Volume loss - Best type of filler and filler placement? (Photos)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. Thank you for your thoughtful message—it's very common to notice subtle but impactful changes in facial volume and structure over time, especially when comparing photos from several years ago. At 49, even with minimal weight change, natural aging processes like fat pad descent, bone resorption, and collagen loss become more apparent. From what you've described, volume loss in the upper cheeks is a key contributor to a more aged appearance. When the cheekbones lose support, it can cause a cascade effect—flattening of the midface, deepening of the nasolabial folds, and even subtle sagging around the mouth or jawline. You also mentioned possible volume loss around the mid-lower lip, which may relate to thinning of the lips themselves or loss of support in the chin or perioral area, leading to a more tired or deflated look. For restoring a more youthful balance, cheek filler using a structured, lifting product like Voluma or Restylane Contour can be very effective in replenishing midface volume and subtly lifting the lower face. If lip volume or mouth area support is lacking, a small amount of filler in the vermillion border or oral commissures (corners of the mouth) using a softer filler like Restylane Kysse can help restore shape and definition without looking overdone. Since you’ve had filler in the past and responded well, a conservative approach focusing on structural support and natural contouring can help you regain that refreshed, youthful appearance you saw in the older photos. I hope this helps and best of luck!

Age related fat loss can cause our faces to look older. A great tool to combat this is fillers. Renuva is a filler that is specifically designed to address age related fat loss. It is similar to traditional HA fillers in that you will see some improvement immediately. It differs though in that over time the product is replaced by your own fat. This gives longer lasting results. See my website or a provider near you to learn more.

To address volume loss and achieve a more youthful appearance, fillers can be a highly effective solution. Here are some considerations for filler types and placement:

Upper Cheeks: Volume loss in the upper cheeks is common with aging and can lead to a tired appearance. Hyaluronic acid-based fillers like Juvederm Voluma or Restylane Lyft are excellent choices for restoring volume and contouring the cheeks, providing a lifted and rejuvenated look.

Mid-Face: If there is volume loss in the mid-face region, strategically placing fillers here can help enhance facial balance and smooth transitions between facial zones.

Lower Face and Lips: For the lower face and lips, fillers such as Juvederm Ultra or Restylane Kysse can add volume to the lips and address any perioral lines, resulting in a fuller and more youthful appearance.

Considerations: It's important to choose fillers based on their specific properties, such as viscosity and longevity, to match the treatment area and desired outcome. Consulting with a qualified practitioner will help determine the best approach for your individual needs.

Overall, a personalized treatment plan that targets specific areas of volume loss can effectively restore a youthful appearance and enhance facial harmony.

The reason your face looks younger from your earlier days is because the face was considerably fuller, even though you may have been at the same weight. Patients who have been at the same way throughout their lifetime benefit the most from having fat grafting done to their face. It does not mean that the fat has to go to your cheek alone, because then you will look almost alien like. The fat has to go almost everywhere: your eye brow, upper eyelids, lower eyelids, temples, forehead, and all that fat needs to be spread out throughout your face and jawline in order to match your younger appearance. When properly done the procedure of facial rejuvenation, using fat grafting produces natural and permanent results. The amount of fat does not have to be large, but it can easily be estimated by a specialist. I hope this helps and good luck from Leonard Grossman, MD, organic Plastic Surgery NYC.