The benefits from exercise are tremendous and their merits become even more significant as we get older. We also live in a time when it is not uncommon for a 45 or 50 year person to run half-marathons. There are probably more than people, both men and women, that are avid runners and exercise addicts today than ever before. While America may be suffering increasing rates of obesity, there is also a growing number of exercise enthusiasts.
One interesting phenomenon that I have seen in middle-age runners is what has become known as the ‘runner’s face’ or exercise-induced facial atrophy. This can occur naturally in anyone that has always been thin and begins to show their age, but the mechanism of running can induce this visual loss of facial volume. You may say that as the body slims and one’s weight drops, the face can become drawn inward or more gaunt. This is the result of the face losing fat or volume with the cheeks turning inward and the frown lines becoming more pronounced. Facial wrinkles can also become exaggerated from the grimacing of the facial muscles with the exertion of aerobic exercise.
This unwanted change in one’s facial appearance seems an odd contrast to the other favorable effects that running has on the body. This is a unique affliction in my observation that strikes middle-aged runners in their forties and fifties. It is the result of exercise-induced fat loss, particularly that of the buccal fat pads which lie right below the cheek bones, which causes loss of support of the cheek, temple and perioral (lip) skin. This volume-loss skin contracture causes the face to look skeletonized or too gaunt. In severe cases, the eyes can even look sunken in and the temples concave. It can be most magnified in runners who were thin from their youth. When body fat percentages get below 8% to 10% in women and 10% to 12% in men, facial volume loss can be seen.
While sunscreen is the first line of defense for any runner, restoring facial volume and reducing wrinkles is the basis of a proactive approach. Injectable fillers are the backbone of effective facial volumizers. Well known injectable fillers, such as Juvederm and Restylane, induce facial fullness by adding a sponge-like sugar-based material known as hyaluronic acid or hyaluron. Similar to the fluid in one’s eyeball, their gel material consistency make them the easiest to inject with the least risk of lumps and irregularities. While none of them is permanent, their volume effects can last over half a year or longer depending upon how they are concentrated from the manufacturer. Other semi-permanent (Sculptra) and permanent fillers (Artefill) are also options that cost more but also last longer
Interestingly, the use of fat injections to the face is usually not a good idea for the runner. Besides the obvious likelihood that they may not have enough fat to harvest, the burning of calories from continued running makes fat injections last less than most of the synthetic injectable fillers.
Dr. Barry Eppley
Indianapolis, Indiana