The face ages in a broadly predictable regional sequence, though the specific timeline varies significantly between individuals. In general, the periorbital area and forehead tend to show the earliest visible changes, driven by thin skin and repetitive muscle movement. The temples often hollow before patients notice changes elsewhere. The midface follows, with fat pad redistribution and descent becoming apparent from the late thirties to mid forties in many patients. The lower face and jawline typically change later, and the perioral area follows its own trajectory based on muscle activity and individual anatomy. This page was prepared by Corey Anderson, Registered Nurse (AHPRA NMW0001047575) at Core Aesthetics, Oakleigh, Melbourne. Results vary between individuals; a consultation is required to assess your specific stage of change.
Why the Face Does Not Age Uniformly
A common assumption is that the face ages like a uniform surface, gradually accumulating lines and losing volume across all areas simultaneously. In clinical practice, this is not how facial ageing proceeds. Different regions of the face are made up of different tissue types, different fat compartment distributions, different bone structures, different degrees of muscle activity, and different skin thicknesses. Each of these variables produces a different rate and pattern of change over time.
The result is that facial ageing is a regional process. Some areas change in the late twenties or early thirties. Others remain relatively unchanged until the mid forties or beyond. And because the regions are anatomically connected, changes in one area often affect the appearance of adjacent areas, even when those adjacent areas have not undergone direct change themselves.
Understanding this regional sequence has practical value. It helps patients make sense of what they are noticing at different life stages. It explains why two people of identical age can look very different. And it informs the clinical approach to assessment, because identifying which regions are primarily driving a concern is essential before any treatment decision is made.
The following is a clinical overview of the typical regional sequence, presented as a general pattern. Individual timelines vary considerably. Genetics, sun exposure history, lifestyle factors, hormonal changes, and prior treatment history all influence when and how prominently each region changes. The ages referenced throughout are approximations based on general clinical observation, not diagnostic thresholds.
The Periorbital Area: Why the Eyes Show Change Early
The area around the eyes is, for most patients, where visible ageing becomes apparent first. Several factors converge to make this the earliest changing region of the face.
The skin around the eyes is the thinnest on the face, averaging around 0.5mm compared to 2mm elsewhere. This thinness means structural changes beneath the skin become visible sooner than in other areas. Fine lines from facial expression, squinting, smiling, concentrating, begin to be visible at rest in this area earlier than anywhere else, typically appearing as static lines at the outer corners of the eyes (crow’s feet) for many patients in their late twenties to early thirties.
Below the eyes, the tear trough develops as orbital fat redistribution and bony orbital remodelling begin to create a hollow or shadow in the groove where the lower eyelid meets the upper cheek. For some patients this begins in the early thirties. For others it becomes noticeable in the late thirties or forties. The onset is influenced by genetics, body composition changes, and whether there is an underlying bony contour that creates predisposition to hollowing.
The brow also descends over time, a gradual process related to changes in the supporting structures of the forehead and the accumulated effect of repeated muscle movement. Brow descent alters the shape and opening of the eye and changes the balance of the upper third of the face. It is often noticed as a heaviness over the outer corners of the eyes or a sense that the eyes look less open than they used to.
Because the periorbital area is visually prominent and emotionally significant, it is the primary focus in face to face communication, changes here are often noticed and felt before changes elsewhere, even when the degree of structural change is modest.
The Forehead and Glabella: Expression Lines Over Decades
The forehead and glabella (the area between the brows) are subject to decades of repetitive muscle movement. The frontalis muscle, responsible for raising the eyebrows, creates horizontal forehead lines. The corrugator and procerus muscles, responsible for frowning and squinting, create the vertical lines between the brows commonly referred to as frown lines or the eleven lines.
Dynamic lines, those that appear during expression and fade at rest, are typically noticeable in this region from the mid twenties onward. The transition from dynamic to static lines (present at rest, independent of expression) occurs at different ages in different patients, but is commonly seen in the thirties and forties. Sun exposure, skin type, and the habitual strength and frequency of the underlying muscle movement all influence the rate of this transition.
The forehead is often one of the first areas patients enquire about in terms of anti-wrinkle assessment, because the lines here are both early appearing and visually prominent. An assessment of this area involves evaluating which lines are dynamic (movement driven) and which are static (already present at rest), as this distinction influences the clinical approach. Static lines at rest require a different and more cautious assessment than purely dynamic lines.
Forehead volume and contour also change over time, with gradual resorption of the frontal bone and changes in the superficial fat affecting the overall shape and contour of the forehead. For most patients these changes are subtle relative to the dynamic lines, but they are clinically relevant in comprehensive facial assessment.
The Temples: An Often-Unnoticed Early Change
Temporal hollowing, a concavity at the sides of the forehead, above and behind the outer corners of the eyes, is one of the earlier structural changes to occur in the face, and one of the least recognised by patients until it is pointed out or becomes pronounced.
The temporal fat pads atrophy relatively early in facial ageing, typically beginning to thin in the mid thirties to forties for many patients. As these fat pads reduce in volume, the temporal fossa becomes visibly concave. The visual effect is a narrowing of the upper face, a change in the proportional relationship between the width of the forehead and the cheeks, and a sense that the side of the face looks hollow or skeletonised.
Temporal changes are significant out of proportion to their apparent subtlety because they alter the overall proportional balance of the face. A face with significant temporal hollowing can look structurally different even when the central face appears relatively unchanged, because the framing of the face has shifted. Patients often describe this as looking gaunt, or noticing that their face looks different in photographs without being able to identify exactly why.
In clinical assessment, the temples are evaluated as part of a full upper face assessment. Because of the proximity of neurovascular structures in this region, treatment consideration for temporal hollowing requires specific anatomical knowledge and clinical experience.
The Midface: When Volume and Structural Support Shift
The midface, the area from the lower eyelids to approximately the mouth corners, encompassing the cheeks, the nasolabial folds, and the orbital rim area, typically becomes a more prominent area of concern from the late thirties onward, though individual variation is considerable.
The midface contains several discrete fat compartments, including the malar fat pad (the central cheek volume) and the suborbicularis oculi fat (SOOF), each of which has its own timeline of redistribution and descent. As these compartments lose volume and descend, several visual changes occur simultaneously: the cheeks flatten, the area beneath the eyes appears more hollow or shadowed, and the nasolabial folds (the lines from the nose to the corners of the mouth) deepen. These changes are interconnected, midface fat descent is a primary driver of both the tear trough hollowing already described and the nasolabial fold deepening that patients frequently notice in the forties.
This interconnection is clinically important because it means that addressing the nasolabial fold directly may not address the primary structural change driving it. An assessment that evaluates the entire midface region, not just the individual fold, is more likely to identify the actual driver of the concern and inform an appropriate treatment approach.
Midface bone changes also contribute. The zygomatic arch and infraorbital rim lose some projection over time, reducing the structural support for the overlying soft tissue. This bony resorption is gradual and cumulative, and its contribution varies between individuals.
The Lower Face and Jawline: A Later but Cumulative Change
For most patients, significant lower face changes become apparent somewhat later than the periorbital and midface changes described above, typically from the mid forties onward, though again with considerable individual variation. The lower face is subject to the combined effect of mandibular (jawbone) resorption, retaining ligament laxity, and the cumulative descent of fat compartments from the midface.
As the retaining ligaments weaken over time, soft tissue that was previously held in position begins to descend. The result is the jowl, a softening of the jawline contour at its corners where soft tissue accumulates as it descends from above. Jowling changes the silhouette of the lower face when viewed from the front and in profile, and is one of the most commonly described lower face concerns in patients from their late forties onward.
The marionette lines, the creases that run from the corners of the mouth downward toward the chin, develop through a combination of ligament laxity, descent from above, and changes in the depressor anguli oris muscle. Their depth and prominence vary significantly between individuals. The chin region also changes, with mandibular resorption reducing chin projection and altering the relationship between the lower lip, chin, and neck in profile.
Lower face changes are closely connected to midface changes. Treatment planning for the lower face typically requires assessment of the midface as well, because the apparent severity of lower face changes is partly a consequence of what has occurred in the region above.
The Perioral Area: Lips and the Surrounding Anatomy
The lips and the skin immediately surrounding the mouth follow a trajectory that is partly driven by the same structural changes affecting the rest of the face, and partly driven by the specific muscle activity of the perioral region. The orbicularis oris muscle, which encircles the mouth, is active in a wide range of expressions and oral functions, and decades of this activity contribute to the development of vertical perioral lines.
Lip volume changes over time as lip tissue thins and the vermillion border (the defined margin of the lip) becomes less distinct. The upper lip in particular tends to flatten and lose height with age. The corners of the mouth may descend due to the combined effect of depressor muscle activity and the lower face structural changes described above.
The timeline for perioral changes varies considerably. Vertical lip lines are more prominent in patients with a history of significant sun exposure, smoking, or habitual pursing. Lip thinning can begin to be noticeable in the thirties for some patients, or may not become a concern until the fifties for others. The relationship between lip proportion and surrounding facial structure means that perioral assessment is best conducted in the context of a full facial evaluation rather than in isolation.
The Neck: A Connected But Separate System
The neck ages through a combination of skin laxity, platysmal band development, and changes in the submental (under chin) area related to fat distribution and structural changes in the lower face. These changes are anatomically connected to the lower face, the neck and jawline form a single visual unit, but follow their own timeline and involve structures outside the usual scope of facial injectable assessment.
Platysmal bands, the vertical cords that can appear down the front of the neck during muscle contraction, are driven by the platysma muscle. They become more visible as skin laxity increases and the muscle becomes more prominent. Skin laxity in the neck is influenced by sun exposure, genetics, and body composition changes.
For the purposes of clinical assessment at Core Aesthetics, the neck is noted in the context of lower face assessment because its appearance directly affects the overall visual balance of the lower face. Comprehensive assessment considers how the jawline and neck relate to each other, as this relationship influences the approach to any lower face treatment consideration.
Why Individual Timelines Vary So Widely
The regional sequence described above represents a general clinical pattern, not a universal timeline. The rate at which any individual moves through these stages is influenced by a range of factors, some fixed and some modifiable.
Genetics is the single most influential factor. Patients whose parents showed early midface descent or prominent temporal hollowing are more likely to follow a similar pattern. Skin thickness, fat compartment distribution, and bone structure are all substantially heritable.
Cumulative UV exposure accelerates changes in skin quality, collagen density, and skin laxity across all regions. Patients with significant lifetime sun exposure typically show earlier and more prominent skin changes than those with lower exposure histories, independent of structural changes.
Body composition influences fat compartment distribution. Significant weight changes, particularly repeated cycles of weight gain and loss, can alter the timeline and pattern of facial fat redistribution. Lower body fat can accelerate temporal hollowing and midface deflation. Higher body fat can obscure structural changes in the lower face that become more prominent if body weight reduces.
Hormonal changes, particularly those associated with menopause, can accelerate skin collagen loss and contribute to changes in fat distribution that affect facial appearance. Some patients describe a perceptible change in the rate of facial ageing around the perimenopausal period.
Lifestyle factors including smoking, sleep patterns, diet, and exercise all contribute to the rate and pattern of change, though their individual effects are difficult to quantify precisely.
Understanding these variables helps explain why chronological age is only one of many inputs into clinical assessment. A 38-year old with significant cumulative sun exposure and a family history of early midface descent may present with changes typically associated with a later stage. A 52-year old with good sun protection habits and strong genetic facial structure may present with a much earlier stage picture.
How Knowing the Sequence Helps at a Consultation
Understanding the regional sequence of facial ageing is not just anatomical knowledge, it has direct practical value for patients approaching a consultation for the first time.
First, it helps patients contextualise what they are noticing. A patient in their early forties who notices midface flattening and deepening nasolabial folds is seeing a change that is anatomically expected at that life stage, driven by identifiable mechanisms. Understanding this means they can arrive at a consultation with a more grounded description of their concern and more realistic expectations about what assessment might find.
Second, it helps patients understand why changes in one area may be connected to changes elsewhere. A patient concerned specifically about the nasolabial fold, for example, may learn during assessment that the fold is partly driven by midface fat descent rather than by local volume loss, and that the assessment needs to consider the whole midface region to make a useful recommendation. Knowing that the face ages regionally and that regions are interconnected prepares patients for this kind of assessment.
Third, it helps patients think about timing. Patients sometimes defer consultation because they feel changes are too early stage to warrant attention, or because they are uncertain whether what they are noticing is clinically meaningful. Understanding that the periorbital area and temples often show changes in the thirties, while midface and lower face changes are more typical of the forties and beyond, gives patients a frame of reference for deciding when a consultation is appropriate. The answer is not always now, and a practitioner doing their job well will say so clearly if the timing is early or if nothing actionable is identified.
A consultation at Core Aesthetics begins with a full facial assessment that evaluates all regions in the context of the whole face. Corey Anderson, Registered Nurse (AHPRA NMW0001047575), has been in clinical practice since January 1996 and conducts every assessment personally. The goal of the consultation is not to identify treatment for everything that has changed, but to understand what is changing, why, whether any change warrants treatment consideration, and, if so, what that treatment would involve and what it would not address.
For patients who want to understand more about the anatomical mechanisms behind these regional changes, the guide to how facial anatomy changes with age covers the five structural systems in more depth. Patients uncertain about whether filler specifically is appropriate for their concern may find the ageing versus anatomy guide useful before booking a consultation.
About This Information
The information on this page is provided for general educational purposes. It is not a substitute for clinical advice and does not constitute a recommendation that any particular treatment is appropriate for any individual. Facial ageing varies considerably between individuals. The regional sequence described here reflects general clinical observation and is intended as an orientation guide, not a diagnostic framework.
At Core Aesthetics, Corey Anderson, Registered Nurse, assesses every patient individually. The consultation is the point at which your specific anatomy, medical history, current stage of change, and treatment goals are evaluated together. No treatment is offered at a first appointment. This page is a starting point for understanding the process, not a substitute for the assessment itself. If you have questions about any of the content here or about whether a consultation would be appropriate for your situation, you are welcome to contact the clinic directly.
This page provides general clinical information about the regional sequence of facial ageing. It is intended for adults aged 18 and over who are considering cosmetic injectable treatment or who want to understand facial ageing before deciding whether to book a consultation. All treatment decisions at Core Aesthetics follow individual assessment; no treatment is offered at a first appointment. Results vary between individuals.
Clinical accountability and how this page is reviewed
The clinical content on this page is written and reviewed by Corey Anderson, AHPRA registered nurse (NMW0001047575). Core Aesthetics operates as a one practitioner, consultation based, low volume clinic in Oakleigh, Melbourne. The regional ageing sequence described here reflects clinical observation and is consistent with the published literature on facial anatomy and ageing. Individual timelines vary considerably, and this page describes a general pattern rather than a diagnostic schedule.
Patients who want to verify Corey Anderson’s AHPRA registration can do so on the AHPRA public register at ahpra.gov.au using registration number NMW0001047575. The clinic operates from 12A Atherton Road, Oakleigh VIC 3166 by consultation appointment. Results vary between individuals, and the consultation is the appropriate place to discuss what the individual stage and pattern of change means for a specific person’s situation.
Is this for you?
Consider booking a consultation if
- Adults aged 18 and over who want to understand the clinical picture of facial ageing before considering any treatment
- Patients who have noticed changes in their face and want a framework for understanding which region is changing and why
- Patients preparing for a first consultation who want to arrive with a clearer understanding of what the assessment will involve
- Patients who are uncertain whether their stage of change warrants a consultation
This may not be for you if
- This is an educational page and does not replace a clinical consultation
- Patients under 18, cosmetic injectable assessment is not available
- Patients who are pregnant or breastfeeding
- Patients with an active skin infection or condition in the area of concern
Suitability is confirmed at consultation. This list is general guidance, not a substitute for clinical assessment.
Frequently asked questions
Which part of the face shows the first signs of ageing?
For most patients, the periorbital area, the skin around the eyes, shows the earliest visible changes, driven by the thinness of the skin in this region and the constant movement of the surrounding muscles. Crow’s feet and early tear trough changes are typically the first concerns patients notice. The forehead and glabella also show early dynamic lines due to repetitive expression. Individual variation is significant; genetics, sun exposure, and lifestyle all influence the regional timeline.
At what age does the midface typically start to change?
Midface changes, including cheek flattening, deepening of the nasolabial folds, and changes in the under-eye area, typically become noticeable from the late thirties to mid forties for many patients. This is a general pattern; some patients notice midface changes earlier, particularly those with certain genetic predispositions or significant lifetime sun exposure. A clinical assessment is required to evaluate the current stage of change for a specific individual.
Why do my nasolabial folds look deeper even though my cheeks don’t look hollow?
The nasolabial folds can deepen as a consequence of fat pad descent in the midface, even before obvious cheek hollowing is apparent. The descending tissue pushes the soft tissue lateral to the fold downward, accentuating its depth. This is why the fold is not always best addressed directly, the structural driver may be in the midface above it. A full facial assessment identifies whether the fold is primarily local or whether it is being driven by changes in the region above.
Why do temples hollow early?
The temporal fat pads are among the earlier fat compartments to atrophy in facial ageing. As they reduce in volume, the temporal fossa (the concavity at the side of the forehead) becomes more visible. This change alters the proportional balance of the upper face, making it appear narrower. It is often noticed in the mid thirties to forties and is one of the changes patients describe when they say their face looks ‘gaunt’ or different in photographs without being able to identify exactly why.
I’m in my early thirties. Is it too soon to have a consultation?
Not necessarily. The periorbital and forehead regions can show clinically relevant changes from the late twenties onward, and a consultation provides an assessment of your current stage of change, which may or may not indicate that any treatment is appropriate at this time. A ‘not yet’ or ‘nothing indicated’ recommendation from a consultation is a useful outcome; it gives you a clinical baseline and an understanding of what to watch for. Under AHPRA September 2025 guidelines, a consultation must precede any treatment in any case.
Are there things that speed up facial ageing?
Yes. Cumulative UV exposure is the most significant modifiable factor, it accelerates skin collagen loss, skin laxity, and surface changes across all regions. Smoking also accelerates perioral and skin changes. Significant body composition changes can affect facial fat distribution. Genetics, hormonal changes (particularly perimenopausal), and sleep related factors also influence the rate and pattern of change. Most of these factors interact with each other and with individual anatomy, which is why the rate of visible change varies so widely between people of the same age.
Can knowing which areas age first help me decide what treatment I need?
It can help you understand what you are seeing and ask better questions at a consultation. But it does not replace the assessment itself. Knowing that midface changes typically precede lower face changes, for example, helps explain why a concern you are noticing in the lower face may have its primary driver in the midface region. The clinical assessment maps the specific changes present in your face, their drivers, and whether any treatment is appropriate, and if so, what that treatment would involve.
How is suitability for treatment determined?
Suitability is determined through individual consultation with Corey Anderson, Registered Nurse. The assessment reviews your facial anatomy at rest and in movement, your medical and treatment history, the stage and pattern of change present, and your treatment goals. No treatment is offered at a first appointment, and the recommendation may be that treatment is not indicated at this time. Results vary between individuals.