The aging process affects various parts of the face, including the mouth and lips, leading to noticeable changes in appearance. These changes result from the interaction of multiple factors involving skin, muscles, fat, and bone.
1. Skin Changes and Lip Thinning
As we age, the skin around the mouth becomes thinner and loses elasticity. The lips tend to thin out and lose their fullness due to the loss of collagen and elastin fibers, which are crucial for maintaining skin firmness and elasticity. This leads to the formation of vertical lip lines, often referred to as “barcode lines” or “lipstick bleed lines,” which radiate from the vermilion border of the lips. These lines are particularly evident in smokers due to the repetitive pursing of the lips.
2. Muscle Changes
The orbicularis oris muscle, which encircles the mouth, undergoes significant changes with age. In youth, this muscle has well-defined bundles and fascicles surrounded by a thin layer of connective tissue. However, with age, the muscle thins and weakens while the connective tissue thickens. These changes cause the forward curve of the muscle to decrease, leading to a loss of structural support beneath the lips. As a result, the lips retrude, and the vermilion border lengthens and thins, diminishing the upper lip pout.
3. Bone Remodeling
The bones supporting the mouth and lips also undergo changes. The mandible (jawbone) shrinks and recedes with age, resulting in a reduction in the bony bulk of the mandible and dentoalveolar regression. This shift changes the structural foundation of the mandible from an L shape to a thinner and more slanted I shape. Additionally, maxillary retrusion causes a dramatic shift of the overlying soft tissue, contributing to changes in the mouth and lips’ appearance.
4. Fat Redistribution and Volume Loss
The fat pads around the mouth also experience changes. Atrophy and repositioning of the superficial and deep fat pads impact the signs of aging in the perioral area. For instance, the atrophy of suborbicularis fat diminishes the vermilion border, and atrophy of the deep fat pads of the lip causes lip retrusion and flattening. This loss of fat volume contributes to the development of perioral lines and folds.
5. Development of Perioral Lines and Folds
The loss of support from changes in the underlying structures of the perioral region creates skin laxity, contributing to the development of perioral lines and folds. Prominent signs of aging in the perioral area include drooping of the oral commissures and the formation of labiomandibular folds, also known as marionette lines. These features can make an individual appear sad due to the drooping of the oral commissures into the chasms created by chin zone volume loss. These changes are caused by the hyperactivity of the depressor anguli oris and platysma muscles, exacerbated by the loss of cheek support and inferior pull from jowl fat.
The aging process around the mouth and lips involves a combination of changes in the skin, muscles, fat, and bone. These changes lead to thinning lips, the formation of vertical lines, drooping of the oral commissures, and the development of marionette lines. Understanding these changes are important for doctor to design a treatment for your aging mouth.