What Actually Happens As You Age: The Weakening Pillars And What You Can Do About It

By Dr. Manoj Johar in Aesthetic And Reconstructive Surgery

Jan 15 , 2019 | 2 min read


For all of us, the first signs of aging are on the surface, creep up slowly, and are vague: darker undereye circles that seem somehow larger than the last time, a few lines between our eyebrows, an odd collection of extra skin folds where none existed, fullness under the chin, blunted jaw lines, a bulge here and a sag there…
But these outward changes are the result of deeper structural changes in our bones, muscle, fat, and skin. These small changes add up and make the big difference in how we look as we age. Here, we define the four weakening pillars of aging, from inside out starting with the bones.


Despite their rigidity, bones don’t stay the same as we age—they lose mass, migrate, and cause major changes in our appearance. Bone loss can lead to narrowing of the frame, slouching, loss of height, and on the face, retraction of the jawline and mouth, hollowing of the temples. The nose tip starts to descend, the lips thin and elongate and cheek fullness falls to make the creases deeper.
The eye sockets widen, particularly along the outer lower edge, giving our eyes a more sunken appearance, more prominent fat pads, a tired look. That retraction of the jawline causes “jowls and a sagging neck,” 
Solutions: There are not many corrective measures for bone anti-aging, but there are preventive ways to preserve bone health. And pres
erving strong foundations is a good way to plan anti aging.


When bones give way, the muscles follow. As the muscles weaken, the bones bear the brunt and weaken more…
Dr. Manoj Johar, Aesthetic And Reconstructive Surgery puts it this way: “The muscles and fat pads decrease in volume, while the tissues holding them together lose elasticity, causing a true compounding effect.”
Before this loss of volume takes place, our muscles produce lines on the skin from repetitive movements. 
Solutions:  While Botulinum toxins can help in preventing and reversing early lines before they set in, the loss of muscles can only be prevented and needs constant effort to keep them in the best health. 


When young, our bodies are rounded and full of pockets of fat. This is what gives the fullness and roundness of youth. With age, this fat diminishes and rearranges itself slowly, drifting downward, collecting around the chin, jaw, and neck, waist, flanks, thighs, etc. This movement starts in thirties and in our forties in particular, and continues steadily as the years pass. The result is that it looks like our skin is  wrinkling and sagging but the underlying cause is the deflation of fat.
Solutions: Fillers, fat grafting, radiofrequency, lasers, and and now ultrasound therapy are being used more and more to correct this.


Skin is the largest human organ and always exposed to the environment. Our skin reflects our health and age. As one ages, skin tends to become uneven in color, rough, lax, and wrinkled. Solar ultraviolet (UV) irradiation is the most common environmental cause of ‘external’ aging. Damage caused by solar UV irradiation, the so-called photoaging, is superimposed on chronological aging. The finding that both photoaged and chronologically-aged human skin possess substantial capacity to produce new collagen provides the basis for therapeutic interventions.  New collagen can result in marked improvement in appearance of aged skin.
Solution: Clinically-proven anti-aging treatments such as topical retinoic acid, CO2 laser resurfacing, and intradermal injection of cross-linked hyaluronic acid stimulate production of new undamaged collagen. Similarly, deep peels, micro needling, etc are also known to stimulate new collagen production.