Facial Volume Loss

• Temporal-hollowing: The temples are an often overlooked area of facial volume loss. They are a common site for hollowing which is particularly ageing and which can be remedied by dermal filler or fat transfer.
• Hollowing above the Eyes: The area above the eyes can appear sunken, often leading to deep grooves and an outlining of the eye socket. This is typically due to the loss of fat in this delicate area.
• Flattened Cheeks: Loss of fat and resorption of bone in the cheek area can cause them to look flat or sunken, impacting the overall facial contours and leading to a less youthful appearance. This also has a knock-on effect on the lower eyelid contour and appearance, hence why volume addition in the cheek is often used in conjunction with lower eyelid surgery to improve the contour and appearance of the midface.
• Thinning of the Lips: Lips may lose their fullness, making them appear thinner and less defined. This can also lead to the development of fine lines around the mouth, often referred to as “lipstick lines.”
• Sagging Skin: Reduction in volume can lead to sagging or loose skin, particularly noticeable around the jawline and neck area, contributing to the appearance of jowls and a double chin.
• Nasolabial Folds: Deepening of the lines that run from the nose to the corners of the mouth, often becoming more pronounced with volume loss and age – due to a combination of drooping of the medial cheek which creates a shelf over the nasolabial fold, making for a deeper groove, and a loss of bone in the area which allows the issues in this area to sink further.

Overall, weight loss tends to have a slimming effect on the face, which can exacerbate these features, especially with age, where the skin has lost elasticity and may not retract as much as it would do in youth.

It’s important to note that while some individuals aim to lose facial fat for a more sculpted look, excessive loss can lead to a gaunt appearance. Maintaining a healthy weight and balanced diet can help manage these changes, while treatments such as facial fillers and fat grafting can restore lost volume and enhance facial features.

There are various treatments available to address facial volume loss. Here is an overview of common treatments, including non-surgical and surgical options.

Non-Surgical Treatments: Facial Fillers

Dermal Fillers: Injectable fillers can restore lost volume in many areas of the face. The commonest being the cheeks, lips, and temples. These fillers are often composed of hyaluronic acid, a natural substance found in the skin that helps maintain hydration and elasticity. By replenishing this essential component, dermal fillers can effectively smooth out wrinkles and enhance facial contours, providing a more youthful and rejuvenated appearance. Other types of filler exist that can help with volume boosting and these include poly-L Lactic acid filler e.g. Sculptura and Calcium Hydroxyapatite based fillers. These fillers whilst effect have the drawback of not being dissolvable in the event of a complication, unlike the hyaluronic acid based fillers and tend to persist in the deeper tissues.

Surgical Treatments:

Fat Transfer: Fat is harvested from another part of the patient’s body using liposuction through a fine cannula that enters the body through an incision of several millimeters in size. It is then processed gently to make it smooth and injected into the face to restore volume. This technique utilizes the patient’s own fat cells, providing a natural and biocompatible solution for facial rejuvenation. Fat transfer can effectively address hollow areas, enhance facial contours, and improves skin texture, offering a comprehensive approach to facial volume enhancement.