[Doctor's Column] Facial Changes After 40: Is It Really Age? A Doctor Explains the Real Reason

Are facial changes after 40 really our responsibility?

“Once you’re over 40, you’re responsible for your face.” You've probably heard the saying, "The face is a living organism." It may sound a bit harsh, but from a medical perspective, this phrase isn't just a saying; it accurately captures the biological changes that actually occur in our faces. From a medical perspective, From this age onwards, the changes that occur in our face go beyond simple ‘natural aging’. no see.

The bones that form the foundation of the face also continue to change.

Many people believe that once bones are formed, they remain that way, but clinical studies show that Adults' bones are replaced by about 5-10% each year. This process is repeated in a balanced manner between 'bone-absorbing cells' and 'newly forming cells.' The important point is that The fact that the shape of a bone is influenced by the way the surrounding muscles are used . Especially Areas that are repeatedly subjected to strong force, such as the chewing muscles or jaw muscles, can cause changes in the shape of the jawline and cheekbones. may lead to.

Repeated expression wrinkles eventually become permanent wrinkles. ❙ Source: Clipart Korea

How facial expressions affect the face

According to a long-term follow-up study, The tendency for the wrinkles that appear repeatedly when smiling or frowning to turn into fixed wrinkles over time This has been clearly observed. In other words, the expression lines that appear in front of the mirror now can be seen as a 'preview' of the wrinkles that will appear in the future. As we age, our skin loses elasticity, making these repeated folds more easily harden into wrinkles. So After the age of 40, wrinkles appear much faster even with the same facial expression habits. no see.

Botox: Beyond Simple Cosmetics, It's About "Controlling the Speed of Change."

Botox is not simply a procedure to smooth out wrinkles, but a treatment that temporarily controls excessive muscle contraction. It is close to. According to research, After the procedure, the thickness of the jaw muscles and the volume of the lower face are reduced for approximately 3 to 6 months. However, excessive dosage or frequent repetition can lead to decreased chewing power or muscle atrophy. ▲It is important to accurately design the capacity, area, and spacing. do.

Facial expressions influence emotions

Facial expressions affect not only the shape of the face but also the emotional state. There are also research results showing that even intentional smiling tends to slightly improve subjective mood and sense of stability. While this effect is not significant, if repeated daily facial expression habits accumulate over the long term, it can make a significant difference. A face is not just a reflection of appearance, but also a reflection of a person's ▲expression ▲emotions ▲habits. It can be said that.

Conclusion: After age 40, your options for management open up.

Here are some medical facts:

① Bones are newly created every day and their shape changes depending on the strength of the muscles.

② Repeated facial expressions determine future wrinkles.

③ Facial expressions affect emotions.

thus "Taking responsibility for your face" means understanding these scientific changes and guiding them in the desired direction with appropriate management. This means that Botox is not simply a cosmetic procedure, but can be viewed as a preventive medical approach that regulates biological changes.

👉 A closing line from an expert

Your face after 40 isn't a fateful outcome. Rather, it can be significantly transformed by understanding and managing the changes in your bones, muscles, and skin. The key isn't "how much" you do, but "how you approach it."

※ This article provides general information about facial changes after age 40. It does not recommend any specific procedures or guarantee their effectiveness, and is not a substitute for consultation with a specialist.

**References**

1. **Bone Remodeling**: Kenkre, JS & Bassett, JH "The Bone Remodeling Cycle" *Annals of Clinical Biochemistry* 55:308-327 (2018). DOI: 10.1177/0004563218759371; StatPearls "Physiology, Bone Remodeling" (2024), and other reviews report a 5-10% turnover rate.

2. **8 Year Wrinkle Study**: Hillebrand, GG et al. “New wrinkles on wrinkling: an 8-year longitudinal study” *British Journal of Dermatology* 162:1233-1241 (2010). PubMed ID: 20184587

3. **Facial movement and wrinkles**: Hwang, UJ et al. “Effect of a Facial Muscle Exercise Device on Facial Rejuvenation” *Aesthetic Surgery Journal* 38:463-476 (2018). PubMed ID: 29365050

4. **Botox effect**: Nobre, BB et al. “Exploring botulinum toxin's impact on masseter hypertrophy: randomized triple-blinded trial” *Scientific Reports* 14:14522 (2024). PubMed ID: 38914688

5. **Facial Feedback Meta-Analysis**: Coles, NA et al. "A meta-analysis of the facial feedback literature" *Psychological Bulletin* 145:610-651 (2019). DOI: 10.1037/bul0000194

6. **Facial expression study in 19 countries**: Coles, NA et al. "A multi-lab test of the facial feedback hypothesis" *Nature Human Behaviour* 6:1731-1742 (2022).

7. **Botox side effects**: Mazzitelli, M. et al. "Botulinum Toxin-A for Myogenous TMD: An Umbrella Review" *Drugs* 84:779-809 (2024). DOI: 10.1007/s40265-024-02048-x, PubMed ID: 38900335

8. **Massage muscles and square jaw**: Multiple case reports, PMC and Cureus journals (2024-2025).

Seo Hyeong-cheol, CEO of Maypure Dongdaemun branch

Graduated from Dankook University College of Medicine, Department of Medicine

· Emergency Medicine Specialist, Dankook University Medical Center

· Regular member of the Korean Society of Aesthetic Medicine

· Regular member of the Korean Society of Laser Dermatology and Prosthetics

· Regular member of the Korean Society for the Study of Obesity

· Restylane's top expert

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