The following article is a simple interpretation of the complex study done by respected plastic surgeon Claude Le Louarn.
All pictures used are property of Claude Le Louarn.
Sensational Truth About Aging
Oct. 6th 2020
Do not confuse structural aging with cutaneous aging because they’re not the same things. Although they both involve the aging of the face, they have different components to them. That is why different treatments are required for each one. 
When you see the term “cutaneous aging”, it basically refers to changes to the skin (or the outer coating). As we get older, we lose elasticity in our facial skin. The symptoms of reduced elasticity include creases, cracks, red blotches, discoloring and dilated pores in the facial skin. 

When you see the term “structural aging”, it refers to the deeper layers and components that are under the skin, such as the muscles, bones, and fat. Symptoms like bags or rings under the eyes, folds, cervical bands, and saggy facial tissue are signs of structural aging. 

There is a common belief that what makes structural aging particularly worse is gravity, which causes facial ptosis as you get older. Gravity pulls down on certain points of the face and causes furrows and fat to accumulate in it. Although, some experts suggest that gravity and fixed points on the face don’t always equal more structural aging
If you study the older and new photographs of a person’s face, then you can see that the theory of gravity causing structural aging doesn’t seem consistent each time. Let’s look at the observations that were made about this:

Upper Face

The eyebrows don’t always descend as someone gets older. Some people show signs of having higher eyebrows in their later years. How can that be if gravity is supposed to pull the eyebrows downward? 

Underneath the eyebrows, there is a hollowing or upper eyelid furrow that is supposed to be part of the upper tear trough. This hollowing causes the upper eyelid to look bony. If you look closely, the inner upper eyelid has an upward hollow effect. This should not happen under the gravity theory because that would require a cutaneous bulge inward rather than outward. 

The upper circum-orbital wrinkles do not have horizontal lines, but rather vertical lines across the eyebrows. When the person gets older, their lower eyelid goes upward instead of downward and ends up covering the lower portion of their eye’s iris. That is why so many older people’s eyes appear smaller than they did when they were younger. If the gravity theory were true, then the lower eyelid would drop downward rather than move upward.


The gravity theory suggests that the lower lip of a person will drop in the middle when they get older. However, most older people’s lower lips will curve into their mouth rather than move outward or drop. 


Like mentioned above, the gravity theory tells us that people have horizontal folds and lines on their cheeks when they get older. Instead, what we find are vertical lines with extra skin in between them. This would not be the case if the gravity theory was real.  


The second picture of a 60 year old presents a loss of volume between the chin and
the jowl (in yellow), should gravity theory apply the aspect would be quite different (in orange)
Do you notice how older people have a curved line that runs between their jowl and chin? This line is called a concavity. If you look at the fixed point of this area, it should have the same volume in the front and back of it, according to the gravity theory. But what you’ll find is less volume throughout this curved line.   


As time goes on, the right cervical band and left cervical band will become more noticeable on the front of the neck. Not only that, but a hollow area will form in between the two bands. If gravity affected the appearance, then excess skin should exist in between the two bands. But that is not what you see. 

Younger People and Structural Aging

When it comes to structural aging signs in younger people, they can actually show the same signs of structural aging as older people. All they have to do is contract the muscles in their face to mimic the same signs of structural aging. 
 Think about when a teenager pouts because they’re upset. Don’t you see jowl lines on their face, just like you would see on an older person? When someone is disgusted or enraged, it causes their nostrils to rise. This allows us to see the naso-labial fold more clearly. Front neck contraction will allow vertical cervical bands to be seen in younger people as well.   
Is it possible for someone to “fake” the effects of gravity? We know that a person’s facial muscles can be used to mimic the appearance of structural aging, but can they mimic the signs of gravity-based aging? No, it would not seem logical to assume that. Therefore, gravity must not be a factor in structural aging.  

The Effects of Aging

The hollow rings around the eyes can tell you a lot about the effects of aging. How could gravity ever cause the skin tissue in this area to go deeper into the bone? Shouldn’t it droop down and cause vertical sagginess? The same applies to the mouth too. Why are there curvy lines and creases between the jowls and chin? That should not be there if gravity influences the symptoms of older age. 
Repeated muscular contraction in the face seems to play a big part in these symptoms. When a person spends many years making different facial expressions, whether consciously or unconsciously, it causes the fat tissues between their facial bones and muscles to trend upwards rather than downwards. Once the bags form under the eyes, the hollow ring appears everywhere else because the eye muscle contraction puts pressure on the orbital bone.
Deep fat on a young subject (left) and on an older subject (right)
There is no doubt that younger people and older people have different facial structures. For instance, younger people have lots of fatty tissue that surround their muscles. That is why the lines and creases on their face will go away after they’re done contracting their facial muscles. 

Unfortunately, older people have far less deep fatty tissues in comparison to younger people. Instead, older people are stuck with superficial fat near the surface of the skin. As their facial expressions continue to be made each day, their superficial fat causes more marks, creases and deep furrows to form on the face. Then you have volumes of excess skin develop in regions of the face where it is unwanted.

Now you can see why so many older people choose to get cosmetic facial treatments, such as Botox injections. These injections basically replace the deeper fatty tissues that diminish in older people. By getting some of these injections, their muscle contractions won’t cause anyone to see the lines and creases on their face anymore. 

Some experts believe that facial muscles become more relaxed as people get older, and that aging causes a retraction in the muscles. Could this be true when Botox works so well to smooth out wrinkles around the eyes and relax the facial muscles? That might be true if you believe the gravity theory, but contradictory evidence suggests otherwise.

The Effects of Aging

The muscles responsible for our facial expressions are found deep within the skin next to the bone. Younger people have curved facial muscles when they’re resting because of all the deep fatty tissues in them. This creates the appearance of smooth skin on the outside. After their facial muscles are contracted, the fatty tissues allow the skin to go back to its original position. That is why the lines are not permanent on the face. 
MRI realized by Dr Didier BUTHIAU, Institut de Radiologie de Paris
Some people assume that facial muscles become more relaxed as they get older. But if that were the case, then wouldn’t the facial muscles stop contracting so much? The opposite is actually true because older people experience an increase in facial muscle contractions. So, instead of their facial muscles being more relaxed, they become more tense.   

Tense facial muscles cause more contractions, which then causes more lines and creases on the face. The Botox injections are only a temporary remedy for the tense muscles because they stop the contractions from taking place. Unfortunately, this is not a long-term treatment that anyone should use. There are other side effects to using Botox that should be considered.

To Conclude

Therefore, your goal should be to relax your facial muscles in more natural ways as you get older. Facial exercises and massage techniques are a great way to combat structural aging of the face and retain a more natural-looking appearance. You won’t have to get any unnatural injections and you can enjoy long-term results at the same time. 

And, as you just learned, relaxed facial muscles are how you reduce repeated involuntary facial muscle contractions over the course of the day.

About Claude Le Louarn:

"It is my priority to respect the patient himself since he has entrusted me his unique body for a wellbeing oriented procedure thus consequently in a certain way his spirit" 
  • 1 – LE LOUARN C. : Emploi de l’acide hyaluronique selon le concept du Face Recurve® : vacuum technique et interpores technique
  • Use the hyaluronic acid according to the concept Face Recurve®: vacuum technical and interpores technical
  • Ann Chir Plast Esthet. 2007 Oct 17;

  • 2 – LE LOUARN C : Toxine botulique et Face Recurve® : action sur le tonus de repos et la régénération musculaire
  • Botulinum toxin and the Face Recurve® concept: decreasing resting tone and muscular regeneration
  • Ann Chir Plast Esthet. 2007 Jun ; 52(3):165-76.

  • 3 – LE LOUARN C, BUTHIAU D, BUIS J. : Structural aging: the Facial Recurve concept
  • Aesthetic Plast Surg. 2007 May-Jun ; 31(3):213-8

  • 4 – LE LOUARN C, BUTHIAU D, BUIS J. : The Face Recurve concept: medical and surgical applications
  • Aesthetic Plast Surg. 2007 May-Jun;31(3):219-31; discussion 232.

  • 5 – LITTLE J.W. : Structural aging: the facial recurve concept
  • Aesthetic Plast Surg. 2007 Nov-Dec ; 31(6):754-6.

  • 6 – LE LOUARN C, BUTHIAU D, BUIS J. : Rajeunissement facial et lifting malaire concentrique : le concept du FACE RECURVE®
  • Facial rejuvenation and concentric malar lift: the FACE RECURVE concept
  • Ann Chir Plast Esthet. 2006 Apr ; 51(2):99-121.

  • 7 – LE LOUARN C, BUTHIAU D, BUIS J. : Treatment of depressor anguli oris weakening with the face recurve concept
  • Aesthetic Surgery Journal, Volume 26, Issue 5, Pages 603-611C.

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