A careful study of the aging face reveals it to be more than just surface textural wrinkling or loose skin. Changes in three-dimensional topography are responsible for the distinctive phenotypic presentation of the face throughout life. These geometric alterations are secondary to apportioning in the fat compartments and result in the fat dysmorphism characteristic of senescence. Redistributing this fat can rebalance the facial fat compartments and mimic the facial structure present in youth.