The natural aging process can take a toll on every part of the body, including the skin. From forehead wrinkles to under-eye hollows, aging skin on the face is a common concern for many people. Kofi Boahene, M.D., director of facial plastic and reconstructive surgery at Johns Hopkins Medicine, explains how your skin ages and which facial rejuvenation procedures might be right for you. What are the signs of an aging face? Every person’s face ages differently, but there are telltale signs that facial skin is losing some of its firmness and elasticity. “A youthful face has certain characteristics,” explains Boahene, “including a defined neck and jawline, firm skin, high brows, short eyelids and an egg-like shape.” Aging usually starts in the eyelids and around the eyes. The skin around the eyes is the thinnest in the face. As you age, you may notice dark circles and under-eye hollows, resulting in eyes that look sunken. Some people also develop puffiness beneath the eyes, drooping or excess eyelid skin or fine wrinkles at the corners of the eyes (crow’s feet). The fat in the face also starts to move downward, especially in the cheeks, says Boahene. The skin might look droopy around the nose, cheeks and jawline. Many people develop wrinkles, lines and folds, including deep frown lines above or around their lips. Then, fat around the jaw and neck move down and people get “jowls.” Other common signs of an aging face include: Changes in the contour of the face (lower part becomes wider, face becomes squarer) Dull skin texture Larger pores Less definition Pigment changes (skin discoloration) How does the skin age? The skin has three layers: the epidermis, dermis and hypodermis. Most age-related skin changes involve the dermis, which is the middle layer of skin. The dermis contains a lot of the substances that keep skin firm and smooth, such as collagen, elastin and hyaluronic acid. Around age 35, we start to lose these substances and the skin becomes lax. There’s also a layer of fat under the skin called subcutaneous fat, which gives your face volume and definition. As the skin loses collagen, elastin and other substances that keep it firm, the fat pads around the eyelids, cheeks, temples and chin shift downward. As a result, the face loses its contours and it wrinkles, and lines and loose skin start to develop. Are there ways to improve the appearance of an aging face? You can improve the look of an aging face in a variety of ways, both nonsurgically and surgically. Some of the most common goals for facial rejuvenation include: Restore volume and face contour Reduce the appearance of under-eye wrinkles and hollows Correct forehead wrinkles and sagging brows Tighten sagging skin around the neck and jaw Correct pigmentary changes