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Why is My Face Changing Shape?

illustration of women's face profiles in shades of pink, mauve, tan and black

If you hardly recognize yourself these days, there’s a reason for that. It’s called midlife. Here, what’s growing, shifting and shrinking. And also, solutions.

With everything else going rogue these days, it would be nice if at least our face stayed in place.

You reach a certain age, and yeah, you expect some things. Wrinkling around the eyes? Sure. Forehead creases? Not surprised. But a different face shape with “new” features, some bigger, some smaller, others wonkier? This was not likely included on the mental tally of midlife issues.

With everything else going rogue these days, it would be nice if at least our face stayed in place. And yet, doctors confirm that indeed, such shifts do happen as the years climb. It’s called facial morphology.

“Often, we think of aging just as what we can see on the outside, like skin texture and tone. However, there are significant changes occurring much deeper, in the bone, fat, muscle and skin layers,” says Dr. Camille Cash, MD, a board-certified plastic surgeon in Houston, Texas. And these internal mutations translate to an altered overall look.

Statue of a woman's head and shoulders with a glitch effect on a black background

What Face Changes Should I Expect During Menopause?

Brace yourself. But note that this is a dramatic list of what can happen, not what will happen. Everyone evolves differently. At the same time, showing the hallmarks of a life fully lived is a point of pride, and not necessarily something that needs fixing. The beauty is that you have choices. That said, here goes:

A sunken appearance:

Less estrogen, due to perimenopause, causes a decrease in collagen production, the spongy scaffolding that holds skin in place and keeps it plump and firm.

“As you age, facial fat pads also shrink or atrophy, further compromising the structure that supports the overlying skin,” explains Dr. David Shafer, MD, a double board-certified plastic surgeon in New York City. Overall, you lose about a teaspoon of fat in your face each year, starting around age 30. And what does remain will drift downwards, because, gravity.

“The heavier tissue in the bottom of your face accentuates the nasolabial folds, those lines between your lips and nostrils,’ continues Dr. Shafer. Basically, the look is the facial equivalent of melted wax.

A bigger forehead:

That same lack of support can cause the forehead tissue to droop, giving you a heavy brow—hooded eye effect. Combine that with a retreating hairline due to age-related thinning strands, and you get the picture.

Hollowed eye sockets:

Along with disappearing fat, we’re also losing bone, another consequence of dwindling hormones. “As a result, the eye socket, or orbital bone, becomes wider and thinner, allowing the soft tissue in the area to sink inward,” says Dr. Cash

Thinner lips:

“As our jawbones lose density, coupled with receding gums, and even dental shifts, the skeletal integrity of the lower face weakens,” says Dr. Cash. Your moustache area elongates, so your lips appear thinner. Their volume also disappears as hydration levels naturally diminish. “Think grapes turning into raisins,” says Dr. Shafer. A longer nose: “It’s not actually growing,” says Dr. Shafer. “It’s just not supported the way it once was. Weaker underlying bone and cartilage causes the tip to fall and look elongated.”

Does Skin Type and Tone Have An Effect?

All faces are prone to change with age, but skin color can affect the pace at which these shifts happen. “Black people are not only born with denser bones in our faces, those bones don’t break down as quickly as our Caucasian counterparts,” says Dr. Cash. “The same goes for volume loss, but it does happen, slowly. The old adage, ‘black don’t crack,’ is somewhat true when it comes to fine lines, but it’s also true that black skin can sag.” She explains: Black, brown and Asian skin also has greater protection from increased melanin levels, so all shades better cope with damage caused by UV exposure, and collagen doesn’t break down as quickly as it does in white skin.

How Can Women Maintain Their Face Shape During Perimenopause?

Anything we can do to maintain our face fitness? There’s plenty, say Dr. Shafer and Dr. Cash. Both impress that lifestyle is the driving force in skin and bone longevity:

  • Eat a nutritious diet of whole foods high in antioxidants from vegetables and fruit, protein, and good fat. Lean into supplements with added beauty benefits to ensure you're easily getting the nutrition you need.

  • Exercise most days, in whatever form you prefer.

  • Adopt practices like meditation or journaling to manage your stress.

  • Don’t smoke.

  • Be vigilant about protecting skin from UV rays.

These habits go a long way to stave off DNA damage that breaks down collagen and elastin.

“Erosion of those vital proteins causes the connective tissue that holds structures such as fat pads in place to lose integrity,” says Dr. Cash.

Topical products help too. Over-the-counter retinols or prescription-strength retinoids help maintain and stimulate the production of collagen and elastin. Dr. Dennis Gross Advanced Retinol + Ferulic Intense Wrinkle Cream and Obagi Retinol 1.0 are two great options with retinol.

At the same time, it’s vital to protect your skin barrier to retain moisture and restore bounce. Phenology’s Daily Glow Facial Cream is scientifically formulated to do both, in addition to combating stress-induced collagen loss by literally blocking the formation of cortisol.

Related: How To Get Glowing Skin

Skin-firming laser treatments, like Thermage, (which uses radiofrequency) and Ultherapy (via ultrasound), prompt more dramatic collagen production to lift and tone. They are effective, but everyone’s response is different, and Dr. Cash reminds us to keep expectations in check for all strategies: “treatments should be viewed as maintenance, not a complete reversal of the aging process.” And be patient—improvement typically takes three to six months, and may require a series. Prices vary, but none are cheap. Which is all the more reason to protect your investment with consistent healthy habits.

Dermal fillers, like Juvederm and Restylane, placed strategically are another way to temporarily increase volume in the face, and make it look less saggy. A doctor will typically inject the viscous substance in the cheek and temple area to boost fullness, while simultaneously lifting up loose skin around the jawline. For an added benefit, fillers also trigger the skin’s own collagen production. Depending on the type used, results can last six months to two years.

Does Consuming Collagen Help With Perimenopause Skin and Face Changes?

Powders, gummies and supplements are populating the market as the importance of this hero substance has come to light. And while more research needs to be done to make a clear conclusion, experts agree they do show promise.

“Ingesting collagen does not translate directly to new collagen in the skin, but it does provide the building blocks for collagen production which may lead to stronger and tighter skin,” says Dr. Shafer. To try, look for hydrolyzed collagen (broken down small enough to absorb) or peptides. A great source: Ancient Nutrition Collagen Peptides Proteins

Isabel Burton
Isabel Burton is an award-winning writer, editor and content strategist. She’s held senior editorial positions at Shape, Self, and Cosmopolitan, among other titles. Her work has appeared in a slew of national media brands covering all things lifestyle: Beauty, wellness, home décor, food, drink, love, lust, travel and more.

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