces is disrupted after menopause

Objectives Despite variation in lifestyle and environment, first signs of human facial aging show between the ages of 20-30 years. It is a cumulative process of changes in the skin, soft tissue, and skeleton of the face. As quantifications of facial aging in living humans are still scarce, we set out to study age-related changes in three-dimensional facial shape using geometric morphometrics. Materials and methods We collected surface scans of 88 human faces (aged 26-90 years) from the coastal town Split (Croatia) and neighboring islands. Based on a geometric morphometric analysis of 585 measurement points (landmarks and semilandmarks), we modeled sex-specific trajectories of average facial aging. Results Age-related facial shape change was similar in both sexes until around age 50, at which time the female aging trajectory turned sharply. The overall magnitude of facial shape change (aging rate) was higher in women than men, especially in early postmenopause. Aging was generally associated with a flatter face, sagged soft tissue ("broken" jawline), deeper nasolabial folds, smaller visible areas of the eyes, thinner lips, and longer nose and ears. In postmenopausal women, facial aging was best predicted by the years since last menstruation and mainly attributable to bone resorption in the mandible. Discussion With high spatial and temporal resolution, we were able to extract a shared facial aging pattern in women and men, and its divergence after menopause. This fully quantitative three-dimensional analysis of human facial aging may not only find applications in forensic and ancient human facial reconstructions, but shall include lifestyle and endocrinological measures, and also reach out to studies of social perception.