Facial bone aging is a multifactorial process involving progressive skeletal remodeling, selective bone resorption, and architectural changes that contribute substantially to the aged facial appearance. Craniofacial skeletal changes occur throughout adult life with region-specific bone loss affecting the orbital rims, maxilla, and mandible. This review summarizes contemporary evidence on facial bone aging, with a focus on morphometric changes, imaging findings, and clinical implications between 2020 and 2023. A systematic literature search of MEDLINE, PubMed, Ovid, Cochrane Library was conducted using predefined keywords related to facial bone aging, orbital remodeling, maxillary and mandibular resorption, mechanotransduction, and advanced imaging. Studies involving adult human subjects that reported quantitative or clearly described craniofacial skeletal changes using validated imaging or morphometric techniques were included. Case reports with ≤5 patients, non-craniofacial skeletal studies, purely soft-tissue analyses, and studies lacking primary data were excluded. Included studies were classified according to Oxford Centre for Evidence-Based Medicine levels. Across the included studies, orbital enlargement averaged 15–20% by the 7th decade, maxillary height decreased by 8–15%, and mandibular angles increased by 3–7° Distinct resorption patterns were observed around the periorbital region, pyriform aperture, and alveolar processes. Women demonstrated greater orbital change, whereas men exhibited more pronounced mandibular remodeling. Ethnic, hormonal, and mechanotransduction-related loading factors contributed to interindividual variability. Key methodological characteristics and outcome measures of representative studies are summarized in Table 1. Facial bone aging represents a fundamental component of craniofacial aging with important implications for aesthetic, reconstructive, and dental practice. Advances in imaging and standardized morphometric analysis enable more precise characterization of region-specific skeletal changes, supporting evidence-based treatment planning and patient counseling.

Injectable biostimulatory agents such as poly-L-lactic acid (PLLA), polycaprolactone (PCL), and calcium hydroxyapatite (CaHA) have emerged as key tools in regenerative aesthetics due to their ability to stimulate adipogenesis and adipocyte metabolic activity, enhance collagen production, and improve dermal quality. This review aimed to provide an updated synthesis of the role of these agents in adipocyte stimulation, focusing on their mechanisms of action, clinical efficacy, and therapeutic applications. A comprehensive search of the MEDLINE, PubMed, and Ovid databases was conducted for studies published from 2018 onward, including in vitro and in vivo experiments, randomized controlled trials, and observational studies, which were evaluated according to the Oxford Centre for Evidence-Based Medicine hierarchy. The findings demonstrated that PCL promotes adipose-derived stem cell differentiation and extracellular matrix remodeling, while PLLA exhibits dual effects on collagen synthesis and adipocyte stimulation, with clinical trials such as the SPLASH study confirming significant improvements in dermal thickness and adipogenesis. CaHA provided immediate volumizing benefits with long-term tissue regeneration, and innovative approaches including combination therapies and novel injection protocols expanded clinical applications. Overall, PLLA, PCL, and CaHA represent effective and versatile biostimulatory agents that support natural and durable outcomes in aesthetic practice. Nevertheless, the absence of large-scale trials and standardized protocols highlights the need for further research to optimize safety, efficacy, and long-term treatment strategies.

Selective chemodenervation of the inferior gluteus maximus (GMax) may induce compensatory hypertrophy of its superior fibers. Two healthy female subjects underwent ultrasound-guided botulinumtoxinA (JETEMA THE TOXIN, JETEMA Co., Ltd., Korea) injections (100 IU) into the inferior GMax. Six-week follow-up revealed increased fullness and definition in the superior region without adverse effects. The observation supports the concept that targeted muscle weakening can promote adaptive hypertrophy in adjacent fibers. This minimally invasive approach may have potential applications in aesthetic body contouring and functional rehabilitation.