D&PS – D&PS August 2025 Column
Dr. Chang-hwan Cho of Dong-An Joongsim Clinic contributed a column to the August 2025 issue of D&PS Magazine,
titled “2017–2025 Aesthetic Medicine Trends: Anatomical Diagnosis of Facial Aging II.”

-Column Summary-
Facial aging begins in the late 20s and accelerates after the mid-30s. The dermis becomes thinner, fat is redistributed, and muscles and ligaments loosen,
reducing structural support and intensifying sagging and wrinkles. The periorbital area, where the skin is thin and structurally fragile, is particularly
prone to wrinkles, hollowing, fat protrusion, and tear trough formation. Fat descent and muscle weakening contribute to a tired, aged appearance, while
midface volume loss leads to the development of deep grooves. Perioral wrinkles arise from two primary causes: deepening nasolabial folds due to volume loss,
and fixed wrinkles caused by changes in the muscles and ligaments. Marionette lines are associated with fat descent, ligament weakening, and positional changes
in the modiolus. Jowl sagging results from a combination of fat pad descent, ligament laxity, reduced soft tissue elasticity, and skeletal changes, closely
related to midface ligament weakening. Since aging is a complex process involving concurrent changes to the skin, fat, muscles, ligaments, and bone, treatment
should go beyond simple volume augmentation to focus on restoring and maintaining anatomical structures. Dr. Cho emphasized the importance of customized
treatment based on an anatomical understanding of fat, ligaments, and muscles, as well as the concept of “Facial Fat Fitness.” Modern aesthetic medicine is
shifting away from mere filling, toward achieving anatomical harmony and restoring youthful expressions and natural facial dynamics.