DR. Wafaa Clinic

loss of volume

-What constitutes loss of volume? When we’re young, we have plump skin and defined, sculpted cheeks. But ageing brings about a loss of volume in our faces, and this happens for a whole bunch of reasons. For one thing, there’s a decrease in our skin’s supplies of collagen and hyaluronic acid, so our skin becomes less firm and plump, and for another, gravity takes its toll, and for a third, the fat pads that sit under our skin, beneath our eyes and across our cheeks and give the face its structure, start to head for the floor. Our bone structure changes too - our bones are gradually resorbed, meaning that our face’s scaffolding is no longer as strong and defined as it once was. Put together, that means we get a loss of volume - of plump softness - in the face, which is made worse by the way we are also losing bone. It’s a bit like when a balloon that used to be blown up full and tight begins to lose air and shrink and lose its shape.
While it is totally natural to lose volume in the face as we age, there are certain lifestyle factors which can prematurely age us and accelerate this loss of volume. These include smoking, stress, drinking alcohol and sun damage. Losing weight also reduces the volume we have in our face, and there are many reasons we might lose weight that aren’t just exercise and diet-related - we may lose weight because of illness, medication or drug use. In terms of exercise, continuous high-impact training has been found to lead to both loss of volume and skin sagging as well as higher levels of oxidative stress and free radicals (and these two things break down the collagen and elastin structural proteins) in the skin, making the skin weak and prone to sagging and wrinkling. Not that exercise is a bad thing, but if you exercise a great deal your whole body is likely to be leaner and so will your face, and that leanness will show more the older you become. Someone who is on the heavier side may well have a fuller face as they age, whereas someone who is particularly slim will have less fat in the face and therefore look much more gaunt as they age.

While losing volume in your face and your skin sagging as a result of this are completely natural parts of the ageing process, you can slow down the rate at which these happen prematurely. As mentioned above, various lifestyle factors contribute to loss of volume, so you can work on these. We are not recommending stopping exercising because it’s so good for you and important to all-round health, but what are recommending is stopping smoking, drinking less alcohol, protecting yourself from the sun (by both covering up and wearing a high-factor sunscreen) and trying to minimise stress in your life (easier said than done, I know). Getting enough sleep helps with everything. In addition, looking after yourself in general with a healthy, balanced diet won’t stop you from ageing, but the healthier you are the more of a difference it makes to your outward appearance too. It’s also important to maintain a healthy weight because dramatic weight loss resulting from yo-yo dieting can contribute to a loss of volume in the face.

No skincare product is going to help prevent, let alone treat, volume loss in the face. Sorry, but it won’t. Wearing SPF daily is a good habit. It won’t stop fat or bone loss from the face, but it will keep your skin healthier and in better condition as it prevents the age-accelerating damage done by UV light.

Dermal fillers are one of the best treatments for volume loss, and they’re very popular. While lips are one of the most common areas to be treated, cheeks are commonly lifted up and out with filler too, as the filler restores the facial contours - it can be placed deep, to enhance the structure of the cheeks, and also used more superficially, to replace the soft volume that gets stripped from the face with age. Fillers can also be used to rebuild volume in the tear trough under hollow-seeming eyes which result from the fat pads in these areas shrinking with age - if you’re an appropriate candidate (if you have puffy eyes, for instance, it’s not a good idea to have fillers around the eyes).
Most fillers are made from a substance that is found naturally in the body, called hyaluronic acid. It’s deeply hydrating, so you might also recognise it as the primary active ingredient in hydrating serums. But in the case of fillers, its molecules are ‘cross-linked’ into a gel, which means that it hangs around in the body for much longer (six to twenty-four months, depending on its consistency) before it gets broken down. There are different thicknesses and fluidities of filler depending on where in the face they’re going to be used - volumising fillers are usually thicker and more viscous. Other fillers like Sculptra and Ellanse are made with ingredients that stimulate the growth of our own collagen, to help rebuild volume in the face.

You can also treat a hollow face with treatments such as PRP (platelet-rich plasma). This is one of a number of ‘regenerative treatments’, named because they encourage the body to build its own new collagen and replenish its own hyaluronic acid levels.
Regenerative treatments also include fat transfer, where fat extracted from the tummy or the thighs is reinjected in the face as a kind of filler, which can be enhanced with the addition of a ‘stromal vascular fraction’, a ‘soup’ of skin-stimulating elements like growth factors and cytokines that have been extracted from a person’s own fat, or ‘nano fat’, which is a finely processed reduction of extracted fat that is somewhere between the two.
These are all different from ‘bio- remodelling products’ such as the injectable moisture treatments (Profhilo, Volite, Skinboosters,
7Belotero Revive etc) which all encourage the skin to become fresher, tighter and stronger, but they don’t actually increase volume in the face at all.

If you want to know more You can book a comprehensive consultation with Dr Wafaa El Mouhebb at our Clinic in Reading to discuss your concern and explore the different approach of treatment

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