Simulation of the aging face.

A three-dimensional finite element program is described which attempts to simulate the nonlinear mechanical behavior of an aging human face with specific reference to progressive gravimetric soft tissue descent. A cross section of the facial structure is considered to consist of a multilayered composite of tissues with differing mechanical behavior. Relatively short time (elastic-viscoplastic) behavior is governed by equations previously developed which are consistent with mechanical tests. The long time response is controlled by the aging elastic components of the tissues. An aging function is introduced which, in a simplified manner, models the observed loss of stiffness of these aging elastic components due to the history of straining as well as other physiological and environmental influences. Calculations have been performed for 30 years of exposure to gravitational forces. The deformations and stress distributions in the layers of the soft tissues are described. Overall, the feasibility of using constitutive relations which reflect the highly nonlinear elastic-viscoplastic behavior of facial soft tissues in finite element based three-dimensional mechanical analyses of the human face is demonstrated. Further developments of the program are discussed in relation to possible clinical applications. Although the proposed aging function produces physically reasonable long-term response, experimental data are not yet available for more quantitative validation.

Nonlinear elastic-viscoplastic constitutive equations for aging facial tissues.

This paper reports on the initial stages of a project to simulate the nonlinear mechanical behavior of an aging human face. A cross-section of the facial structure is considered to consist of a multilayered composite of tissues with differing mechanical behavior. The constitutive properties of these tissues are incorporated into a finite element model of the three-dimensional facial geometry. Relatively short time (elastic-viscoplastic) behavior is governed by equations previously developed which are consistent with mechanical tests. The long time response is controlled by the aging elastic components of the tissues. An aging function is introduced which, in a simplified manner, captures the observed loss of stiffness of these aging elastic components due to the history of straining as well as other physiological and environmental influences. Calculations have been performed for 30 years of exposure to gravitational forces. Progressive gravimetric soft tissue descent is simulated, which is regarded as the main indication of facial aging. Results are presented for the deformations and stress distributions in the layers of the soft tissues.

An elastic-viscoplastic model for excised facial tissues.

Unified constitutive equations for elastic-viscoplastic materials were modified and used to model the highly nonlinear elastic and rate-dependent inelastic response exhibited in recent experiments on excised facial tissues. These included the skin and the underlying supportive tissue SMAS (the Superficial Musculoaponeurotic System). This study indicates a number of relevant results: The skin is more strain rate dependent than the SMAS; the nonlinearity of the elasticity of the skin is greater than that of the SMAS; both tissues exhibit a hardening effect indicated by increased resistance to inelastic deformation due to stress acting over a time period; the hardening effect leads to a decrease in time dependence and an increased elastic range, which is more pronounced for SMAS. Consequently, the SMAS can be viewed as the firmer elastic foundation of the more viscous skin. Moreover, the relaxation time for the skin is fairly short so the skin would be expected to conform to the deformation of the SMAS if it remained attached to the SMAS during stretching. This is relevant when it is undesirable to separate the skin from the SMAS for physiological reasons.

Viscoelastic properties of the superficial musculoaponeurotic system (SMAS): a microscopic and mechanical study.

A study was undertaken to determine the physical properties and microscopic structure of the superficial musculoaponeurotic system (SMAS) tissue. Forty virginal specimens and eight reoperated specimens were examined. The following findings were discovered. 1) Microscopic appearance shows the SMAS to consist of collagen fibers, a relatively high concentration of elastic fibers interspersed with fat cells. 2) On scanning electron microscopy, the virginal SMAS shows the collagen fibers to have a similar convoluted appearance as in the dermis. There is some evidence of parallelization of the collagen fibers in the reexcised SMAS specimens. 3) Mechanical testing (Instron) demonstrates that both the SMAS and preauricular skin were subjected to a series of loading/ unloading tests at various rates, amplitudes, and stress relaxation tests. Both sets of specimens indicated definite viscoelastic properties. Although the mechanical behavior of both tissues was somewhat similar, the viscoelastic effect of the SMAS was less pronounced. A slackening effect of the SMAS indicated a gradual expansion of the SMAS postoperatively. These results could provide some indication of the long-term effects of SMAS surgery.

Mechanical properties and microstructure of the superficial musculoaponeurotic system.

Because of the widespread reliance on SMAS tightening procedures in present-day face lift surgery, a study was undertaken to examine the physical properties and microscopic structure of both virginal (40 specimens) and reoperated (8 specimens) SMAS tissue. The findings could be of practical value to the surgeon and are reported herewith: First, the SMAS is a composite fibrofatty layer comprising collagen and elastic fibers interspersed with fat cells. Second, microscopic appearance shows a considerable amount of elastic fibers in close relationship to the collagen fibers. Third, on scanning electron microscopy, the collagen fibers in the virginal SMAS show a convoluted appearance similar to that found in the dermis. In the reexcised SMAS tissue, there is some evidence of parallelization of the collagen fibers as seen in the stretched dermis. Fourth, mechanical testing (Instron), i.e., a series of loading/unloading tests at various rates and amplitudes, and stress relaxation tests were performed on samples of preauricular skin and SMAS. These indicated definite viscoelastic properties for both sets of specimens, with the tendency of an increased stiffness and a reduction in viscoelastic effects on repeated working of the samples. Overall, the mechanical behavior of both tissues was somewhat similar, the viscoelastic effects in SMAS being less pronounced. A nonlinear viscoelastic model is under development to represent the behavior of both tissues. The implications of these results may help to explain the slackening effect observed in some postoperative patients.