Quantification and visualization of 3D facial aging in individuals of European ancestry

Facial features undergo continuous transformations across the lifespan. This study quantified and visualized the effects of aging on facial morphology in individuals of European ancestry. Three-dimensional facial photographs of 4,038 individuals (1,455 males and 2,583 females), aged 5 to 85 years and of European descent, were analyzed. Morphological changes in the face were modeled using kernel linear regression, with a focus on age-related changes. Age- and sex-specific expected facial shapes were generated for individuals aged 10 to 60 years in 5-year intervals. Changes in the face were analyzed in the sagittal, vertical, and horizontal directions, with linear distances and angular variations in the upper, middle, and lower regions of the face evaluated. Our results show that facial shape changes decelerate progressively after the age of 25 for both males and females. Facial aging is characterized by the loss of fullness in the forehead, sunken temples, formation of eye bags, deepening nasolabial folds, cheek hollowness and thinning, lengthening, and retrusion of the lips. Notable changes begin in the 30s, with the most pronounced alterations occurring in the 40s and 50s, intensifying in the 50s and 60s. Although the overall aging trajectory is similar in males and females, the magnitude and rate of change demonstrate sexual dimorphism. This study provides comprehensive insights into age-related facial morphological changes in healthy individuals of European ancestry using 3D photogrammetric analysis. These findings have important implications for clinical disciplines such as dentistry, plastic and maxillofacial surgery, and forensic medicine.