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YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME

Year 2025, Volume: 27 Issue: 2, 239 - 245, 25.08.2025
https://doi.org/10.24938/kutfd.1675261

Abstract

Yüz çizgileri, cildin anatomik yapısı ve yaşlanma süreci ile doğrudan ilişkilidir. Bu çizgiler, deri altındaki kollajen ve elastik liflerin uzanım yönleri, cilt gerilim hatları ve mimik kaslarının hareketleriyle şekillenir. Yaşlanma sürecine bağlı olarak cilt çizgileri belirginleşirken, genetik faktörler, hormonal değişimler ve çevresel etkenler (UV maruziyeti, sigara, beslenme, stres) de bu süreci hızlandırabilir. Tarihsel olarak Langer, Borges ve diğer araştırmacılar, yüz çizgilerinin anatomisini farklı yöntemlerle incelemiş ve estetik ile cerrahi uygulamalar için rehber niteliğinde çizgiler ortaya koymuşlardır. Ancak günümüzde halen cerrahi insizyonlar ve estetik işlemler için evrensel olarak kabul edilen tek bir yüz çizgisi haritası bulunmamaktadır. Bu derleme, yüz çizgilerinin oluşum mekanizmalarını, biyolojik ve çevresel faktörlerle ilişkisini, tarihçesini ve klinik uygulamalardaki önemini detaylı bir şekilde ele almaktadır.

References

  • Keaney TC. Aging in the male face: intrinsic and extrinsic factors. Dermatol Surg. 2016;42(7):797-803.
  • Farage MA, Miller KW, Elsner P, Maibach HI. Intrinsic and extrinsic factors in skin ageing: a review. Int J Cosmet Sci. 2008;30(2):87-95.
  • Moon H, Fundaro SP, Goh CL, Hau KC, Paz-Lao P, Salti G. A Review on the combined use of soft tissue filler, suspension threads, and botulinum toxin for facial rejuvenation. J Cutan Aesthet Surg. 2021;14(2):147-155.
  • Coleman SR, Grover R. The anatomy of the aging face: volume loss and changes in 3-dimensional topography. Aesthet Surg J. 2006;26(1_Supplement):S4-S9.
  • Kim BJ, Choi JH, Lee Y. Development of facial rejuvenation procedures: thirty years of clinical experience with face lifts. Arch Plast Surg. 2022;42:521-531.
  • Rosicka K, Hill M, Wdowski MM. Skin anisotropy: finding the optimal incision line for volar forearm in males and females. J Mech Behav Biomed Mater. 2021;124:104805.
  • Rennekampff HO, Tenenhaus M. Theoretical basis for optimal surgical incision planning to reduce hypertrophic scar formation. Med Hypotheses. 2020;140:109672.
  • Friedman O. Changes Associated with the aging face. Facial Plast Surg Clin North Am. 2005;13(3):371-380.
  • Rinnerthaler M, Bischof J, Streubel MK, Trost A, Richter K. Oxidative stress in aging human skin. Biomolecules. 2015;5(2):545-589.
  • Charles Finn J, Cox SE, Earl ML. Social implications of hyperfunctional facial lines. Dermatol Surg. 2003;29(5):450-455.
  • Goodman GD, Kaufman J, Day D, et al. Impact of smoking and alcohol use on facial aging in women: Results of a large multinational, multiracial, cross-sectional survey. J Clin Aesthet Dermatol. 2019;12(8):28-39.
  • Danby FW. Nutrition and aging skin: sugar and glycation. Clin Dermatol. 2010;28(4):409-411.
  • Fisher GJ, Talwar HS, Lin J, Voorhees JJ. Molecular mechanisms of photoaging in human skin in vivo and their prevention by all-trans retinoic acid. Photochem Photobiol. 1999;69(2):154-157.
  • Castelo-Branco C, Figueras F, Martínez de Osaba MJ, Vanrell JA. Facial wrinkling in postmenopausal women. Effects of smoking status and hormone replacement therapy. Maturitas. 1998;29(1):75-86.
  • Morita A, Torii K, Maeda A, Yamaguchi Y. Molecular basis of tobacco smoke-induced premature skin aging. J Investig Dermatol Symp Proc. 2009;14(1):53-55.
  • Vierkötter A, Schikowski T, Ranft U, et al. Airborne particle exposure and extrinsic skin aging. J Invest Dermatol. 2010;130(12):2719-2726.
  • Abramo AC, Do Amaral TPA, Lessio BP, De Lima GA. Anatomy of forehead, glabellar, nasal and orbital muscles, and their correlation with distinctive patterns of skin lines on the upper third of the face: Reviewing concepts. Aesth Plast Surg. 2016;40(6):962-971.
  • Knize DM. Muscles that act on glabellar skin: a closer look. Plast Reconstr Surg. 2000;105(1):350-361.
  • Beer KR, Julius H, Dunn M, Wilson F. Remodeling of periorbital, temporal, glabellar, and crow's feet areas with hyaluronic acid and botulinum toxin. J Cosmet Dermatol. 2014;13(2):143-150.
  • Knize DM. The forehead and temporal fossa: anatomy and technique. Lippincott Williams & Wilkins; 2001. Ann Plast Surg. 2001;47(5):585.
  • Knize DM. Anatomic concepts for brow lift procedures. Plast Reconstr Surg. 2009;124(6):2118.
  • Renton K, Keefe KY. Accurately assessing lines on the aging face. Plast Surg Nurs. 2018;38(1):31.
  • Fujimura T, Haketa K, Hotta M, Kitahara T. Loss of skin elasticity precedes to rapid increase of wrinkle levels. J Dermatol Sci. 2007;47(3):233-239.
  • Stegman SJ. Sleep creases. Am J Cosmet Surg. 1987;4(4):277-280.
  • Fulton JE, Gaminchi F. Sleep lines. Dermatol Surg. 1999;25(1):59-62.
  • Sarifakioğlu N, Terzioğlu A, Ates L, Aslan G. A new phenomenon: “sleep lines” on the face. Scand J Plast Reconstr Surg Hand Surg. 2004;38(4):244-247.
  • Alghoul M, Codner MA. Retaining ligaments of the face: review of anatomy and clinical applications. Aesthet Surg J. 2013;33(6):769-782.
  • Anson G, Kane MAC, Lambros V. Sleep wrinkles: facial aging and facial distortion during sleep. Aesthet Surg J. 2016;36(8):931-940.
  • Arda O, Göksügür N, Tüzün Y. Basic histological structure and functions of facial skin. Clin Dermatol. 2014;32(1):3-13.
  • Gartner LP, Hiatt JL. Color Textbook of Histology E-Book. Elsevier Health Sciences; 2006.
  • Gartner LP, Hiatt JL. Color Atlas and Text of Histology. Lippincott Williams & Wilkins; 2012.
  • Mescher AL. Junqueira’s Basic Histology: Text and Atlas. New York: McGraw Hill; 2018.
  • Brody I. The ultrastructure of the tonofibrils in the keratinization process of normal human epidermis. J Ultrastruct Res. 1960;4(3):264-297.
  • Pawlina W, Ross MH. Histology: A Text and Atlas: With Correlated Cell and Molecular Biology. Lippincott Williams & Wilkins; 2018.
  • Kierszenbaum AL, Tres L. Histology and Cell Biology: An Introduction to Pathology E-Book. Elsevier Health Sciences; 2015.
  • Burkitt HG, Young B, Heath JW, Wheater PR. Wheater’s functional histology: a text and colour atlas. (No Title). Published online 1993.
  • Langer K. On the anatomy and physiology of the skin: I. The cleavability of the cutis. Br J Plast Surg. 1978;31(1):3-8.
  • Bulacio Nuñez AW. A new theory regarding the lines of skin tension. Plast Reconstr Surg. 1974;53(6):663-669.
  • Cox HT. The cleavage lines of the skin. Br J Plast Surg. 1941;29(114):234-240.
  • Rubin LR. Langers lines and facial scars. Plast Reconstr Surg (1946). 1948;3(2):147-155.
  • Kraissl CJ. The selection of appropriate lines for elective surgical incisions. Plast Reconstr Surg (1946). 1951;8(1):1-28.
  • Borges AF, Alexander JE. Relaxed skin tension lines, z-plasties on scars, and fusiform excision of lesions. Br J Plast Surg. 1962;15:242-254.
  • Borges AF. Relaxed skin tension lines (RSTL) versus other skin lines. Plast Reconstr Surg. 1984;73(1):144-150.
  • Faga A. A new method to visualize Langer’s lines. J Dermatol Surg Oncol. 1981;7(1):53-55.
  • Piérard GE, Lapière CM. Microanatomy of the dermis in relation to relaxed skin tension lines and Langer’s lines. Am J Dermatopathol. 1987;9(3):219-224.
  • Bush J, Ferguson MWJ, Mason T, McGrouther G. The dynamic rotation of Langer’s lines on facial expression. J Plast Reconstr Aesthet Surg. 2007;60(4):393-399.
  • Seo H, Kim S jo, Cordier F, Choi J, Hong K. Estimating dynamic skin tension lines in vivo using 3D scans. Computer-Aided Design. 2013;45(2):551-555.
  • Alhamdi A. Facial Skin Lines. Iraqi J Med Sci. 2015;13:103-107.
  • Paul S. Biodynamic excisional skin tension lines for surgical excisions: untangling the science. Ann R Coll Surg Engl. 2018;100(4):330-337.
  • Hwang K. Revisiting the skin lines on the forehead and glabellar area. J Craniofac Surg. 2018;29(1):209.
  • Avci S. Günümüz Sanat Eğitiminde Sanat Anatomisi Dersi. Yedi. 2018;(20):25-37.
  • Heckmann M. Details from dignity to decay: facial expression lines in visual arts. Dermatol Surg. 2003;29(10):1039-1043.

Face Lines, Skin Tension Lines and Aging: An Anatomical Review

Year 2025, Volume: 27 Issue: 2, 239 - 245, 25.08.2025
https://doi.org/10.24938/kutfd.1675261

Abstract

Facial lines are closely associated with the anatomical structure of the skin and the aging process. These lines are shaped by the orientation of collagen and elastin fibers beneath the skin, skin tension lines, and the movements of facial expression muscles. As aging progresses, facial lines become more pronounced. Genetic factors, hormonal changes, and environmental influences (UV exposure, smoking, nutrition, stress) can accelerate this process. Historically, researchers such as Langer, Borges, and others have examined the anatomy of facial lines using different methods and have proposed guidelines for aesthetic and surgical applications. However, a universally accepted facial line map for surgical incisions and aesthetic procedures has yet to be established. This review provides a comprehensive analysis of the mechanisms underlying the formation of facial lines, their association with biological and environmental factors, their historical background, and their relevance in clinical practice.

References

  • Keaney TC. Aging in the male face: intrinsic and extrinsic factors. Dermatol Surg. 2016;42(7):797-803.
  • Farage MA, Miller KW, Elsner P, Maibach HI. Intrinsic and extrinsic factors in skin ageing: a review. Int J Cosmet Sci. 2008;30(2):87-95.
  • Moon H, Fundaro SP, Goh CL, Hau KC, Paz-Lao P, Salti G. A Review on the combined use of soft tissue filler, suspension threads, and botulinum toxin for facial rejuvenation. J Cutan Aesthet Surg. 2021;14(2):147-155.
  • Coleman SR, Grover R. The anatomy of the aging face: volume loss and changes in 3-dimensional topography. Aesthet Surg J. 2006;26(1_Supplement):S4-S9.
  • Kim BJ, Choi JH, Lee Y. Development of facial rejuvenation procedures: thirty years of clinical experience with face lifts. Arch Plast Surg. 2022;42:521-531.
  • Rosicka K, Hill M, Wdowski MM. Skin anisotropy: finding the optimal incision line for volar forearm in males and females. J Mech Behav Biomed Mater. 2021;124:104805.
  • Rennekampff HO, Tenenhaus M. Theoretical basis for optimal surgical incision planning to reduce hypertrophic scar formation. Med Hypotheses. 2020;140:109672.
  • Friedman O. Changes Associated with the aging face. Facial Plast Surg Clin North Am. 2005;13(3):371-380.
  • Rinnerthaler M, Bischof J, Streubel MK, Trost A, Richter K. Oxidative stress in aging human skin. Biomolecules. 2015;5(2):545-589.
  • Charles Finn J, Cox SE, Earl ML. Social implications of hyperfunctional facial lines. Dermatol Surg. 2003;29(5):450-455.
  • Goodman GD, Kaufman J, Day D, et al. Impact of smoking and alcohol use on facial aging in women: Results of a large multinational, multiracial, cross-sectional survey. J Clin Aesthet Dermatol. 2019;12(8):28-39.
  • Danby FW. Nutrition and aging skin: sugar and glycation. Clin Dermatol. 2010;28(4):409-411.
  • Fisher GJ, Talwar HS, Lin J, Voorhees JJ. Molecular mechanisms of photoaging in human skin in vivo and their prevention by all-trans retinoic acid. Photochem Photobiol. 1999;69(2):154-157.
  • Castelo-Branco C, Figueras F, Martínez de Osaba MJ, Vanrell JA. Facial wrinkling in postmenopausal women. Effects of smoking status and hormone replacement therapy. Maturitas. 1998;29(1):75-86.
  • Morita A, Torii K, Maeda A, Yamaguchi Y. Molecular basis of tobacco smoke-induced premature skin aging. J Investig Dermatol Symp Proc. 2009;14(1):53-55.
  • Vierkötter A, Schikowski T, Ranft U, et al. Airborne particle exposure and extrinsic skin aging. J Invest Dermatol. 2010;130(12):2719-2726.
  • Abramo AC, Do Amaral TPA, Lessio BP, De Lima GA. Anatomy of forehead, glabellar, nasal and orbital muscles, and their correlation with distinctive patterns of skin lines on the upper third of the face: Reviewing concepts. Aesth Plast Surg. 2016;40(6):962-971.
  • Knize DM. Muscles that act on glabellar skin: a closer look. Plast Reconstr Surg. 2000;105(1):350-361.
  • Beer KR, Julius H, Dunn M, Wilson F. Remodeling of periorbital, temporal, glabellar, and crow's feet areas with hyaluronic acid and botulinum toxin. J Cosmet Dermatol. 2014;13(2):143-150.
  • Knize DM. The forehead and temporal fossa: anatomy and technique. Lippincott Williams & Wilkins; 2001. Ann Plast Surg. 2001;47(5):585.
  • Knize DM. Anatomic concepts for brow lift procedures. Plast Reconstr Surg. 2009;124(6):2118.
  • Renton K, Keefe KY. Accurately assessing lines on the aging face. Plast Surg Nurs. 2018;38(1):31.
  • Fujimura T, Haketa K, Hotta M, Kitahara T. Loss of skin elasticity precedes to rapid increase of wrinkle levels. J Dermatol Sci. 2007;47(3):233-239.
  • Stegman SJ. Sleep creases. Am J Cosmet Surg. 1987;4(4):277-280.
  • Fulton JE, Gaminchi F. Sleep lines. Dermatol Surg. 1999;25(1):59-62.
  • Sarifakioğlu N, Terzioğlu A, Ates L, Aslan G. A new phenomenon: “sleep lines” on the face. Scand J Plast Reconstr Surg Hand Surg. 2004;38(4):244-247.
  • Alghoul M, Codner MA. Retaining ligaments of the face: review of anatomy and clinical applications. Aesthet Surg J. 2013;33(6):769-782.
  • Anson G, Kane MAC, Lambros V. Sleep wrinkles: facial aging and facial distortion during sleep. Aesthet Surg J. 2016;36(8):931-940.
  • Arda O, Göksügür N, Tüzün Y. Basic histological structure and functions of facial skin. Clin Dermatol. 2014;32(1):3-13.
  • Gartner LP, Hiatt JL. Color Textbook of Histology E-Book. Elsevier Health Sciences; 2006.
  • Gartner LP, Hiatt JL. Color Atlas and Text of Histology. Lippincott Williams & Wilkins; 2012.
  • Mescher AL. Junqueira’s Basic Histology: Text and Atlas. New York: McGraw Hill; 2018.
  • Brody I. The ultrastructure of the tonofibrils in the keratinization process of normal human epidermis. J Ultrastruct Res. 1960;4(3):264-297.
  • Pawlina W, Ross MH. Histology: A Text and Atlas: With Correlated Cell and Molecular Biology. Lippincott Williams & Wilkins; 2018.
  • Kierszenbaum AL, Tres L. Histology and Cell Biology: An Introduction to Pathology E-Book. Elsevier Health Sciences; 2015.
  • Burkitt HG, Young B, Heath JW, Wheater PR. Wheater’s functional histology: a text and colour atlas. (No Title). Published online 1993.
  • Langer K. On the anatomy and physiology of the skin: I. The cleavability of the cutis. Br J Plast Surg. 1978;31(1):3-8.
  • Bulacio Nuñez AW. A new theory regarding the lines of skin tension. Plast Reconstr Surg. 1974;53(6):663-669.
  • Cox HT. The cleavage lines of the skin. Br J Plast Surg. 1941;29(114):234-240.
  • Rubin LR. Langers lines and facial scars. Plast Reconstr Surg (1946). 1948;3(2):147-155.
  • Kraissl CJ. The selection of appropriate lines for elective surgical incisions. Plast Reconstr Surg (1946). 1951;8(1):1-28.
  • Borges AF, Alexander JE. Relaxed skin tension lines, z-plasties on scars, and fusiform excision of lesions. Br J Plast Surg. 1962;15:242-254.
  • Borges AF. Relaxed skin tension lines (RSTL) versus other skin lines. Plast Reconstr Surg. 1984;73(1):144-150.
  • Faga A. A new method to visualize Langer’s lines. J Dermatol Surg Oncol. 1981;7(1):53-55.
  • Piérard GE, Lapière CM. Microanatomy of the dermis in relation to relaxed skin tension lines and Langer’s lines. Am J Dermatopathol. 1987;9(3):219-224.
  • Bush J, Ferguson MWJ, Mason T, McGrouther G. The dynamic rotation of Langer’s lines on facial expression. J Plast Reconstr Aesthet Surg. 2007;60(4):393-399.
  • Seo H, Kim S jo, Cordier F, Choi J, Hong K. Estimating dynamic skin tension lines in vivo using 3D scans. Computer-Aided Design. 2013;45(2):551-555.
  • Alhamdi A. Facial Skin Lines. Iraqi J Med Sci. 2015;13:103-107.
  • Paul S. Biodynamic excisional skin tension lines for surgical excisions: untangling the science. Ann R Coll Surg Engl. 2018;100(4):330-337.
  • Hwang K. Revisiting the skin lines on the forehead and glabellar area. J Craniofac Surg. 2018;29(1):209.
  • Avci S. Günümüz Sanat Eğitiminde Sanat Anatomisi Dersi. Yedi. 2018;(20):25-37.
  • Heckmann M. Details from dignity to decay: facial expression lines in visual arts. Dermatol Surg. 2003;29(10):1039-1043.
There are 52 citations in total.

Details

Primary Language Turkish
Subjects Health Services and Systems (Other)
Journal Section Review
Authors

Furkan Mehmet Özden 0009-0006-2415-3943

Serpil Çilingiroğlu Anlı 0000-0003-1966-7609

Ayla Kürkçüoğlu 0000-0003-4350-4172

Publication Date August 25, 2025
Submission Date April 15, 2025
Acceptance Date May 9, 2025
Published in Issue Year 2025 Volume: 27 Issue: 2

Cite

APA Özden, F. M., Çilingiroğlu Anlı, S., & Kürkçüoğlu, A. (2025). YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME. The Journal of Kırıkkale University Faculty of Medicine, 27(2), 239-245. https://doi.org/10.24938/kutfd.1675261
AMA Özden FM, Çilingiroğlu Anlı S, Kürkçüoğlu A. YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME. Kırıkkale Uni Med J. August 2025;27(2):239-245. doi:10.24938/kutfd.1675261
Chicago Özden, Furkan Mehmet, Serpil Çilingiroğlu Anlı, and Ayla Kürkçüoğlu. “YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME”. The Journal of Kırıkkale University Faculty of Medicine 27, no. 2 (August 2025): 239-45. https://doi.org/10.24938/kutfd.1675261.
EndNote Özden FM, Çilingiroğlu Anlı S, Kürkçüoğlu A (August 1, 2025) YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME. The Journal of Kırıkkale University Faculty of Medicine 27 2 239–245.
IEEE F. M. Özden, S. Çilingiroğlu Anlı, and A. Kürkçüoğlu, “YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME”, Kırıkkale Uni Med J, vol. 27, no. 2, pp. 239–245, 2025, doi: 10.24938/kutfd.1675261.
ISNAD Özden, Furkan Mehmet et al. “YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME”. The Journal of Kırıkkale University Faculty of Medicine 27/2 (August2025), 239-245. https://doi.org/10.24938/kutfd.1675261.
JAMA Özden FM, Çilingiroğlu Anlı S, Kürkçüoğlu A. YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME. Kırıkkale Uni Med J. 2025;27:239–245.
MLA Özden, Furkan Mehmet et al. “YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME”. The Journal of Kırıkkale University Faculty of Medicine, vol. 27, no. 2, 2025, pp. 239-45, doi:10.24938/kutfd.1675261.
Vancouver Özden FM, Çilingiroğlu Anlı S, Kürkçüoğlu A. YÜZ ÇİZGİLERİ, CİLT GERİLİM HATLARI VE YAŞLANMA: ANATOMİK BİR İNCELEME. Kırıkkale Uni Med J. 2025;27(2):239-45.

This Journal is a Publication of Kırıkkale University Faculty of Medicine.