Loss of Volume

Written by: Alice Hart-Davis

Last Updated: 22 September 2023

When we are young our skin is plump and our cheekbones are more defined and sculpted but, as we age, we begin to lose volume in our face. This is due to a number of factors. Not only do the levels of hyaluronic acid and collagen in our skin deplete with age, but gravity also takes its toll and our underlying support structures, such as fat pads under the eyes and in the mid face, start to head south. Our bone structure also changes as we age and we get bone resorption, which means our scaffolding is not as strong as it once was. Scroll down for answers to all the FAQs about loss of volume.

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FAQ ABOUT Loss of Volume

Where has the volume in my face gone?

When we are young our skin is plump and our cheekbones are more defined and sculpted but, as we age, we begin to lose volume in our face. This is due to a number of factors. Not only do the levels of hyaluronic acid and collagen in our skin deplete with age, but gravity also takes its toll and our underlying support structures, such as fat pads under the eyes and in the mid face, start to head south. Our bone structure also changes as we age and we get bone resorption, which means our scaffolding is not as strong as it once was.

What causes lack of volume in the face?

Lack of volume in the face is a natural part of the ageing process but it can be accelerated due to lifestyle factors which prematurely age us, such as alcohol consumption, stress, smoking and sun damage. Volume loss can also be exasperated by weight loss as we get older and of course can be the result of illness, drugs and medication. Recently exercise has also been cited as a cause of volume loss with the term “runner’s face” or “gym face” being coined to describe the hollow looking faces of those who hit the gym hard. Continuous high-impact training can lead to loss of volume and sagging of the skin as well as increased oxidative stress and increased production of free radicals, which in turn causes breakdown of collagen and elastin.

Is it only ageing that causes lack of volume in the face?

Ageing and weight loss are the major contributing factors to volume loss in the face but the two in combination are most likely to make the face look more hollow and gaunt. Friend’s star Courtney Cox once famously said that as you get older you have to “choose your battles”, either your face or your body, and there’s an element of truth in that. Someone who is heavier weight wise may still have a plumper and more full face as they age, whereas someone who is very slim would not have as much fat in their face to begin with so the ageing process would only highlight that.

Can skincare increase volume in the face?

Skincare is primarily designed to treat the canvas, the quality of your skin. Although active and results-driven products can and do work at deeper levels, skincare alone will not replace lost volume but can be used in combination with other tweakments to enhance results and improve the appearance of your skin.

How to I prevent losing the volume in my face and sagging?

Volume loss and skin sagging are natural parts of the ageing process, but there are things you can do to slow premature ageing down. Some of the biggest contributing factors to ageing before your time are sun damage, smoking, stress and alcohol consumption. Wearing daily SPF protects your skin from sun damage. Antioxidants also help provide additional protection against free radical damage, which can accelerate the ageing process. Following a healthy balanced diet and looking after yourself won’t prevent ageing but the healthier you are and the less bad habits you have can make a difference. Dramatic weight loss and yo-yo dieting can also play a part, so maintaining a healthy weight will benefit your face too.

How can I treat loss of volume?

One of the most popular and effective treatments for volume loss is dermal fillers. They can be used to re-build the facial structure, offering more support for the skin, restoring not only plumpness but a lift too. Aside from lips, cheeks are one of the most commonly treated areas with dermal fillers. They can also be used to replace lost volume under the eyes which causes a hollow appearance, known as a tear trough. Most fillers used today are non-permanent and are made from hyaluronic acid, a naturally occurring substance in the body. In order to provide lasting results (anywhere from six to 24 months), the hyaluronic acid is cross linked. Volumising fillers are usually thicker or more viscous products than those used in the lips and there are many different varieties and brands.

Other treatments used to replace lost volume include those which come under the category of “regenerative treatments”. These encourage the body to make new collagen and replenish hyaluronic acid levels itself. Treatments in this category include PRP (platelet rich plasma), fat transfer and also “bio-remodelling” products such as Profhilo.

New collagen can also be stimulated using devices which work at a deep level within the skin. These include technologies such as high-intensity focused ultrasound or HIFU.

How to restore volume to your face naturally?

It is difficult to replace lost volume naturally. Volume loss is mainly due to a loss of fat in the face so gaining a little weight as you age may help your face appear plumper again, however, as most people are trying to lose weight (not put it on) this is not an option that appeals to many. And there’s health issues to take into consideration if you gain too much weight. If you are looking for a more natural option and don’t want to have dermal fillers, then some of the bioregenerative procedures which use your own cells to stimulate new collagen may help.


Alice answers your question. Want to ask Alice a question? Pop it in here and check back in a few days for the answer.

What do you think about HArmonyCA?

It's fascinating – a new type of filler that's a hybrid between a class hyaluronic-acid filler that provides soft volume, and an ingredient that stimulates the face to make more of its own collagen, and improves the skin at the same time. I've had a couple of rounds of it in my face and it is sitting very nicely and softening out hollow bits in my lower cheeks.

Tweakments post-treatment for breast cancer – at 58, I've been lucky that, due to good genes and looking after my skin, I've only needed toxin and cheek fillers every 12-18 months. Now I've lost volume to my face, my jaw is sagging and I've...

Hiya, TTG editor Georgia here. First, make sure you have clearance from your oncologist for injectables and energy-based devices, and following that, ensure that the practitioner(s) you're considering for treatment have your full, up-to-date medical history from the get-go. Providing you get the go-ahead, something like ultrasound could indeed be a good bet to tighten up your jawline – look into Sofwave as well as Ultherapy. The under-eye bags are tricker to treat because it depends what's causing them – if it's fluid retention, sagging skin or a result of the fat pads slipping down under the eyes. A practitioner experienced in treating...

I’m 38 and still get acne on my cheeks but skin also dry and sensitive skin, and I can see the ageing… I use ZO end to end but not sure it’s the answer, plus it’s very £££. I looked at your Acne Fixers Bundle but how do I also tackle...

Dry and sensitive skin suggests that your skin barrier isn't in great shape. Work on this by focussing on gentle, hydrating products – a hyaluronic acid serum, sealed in with a moisturiser and, in the morning, topped with sunscreen. Once your skin is feeling stronger and more comfortable, start using a product with retinol or another retinoid (start slowly, with tiny amounts and twice a week at first) to help with acne management. Taking lots of omega-3 supplements can really help with skin hydration and skin quality, too. These are my current favourites....

Hi Alice, can dermal fillers yield as good a result as threading or would I best to bite the bullet and go with the latter? I am unhappy with my sagging face and the pronounced nose-to-mouth lines as well as loss of volume in my cheeks and jawline....

You need to get your face in front of a great practitioner who can offer both fillers and threads and ask their opinion – they will probably suggest that you have threads and see how much difference that makes, and then perhaps use filler to add in any extra volume that would benefit your face after that.

Hello, I am 48 and really starting to look old, especially when I look at photos. What do you recommend as the most effective way to look fresher and better without toxin or filler? Is it HIFU or profound or another treatment? Or would I really need...

Hiya, TTG editor Georgia here. Dr Strawford will be best placed to answer all these questions for you once he's assessed your face and talked to you about your exact concerns. He is an expert practitioner with a great deal of experience. The tweakments you mention – HIFU, Profound (RF microneedling), toxin, and filler – all do different things that work towards making you look fresher and younger, but not in the same ways. Toxin for example won’t do anything about sagging skin but HIFU will, Profound will stimulate collagen production to tighten and plump the skin, but won’t replace lost volume in the ways filler will. So it all...

Hi Alice, I am 35 and have a 2-year-old child. I really feel like having a baby has aged me and want to look rejuvenated. I already have toxin and don’t want to alter my face contours with filler. What would you recommend?

Congrats, I bet your toddler is fab but I know what you mean. I'm tempted to say that you should start with a bit more sleep and time to yourself but suspect that you know that already, and those things are hard to do when you have a 2-y-o. What about an injectable moisturiser treatment which helps to remodel skin from the inside, and is great for skin that's beginning to lose its mojo? Also, ask your practitioner what they'd suggest, as they know your face already and may have some ideas.

Hi Alice. Pls can you recommend one of the practitioners in the NW who can offer great toxins and filler treatment? I can’t waste money trying them all and don’t know who to go with. 56, wrinkles, muscle loss and scarring.

Hi, take a look at the Practitioner Finder - if you put in your postcode, it will come up with a selection of my trusted practitioners who are closest to you, and show you the treatments they offer.

Hi Alice, I've just watched your video on Secret RF. I'm having the treatment in a few weeks. Did you think it's worth the money for the results seen? Thank you.

I only had one round of Secret RF when filming it (at my age, I'd need about three sessions to see proper results) so I only saw a bit of skin-smoothing. But I know from practitioners who have the device that they absolutely love it for the results it gives, so yes, I'd recommend it.

Sofwave vs Ultherapy – what are your thoughts? I am 56 and looking at trying to refresh my skin.

Sofwave sounds really interesting. Rather than focusing ultrasound energy to a point like Ultherapy does (which creates tiny hotspots), it uses something called parallel beam technology to heat the deeper layers of the skin and I'm told it can't 'melt' fat in the face in the way that Ultherapy is often accused of doing. I've tried Ultherapy three times in the past decade and had good results from it – I've not tried Sofwave yet but I'm sure I will in due course.

I’m 56 years old – post-menopausal. My skin is ageing – fine lines, wrinkles and loss of volume. Bit nervous of treatments. Injectable moisturisers or radiofrequency? Any advice please.

Well, it slightly depends what result you're after. Injectable moisture treatments are great for hydrating and re-conditioning the skin and will give a certain amount of smoothing and a bit of tightening. They cost around £400 a session and you'll need two or three of them to see a result – click here to read our detailed article on the cost of these treatments. RF microneedling is better for skin tightening and smoothing – it's a much more aggressive procedure that provokes wound-healing and remodelling of the collagen over the following three months – and it's much more expensive, it costs between £850 and £1,500 per session, and...

Hi! I would like to ask what treatment is the best for cheeks? I am 52 and I want my face to look younger.

Hi, probably carefully placed dermal filler. Find a brilliant practitioner, book in for a consultation and see what they suggest once they've had a good look at your face.

I am looking for a device to tighten and lift my skin for my face and body. I have Profhilo, toxin and fillers and was wondering which of the following would work best for me: Lyma, Wellbox or Dermalux Flex? Does the Dermalux tighten and lift? I am...

I hate to say it but none of those will give you noticeable lift and tightening. The Lyma is highly unlikely to achieve anything, it doesn't have the power. I don't know the Wellbox. I love the Dermalux – it's a medically-certified device – and while this will help a lot with the condition of your skin, helping it regenerate from the inside and become stronger and better hydrated, reducing redness and helping pigmentation a little, your skin will look younger and smoother, but it doesn't make any claims for tightening and lifting. In-clinic treatment with something like radiofrequency microneedling is a better bet – find a great...

At 53 years old I hate the way my face is losing its 'scaffolding' and the lack of firmness around my jawline. I have had numerous Profhilo treatments and more recently 3 sessions of Morpheus8, but I can't see an improvement. What do you suggest?

I know what you mean about losing the 'scaffolding' in the face – that is exactly what's happening thanks to bone resorption all over the skull. It's like our skull is being sanded down on the inside. Those treatments that you've had WILL have helped – the Profhilo will have improved your skin condition and the Morpheus8 will have helped smooth and tighten your skin. What I'd suggest, if your practitioner thinks it's a good idea, is some careful work with filler along your jawline and in your chin, and maybe in your cheeks, to strengthen that internal scaffolding and redefine your contours....

Hi Alice. I know this isn’t a tweakments question, but could you recommend a good face & neck surgeon. I’m 64 and have used many tweakments but I have volume loss & laxity in my face and neck and I feel this is the only option left.

Hi, I'd suggest a consultation with Rajiv Grover who's an outstanding facial plastic surgeon, and see what he suggests.

How do I lessen the appearance of hollow cheeks and sagging jowls without fillers, please?

You could try a skin-tightening treatment like radiofrequency microneedling or laser. How much of an improvement you might get in terms of skin-tightening depends on what sort of shape your skin is in at the moment. Unfortunately nothing except filler is going to replace lost volume in the cheeks. I understand why you might not be keen to try it, but honestly, in the right hands – like those of the practitioners on this site – you could get some lovely, subtle and appropriate results.  ...

I’m 49 with not many wrinkles but noticing a lack of firmness in my lower cheek and around my eyes. What treatment will give a great result but without losing fat?

Hi, I'd try radiofrequency microneedling which is great for smoothing, strengthening and tightening the skin, particularly in those areas.

What can help with plumping my mid face? My cheekbones are quite high but they look hollow underneath as I'm getting older (57)

Filler! Specifically, just some 'soft' (as in small amounts, thoughtfully placed) filler at the sides of the face beneath the cheekbones, just to soften that gaunt, angular look. Find a great practitioner on our practitioner finder and see what they can do for you.

What is the most effective filler for a 63 year old with a thin face and thin skin?

Hiya, editor Georgia here answering on Alice's behalf. One filler isn't necessarily more 'effective' than another. Each brand will have a range of filler products in its line that are better suited to various indications depending on their composition – like the lips vs. the jawline, for example – but what's best for your own face is impossible to say for anyone other than the practitioner assessing you. Use our practitioner finder to find a brilliant injector near you, and set up a consultation. They may even recommend a treatment other than filler. This is the only way to find out what will be most effective for your concerns....

I'm 57 with thin, dull skin, dark circles/ hollow under eyes, lack volume. What do you suggest please? 🙏

Hi, I'd suggest starting with some great skincare to address the quality of your skin and get it looking a bit fresher and livelier. Take a look at some of the products in the TTG shop eg this radiance-boosting bundle - there are videos explaining what the products do and why I rate them. It's worth considering hormone replacement treatment (start with your GP). Losing oestrogen as we go through the menopause wreaks havoc on the skin (as well as on our moods, joints, sleep etc) and replacing it helps the skin to function so much better and to regain a good deal of its strength, bounce and hydration. Re dark hollows under your eyes and...


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