Facial Volume Loss, Folds and Saggy Skin

What is loss of face volume?

Aging of the face is characterized by three principal changes, loss of volume of the fat and soft tissues in the face, gravitational descent of facial soft tissues and laxity of the skin. Key to natural looking results is an artistic and anatomical understanding of these three elements so the elements of the facial aging can be both restored to their previous appearance.

Younger faces have full volume due to the size and location of the facial fat pads. As we age, our faces lose their fullness because of thinning of the skin, loss of elasticity and shrinking of the fat. This loss of face volume results in the appearance of lines, wrinkles and sagging of the face. Genetics and environmental factors also play a role.

What causes loss of face volume?

The main cause of facial volume loss is aging. Over time, our body produces less collagen, elastin and the fat pads in the face reduce in size. This results in thinner and less elastic skin as well as sagging of the face. Similarly, changes in hormonal profile, in particular, estrogen, can help accelerate this process. Lifestyle factors such as smoking and sun damage also contribute to skin aging as well as loss of facial volume.

How does losing volume affect the appearance of your face?

Loss of skin volume leads to thinner and less elastic skin. This gives rise to wrinkles and uneven texture. At the same time, reduction in the volume of the fat pads, as well as their descent with gravity, occurs. This gives rise to a flatter profile and sagging of the skin in the mid and lower face. Hence this can lead to older appearance, this loss of facial fat volume gives rise to tear trough deformities, hollowing of the temples, malar flattening smile and marionette lines and saggy jawline.

How to add and restore volume to your face naturally

In my opinion a combination of dermal fillers or fat transfer with PDO threads are highly effective for restoring facial volume. This is because they can replace lost volume, help firm up and lift skin, smooth wrinkles and deliver natural looking results. How much, which type of filler and where to pace the PDO threads depends on the degree of facial volume loss and your overall face shape. This is a general approach to restore facial volume loss:

  • Juvederm Voluma or Restyling Lift for contouring and midface lifting.
  • Tear drop dermal filler for under eye circles and shadows.
  • Restoration of lip shape, definition and volume with dermal fillers.
  • Sagging skin, smile and marionette lines and saggy jawline lift with PDO threads. PDO threads allow Dr. Manrique to reposition the fat pads and use less amount of fillers.
  • Fat transfer can be done in all areas in the face.

Additionally, face fillers can be combined with Botox as part of Dr. Manrique artistic liquid facelift to refresh and smooth the face. Micro-needling  can also boost the effects of dermal fillers by inducing elastin and collagen formation for thicker and plumper skin.

When fat transfer is performed, a combination with PRP provides a longer lasting result.

By Dr. Liliana Manrique