Practicing Safe Aesthetic Medicine

Facial Volume Loss – Causes and Treatments

There are numerous factors which contribute towards our process of ageing. These include intrinsic factors like our genetics and extrinsic factors such as our surrounding environment and our way of living. With the passage of time, the effects of ageing starts becoming prominent in the form of facial volume loss, lines, wrinkles and loss of natural glow and density. As a result of facial volume loss, the shape and structure of the face is altered. It contributes towards the sagging skin, loss of facial contours and a ‘drawn’ profile.

The Inverted triangle of Youth

The highlighting features of a youthful facial appearance are high cheek bones with smooth and lean skin and a contoured jawline. It is also referred to as ‘triangle of youth’ which is wider from the top and become narrow at the bottom. With ageing, this triangle of youth becomes inverted with a loose, sagging facial skin and jawline and flatter cheeks. The corners of the mouth turn downwards, giving a heavier and somewhat sad or stressed appearance to the face with deep wrinkles and lines.

These changes are caused due to the progressive decrease in the production of plumping and filling matter within the skin that is responsible for giving a firm, plump and smooth look to the skin. The production of hyaluronic acid within the skin decreases, the skin starts to appear rough and dry and wrinkles and fine lines appear. The production of collagen and elastin inside the skin also decline, causing sagging skin with loss of elasticity. The flow of blood to the skin become restricted which gives rise to a colourless and dehydrated profile that lack youthful glow and density.

Facial Volume Loss

Factors Contributing to Facial Volume Loss

Intrinsic factors

  • Genetic factors
  • Hormonal changes: as we age, the levels of oestrogen decline causing thin and dry skin.

Extrinsic factors

  • Exposure to sun
  • Smoking: the nicotine and other chemicals in cigarettes cause degradation of collagen within the skin.

Peptides: Matrixyl stimulates the production of collagen that helps in creating a firm skin structure.

Vitamin C: it protects the skin from damage by free radicals.

Hyaluronic acid: it is an oxidant which helps skin in water retention and plumps it.

Alpha Hydroxy Acids: these acids improve the dermal thickness of skin while stimulating production of collagen and hyaluronic acid.

Vitamin A Products: these improve the turnover of cells giving smoothness and even tone to the skin. They also stimulate the collagen production while reducing the elastin breakdown while giving thickness to the dermis.

Dermal fillers are meant for restoring the deep facial volume loss and for enhancing the facial silhouettes. There is large variety of dermal fillers are now available including hyaluronic acid and radiesse fillers. These fillers can help in filling up the flattened cheeks, temples while restoring the facial contours and helps in lifting up the facial sagging in the lower part of the face. Dermal fillers such as hyaluronic acid and radiesse are often utilized for plumping the facial grooves appearing around the corners of the mouth. They also help in restoring the chin definition and flabby lips.

This is relatively new and innovative treatment which makes use of absorbable Polydioxane (PDO) threads for improving the volume of skin and promoting production of natural collagen within the skin through a process called ‘mechanotransduction’. The PDO threads are available in different sizes and are positioned within the skin using very fine small needles. These are the similar threads which are used in various surgical operations by the surgeons on daily basis, all across the world.

For creating a lifting effect, longer threads with hooks can be used in the similar manner as it is done in the non-surgical PDO facelift treatment. PDO threads absorb in skin in a period of almost 6 months but their effects are long lasting.

Side Effects

The side effects of facial volume loss treatments vary with the type of treatment you are receiving. In the case of dermal fillers treatment, the possible yet temporary side effects can be bruising, swelling, redness or itching at the site of treatment. In case of PDO threads, there can be slight swelling, bruising, tenderness and numbness with slight facial asymmetry but these are temporary conditions and disappear in few days or in a week.


There is no downtime associated with the cosmeceuticals medications and dermal fillers treatment. Patients can immediately resume their daily routine life after the treatment. In case of PDO threads, there can be little to no downtime. In some rare cases, the patient may need to take off from work for 1-2 days otherwise normal routine activities can be resumed after receiving the treatment.


The cost of facial volume loss treatments vary from treatment to treatment. It depends on which treatment you want to receive. For details about prices you can check our ‘Price’ tab or can directly contact us for details.

You can clearly observe the effects of different facial volume loss treatments after receiving the treatments. The before pictures show sagging, dull, flattened and thin skin with hallowing around the eyes. The after treatment pictures show the fuller, plumper, tightened and rejuvenated skin.

The primary cause of facial volume loss is the process of ageing and genetics. Other contributing factors include stress, lifestyle, traumas and use of certain medications that contribute towards accelerating the process. Intense and frequent dieting can also cause the loss of facial volume.

With the depletion of facial fat and collagen, fine lines and wrinkles start to form. Other signs of loss of facial volume include loos and sagging facial skin and jaw line, flattening of cheeks, hallowing around eye sockets, fine lines appearing around the nose and nasolabial folds.

This varies from individual to individual however generally the process initiates when the individual is in 20s. This is the point when the natural skin support starts to break down, resulting in the gradual loss of volume in the facial areas such as temples, cheeks, jawline, forehead and eye sockets. As we age, this process accelerates or it can also be influenced by other contributing factors like behavioural and environmental factors.

The dermal fillers treatment for facial volume loss can be slightly painful but usually numbing cream is used to numb the area. PDO threadlift treatment can cause slight discomfort and pain with swelling and bruising but these are temporary conditions and vanish in few days.

It depends largely on your age and extent of facial volume loss. For the patients in their 20s and early 30s prescription and cosmeceuticals medications along with dermal fillers can effectively treat facial volume loss while for patients in their late 30s and 40s PDO threadlift is a better option.


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