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The Tapering Face of Youth

My job, all day, every day, is to discuss face and neck aging with patients.  85% of these patients are female and it is not uncommon to see a 40 year old with very minor aging that is driving them crazy.  This is a natural phenomenon as the worst aging is the first aging; or at least in the eye of the beholder.  I frequently tell these patients that if I could take a video of them today and show it to them in 10 years, they would laugh that they were concerned about this minor aging.  Unfortunately, it just gets worse.  Aging is not a bad thing, in fact it is a privilege denied to many!  Well-adjusted individuals will accept the natural aging process, although no one welcomes it. What I do for a living is to reverse aging with surgical and non-surgical procedures.  The best patients are those that are not trying to look 20 years younger (that is when people look plastic), but rather they want to look as good as they can for their age.  Natural cosmetic surgery should whisper, not scream and my goal is to make patients look more youthful and natural.

One of the big things to realize is how our face and neck ages.  When we are young our face is a tapering oval like a heart or upside down egg.  This is because the youthful fat volume and tight skin in the midface produce roundness and the tight jaw and neck skin produce a tapered and defined chin and jawline.

As we age, we undergo atrophy of the cheek fat and have sagging soft tissues which makes the youthful midface droop.  This causes accumulation of tissue at the jawline (jowls) and we simultaneously undergo gravitational changes and fat accumulation of the chin and neck.  All of the above cause the once tapering oval face to become square.  The Loss of a midface volume and increased tissue of the jawline and neck are what makes look old.


The figures below shows illustrate the shape of the youthful face and an aging face.

Figure 2






The figure below show an actual patient on whom I performed facelift surgery.  The pictures illustrate the “square” face and jaw line in the before picture and the tapered oval face after the procedure.


I have performed almost 1,000 facelift procedures and it is for these reasons that it remains my favorite surgical procedure.  No other cosmetic surgery procedure carries the physical and emotional impact of a well done facelift.  You can hide mediocre breast, belly and butt surgery, but the face is in the open for everyone to see.

To find out more about cosmetic facial surgery visit


Joe Niamtu, III DMD

Cosmetic Facial Surgery

Richmond, Virginia

Office Address

Joe Niamtu III, DMD
11319 Polo Place
Midlothian, VA 23113

Office Hours

Monday - Friday
8:00am - 5:00pm

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