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Aging of the Mandible and Its Aesthetic Implications

Shaw, Robert B. Jr M.D.; Katzel, Evan B. B.A.; Koltz, Peter F. M.D.; Kahn, David M. M.D.; Girotto, John A. M.D.; Langstein, Howard N. M.D.

Plastic and Reconstructive Surgery: January 2010 - Volume 125 - Issue 1 - p 332-342
doi: 10.1097/PRS.0b013e3181c2a685
Cosmetic: Original Articles

Background: Facial aging is a dynamic process involving the aging of soft-tissue and bony structures. In this study, the authors demonstrate how specific bony aspects of the mandible change with age in both genders and what impact these structural changes may have on overall facial aesthetics.

Methods: Facial bone three-dimensional computed tomographic scans were obtained from 120 Caucasian subjects (60 women and 60 men). Our study population consisted of 20 male and 20 female subjects in each of three age categories (20 to 40, 41 to 64, and ≥65 years). Edentulous patients were excluded. The following measurements were obtained: bigonial width, ramus breadth, ramus height, mandibular body height, mandibular body length, and mandibular angle. The data were analyzed with one-way analysis of variance and two-tailed t tests, with results considered significant at a value of p < 0.05.

Results: There was no significant change with regard to bigonial width or ramus breadth across age groups for either gender. Ramus height, mandibular body height, and mandibular body length decreased significantly with age for both genders, whereas the mandibular angle increased significantly for both genders with increasing age.

Conclusions: These results suggest that the bony elements of the mandible change significantly with age for both genders and that these changes, coupled with soft-tissue changes, lead to the appearance of the aged lower third of the face.

Rochester, N.Y.; and Stanford, Calif.

From the Division of Plastic and Reconstructive Surgery, Department of General Surgery, University of Rochester Medical Center, and the Division of Plastic and Reconstructive Surgery, Department of General Surgery, Stanford University Medical Center.

Received for publication May 27, 2009; accepted July 16, 2009.

Disclosure:None of the authors has a financial interest in any of the products or devices mentioned in this article.

Robert B. Shaw, Jr., M.D., Division of Plastic and Reconstructive Surgery, Department of General Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, P.O. Box 661, Rochester, N.Y. 14642

©2010American Society of Plastic Surgeons