What can I do about volume loss in my face? I have great skin with no blemishes but volume loss is aging & depressing me (Photo)

Volume loss that comes with the passage of time plays a very prominent role in facial aging. The robust, heart-shaped, convex fat pad of youth that sweeps from the cheekbone toward the bridge of the nose and half-way downward toward the angles of the mouth, shrinks and shrivels with time and falls downward and inward to give rise to the development of deep smile lines, marionette lines, jowls along the jawline and hollow, dark circles under the eyes--much of what is evident in the photos provided.  And the reason that smiling improves the condition is because the descended remnants of the fat pads are pushed upward to fill the voids left by their downward descent.Since volume loss is at the root of the problem, volume repletion is the simple, fast, logical approach to achieving nearly instant "Wow!" improvement. One such approach is known as The Nonsurgical 3D Vectoring Facelift, in which volume is restored to the face in order to restore proper contour and lift, projection, light reflection, etc. Voluma XC, Radiesse Plus, and Restylane Lyft are my injectable volumizers of choice for facial vectoring and contouring in my Upper East Side Manhattan practice. In my Israel satellite facility, where a far greater number of regulatory agency approved volumizers are available, I typically opt for Stylage XXL, Emervel Volume and Hyaluronica 2 for these purposes.Consultation with a board certified aesthetic physician with advanced skills and expertise in nonsurgical facial shaping and contouring is a must. Make sure to ask to see his/her before and after photos.

Hello BreezyBlue, 
The best way to answer your questions is, I would recommend that you set up a consult with a Board Certified Plastic Surgeon. Can dermal fillers be used? Absolutely, but how much and will it achieve the aesthetically appealing results that you are hoping for? The Dernal fillers do not address the Laxity of the skin or the Platysmal muscle of th neck, or the laxity of the jowls and only surgery can help. It's always worth setting up a consultation with a Board Certified Plastic Surgeon who can address your concerns and talk about the varies surgical procedures they have to offer from Rhytidectomy, Platysmaplasty, J-Plasma, etc. I hope this helps and best of luck! 

There are multiple approaches to address volume loss of your face that include injectable fillers, tightening devices and lasers, as well as surgery. You might find that fillers might be the easiest, more instant way of addressing your face in the least invasive manner. Expect the need for multiple syringes which is sometimes referred to "global fillers" or "liquid facelift". Often we utilize combination approach with fillers to mid and lower face, followed by tightening procedures (such as ultherapy) before we move on to the more invasive face lift indication. 

Please consult a plastic surgeon who also offers fillers and Sculptra.  You would benefit from lifting and then replacing volume and will need a combination of treatments.

Hi, I have performed facelifts for over 30 years.  From the photos your cheeks are flat anteriorly (in the front) with excess fat below and in front of the cheeks as well as under the chin.  There is excess skin and lax tissue creating nasolabial folds and jowls.  These combine to create a rectangular shaped face. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.   Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  If you have "jowls" this is sagging facial tissues and an indication for some form of a facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:very small incisionsminimal tissue dissection = less bruising and swelling = rapid recoverycan be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-op I combine whatever facial shaping that's necessary with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.Hope this helps.

Volume loss is part of the aging process. The face can be augmented using the patients own fat or fillers such as Voluma.  In patients where there is excessive lax skin in addition to to the loss of normal contour a face lift can be done in conjunction with injections.