Loss of volume is arguably the key cause of visible facial ageing. We lose volume not only in the dermis, but also in fats and even bone. Facial fats tend to shrink as collagen and elastin production declines with age. Muscle weakens as our hormones decline with age. Surprisingly, the size and weight of your actual skull declines with time as well. Even if the skin didn’t become more lax with time, shrinkage of the underlying structures would result in a sagging of the face. A useful analogy is a table with a table cloth. If you have a table cloth on top of a table, and that table suddenly is small, the table cloth will drape further down the side. Your facial fats, muscle and bone at the table, and since they shrink the table cloth (i.e. your skin) begins to sag. This is compounded by the fact that skin also becomes most lax over time. So not only do you have a small table, but you also have a larger table cloth!
This volume loss transforms the youthful, bouncy face to one that is lean and somewhat drawn and haggard. Due to the lack of volume below the superficial layers of the skin and the descent of the internal fat pads, the lower half of the face adopts a heavy appearance. While spot treatments such as cheek enhancement, temple enhancement, eyebrow augmentation, tear trough treatment, etc. can help, a more holistic view should be taken to achieve an optimal facial rejuvenation.
Experienced clinical specialists can go ‘off-piste’ from traditional spot treatments, and restore volume to other areas using bespoke, non-standard yet safe volume replacement treatments. This is where the decades of experience, skill and artistic flair are necessary to achieve world class rejuvenation with natural looking results.