Why does the face get larger as people reach middle age?

As people reach middle age, their faces may gradually become larger, often associated with factors such as fat accumulation, muscle laxity, hypothyroidism, Cushing's syndrome, and mandibular bone hyperplasia. If facial enlargement is accompanied by abnormal weight changes or fatigue, it is advisable to seek timely medical evaluation at a reputable hospital. Specific causes are analyzed as follows:

1. Fat Accumulation

After middle age, metabolic rate slows down and calorie expenditure decreases, making it easier for excess fat to accumulate in the cheeks and jawline, leading to a wider facial contour. It is recommended to control intake of high-fat and high-sugar foods, engage in 30 minutes of brisk walking or jogging daily, and avoid eating before bedtime to reduce fat deposition.

2. Muscle Laxity

Loss of collagen and decreased skin elasticity weaken the supportive capacity of facial muscles, resulting in sagging and outward expansion that makes the face appear larger. Regular facial massage—lifting from the jawline toward the ears—is beneficial. Consuming collagen-rich foods such as pig trotters and white fungus (tremella) can also help.

3. Hypothyroidism

Insufficient thyroid hormone secretion reduces metabolic rate and may cause mucinous edema, leading to facial swelling and enlargement, often accompanied by cold intolerance and excessive sleepiness. Follow medical advice to take levothyroxine sodium tablets or thyroid extract tablets, and have regular follow-up tests to monitor thyroid function and adjust medication dosage accordingly.

4. Cushing's Syndrome

Excessive secretion of glucocorticoids by the adrenal cortex leads to redistribution of body fat, resulting in a "moon face" and central obesity. Treatment includes medications such as ketoconazole tablets, metyrapone capsules, and mitotane tablets as prescribed. In cases caused by tumors, adrenalectomy (removal of adrenal adenoma) may be required.

5. Mandibular Bone Hyperplasia

Long-term chewing of hard foods or joint wear can lead to excessive growth of the jawbone, increasing the size of the facial skeletal structure and possibly causing pain during chewing. Avoid biting hard items like nuts. Take celecoxib capsules as directed to relieve pain; in severe cases, corrective jaw surgery may be considered.

Maintain a balanced diet and limit high-calorie intake; adhere to regular sleep patterns and avoid staying up late, which accelerates aging; exercise moderately to maintain stable metabolism; and seek prompt medical attention if unusual facial enlargement occurs, so the underlying cause can be identified and properly treated.