How do I best address the loss of volume in my face? (Photo)

It is not unusual for volume loss to accelerate during perimenopause and menopause.  Our bodies slow down collagen production drastically. Based on your pictures, you can definitely use some volume replacement in the mid face region.  If mid face is corrected, up you may not require any fillers for lower face.  Voluma is a great product for a lift and to reduce jowls. It is also a great filler for cheek enhancement. But it is not the appropriate one for the tear trough area.  When I treat my patients, I prefer a filler such as Voluma to help lift.  But for longevity, I have been using Bellafill, a collagen filler which lasts closer to 5 years for cheeks and tear trough.   Realistically, you continue to lose volume everyday.  So the volume put in will stay put for "x" amounts of years based on product.  But because volume loss happens everyday, a touch up filler should still be considered periodically.    If you require 2-4 syringes up front, then you are looking at a cost of $1200-2200.     I hope that helps!

Once the mid cheek loses its round convex surface and it plateaus and then indents, even a little, light does not bounce off the cheek as much and this hollowness creates a dull appearance. As soon as Voluma,  fat injections, or Radiesse is injected and the apple of the cheek expands ever so slightly, the refreshed appearance is realized often. In fact, many times, the smile creases no longer concern the patient once they see the more "healthy and vibrant" face from having the cheek prominence improved.  ( I usually say that babies have deep smile folds but cherubic cheeks and no one says babies look old !) The cheek bone may need to be addressed in some patients which may help raise the jowl slightly. In other patients the smile folds, and marionette lines are treated along with the angles of the corners of their mouth.

The face will lose volume
overtime. The loss of volume will cause:1)Loss of height and definition in cheeks

2)Narrowing of the upper 1/3 of face

3)Decent of facial tissue

4)Irregularities of jawline

5)Thinning of lips

6)Change the overall balance of the face from and upside down
egg to an oval shape

The addition of volume is best used to restore the
balance, height and 3D definition to the face.
This is the true art of facial fillers.Volume can be added by 3 ways: 1)  Injectable fillers in the office 2)  Facial fat grafting 3)  Facial implantsEach of these options has their pros and cons.  Generally speaking, surgical options are more cost effective over the long term secondary to their longevity, but injectables are more affordable in the short term.  I hope this helps  

Great question and thanks for your pictures. You have volume loss in your cheeks and under eye area that has caused some sagging in your mid face. Replacing volume is the best option for you. Injectable fillers are what you will need and plan on using 2-4 syringes to achieve the best results- and the more you use, the longer the fillers should last- which is 1-2 years.  Voluma is great for the cheek areas to 'reinflate' them and I prefer belotero under the eyes. This combination of fillers will do the best. Other filler options include facial fat transfer- its a 'more permanent' option , however it does have more down time after.

Thank you for your question and for sharing your photographs.  When discussing non-surgical facial rejuvenation I recommend a top down approach, addressing the cheeks before the lower face.  When the cheeks are addressed the smile lines around the mouth, jowling, and lower eye areas can all be positively impacted.  As your pictures demonstrate mid-face/cheek descent Voluma can help lift this tissue supplying a good bang for the buck. Pricing will vary across the country, but anticipate 750-2000 depending on the amount used.  Be sure to see a board certified plastic surgeon in consultation. 

There are many tools in the toolbox to address aging of the face.  We lose volume because of loss of collagen and elastin as well as fat in superficial as well deeper compartments. I use combinations of fillers and or your own fat to address specific areas of the face that have seen volume disappear. Belotero is a great filler for superficial volume loss while Juvederm or Voluma can be used to address deeper volume loss.  Microfat graftingis an alternative to fillers with great longevity.  The key is to maintain a very natural appearance by choosing the right tool/s to maintain your best appearance.

I love Voluma for the cheek/mid-face area. It works extremely well and the results are long lasting, about 2 years. Also, lifting that area of the face has a beneficial effect on the under eye/tear trough area as well as the nasolabial folds. If you are looking to economize, I think this would be the right place to start.Kindly,Kouros Azar

I would definitely consider Voluma in the cheek area to replace lost volume.  It is an idea product and if you consult an expert you should have beautiful results.  Best, Dr. Green

Thanks your for your question and photoMidface volume loss is a common early sign gof aging and probably starts in our mid to late 30's. Fillers are a great option to address these changes and Volume is certainly a great choice. I would start of conservatively using 2 or 3 syringes and then re-evalaute in ~6 months to perhaps add more at that time. Subsequent treatments will get spread further apart as the products do build up and you get some collagen deposition as well. It looks like you could benefit from a small amount of filler, after the cheeks are reflated, in the nasolabioal folds. Juvederm plus or Restylane Lyft are both excellent products for this area.Often the changes under the eyes, in the tear trough area, can be improved with correction of the cheeks. If you don't feel this area has been improved enough then very conservative amounts of Restylane Silk can soften these changesBest of LuckDrG

Volume loss of the face can make a person look older than they would like, or even result in a tired appearance. Depending on the area of volume loss and patient preference, either Voluma, a long term but temporary filler, of structural fat grafting, a permanent solution can create a natural, youthful result. However, if over-filled, or placed in the wrong area, the result can look over filled and unnatural. Look for a plastic surgery practice that performs a lot of fat grafting and voluma treatments and has many examples of their results.