Certain areas of the face are prone to fat loss—others are not. The cheeks and eyes frequently fall victim to the effects of volume loss first; the lips, eyes and temples eventually catch up.
Around the Upper + Lower Eye Sockets
The majority of fat in the face is in the cheeks, and as these pockets deflate, a depression forms from the inner corner of the eyes straight downward (called a tear trough or hollow). The appearance of hollows is related to loss of fat and bone expansion. Since the same amount of tissue is occupying a larger volume, the result is that the eyes look hollow. Sometimes, the fat protrudes, creating a bag. Adding a hyaluronic acid filler or fat restores volume, making the eyes the focus of the face.
Around the Brows
A loss of fat and fullness in the brows coupled with lines and wrinkles between the brows and on the forehead can create a saggy brow and hooding on the upper lids. Fillers and fat are the most common ways to fix the problem. Just a little bit of volume (using a filler like Restylane) helps, and it is even more dramatic when combined with a neuromodulator (Dysport, Botox or Xeomin) for an overall rejuvenating effect. The combination of fillers (injectables or fat micro-grafts) plus a neuromodulator produces a better result than either one alone.
At the Temples
You wouldn’t think of the temples as an area of concern but they are. As fat diminishes from the temples, they become sunken and appear narrow. Hollow temples can call unwanted attention to the cheeks. Filler such as Restylane, Perlane and Radiesse, used to gently, soften the area for a more youthful look. Fat micrografts are a good alternative and give a more permanent result.
In the Cheeks
The cheek area is one of the first parts of the face where a loss of volume is noticeable. As the fat in the cheeks begins to descend, it creates nasolabial folds (smile lines) around the mouth and a flattened look in the cheeks, making you look “tired”. To correct the folds and the cheeks, the natural volume needs to be restored, using either iinjectable fillers or fat micro-grafts, for a refreshed, natural look.
In the Lips
The lips are made of collagen, oil and tissue—not fat—but they too experience the effects of volume loss as they start to thin out. While fillers or fat can help to reinstate plumpness in the lips, the surrounding lines need to be softened with either laser resurfacing or a combination of Botox, Dysport or Xeomin and fillers (I prefer Restylane and Belotero).
At The Corners of the Nose Down Toward the Mouth
As the fat in the cheeks begins to fall, there is less support for the skin around the mouth, causing folds to develop in the area where the end of the nose and the lips meet.
On the Jawline
The jaw area loses definition with time and the natural contours become boxy and saggy. Volume loss in the jaw area usually comes along with a lack of structure in the cheeks. Injections of hyaluronic acids, Radiesse or fat can all help reshape and revolumize the area.
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