The Upper Face: Temples and Brow
In a youthful face, the temples have a gentle convexity that transitions smoothly into the forehead and cheeks. As we age, however, this begins to change. The soft tissue and fat pads in the temple region decrease in thickness over time, leading to temporal hollowing. This can make the bony structure of the eye socket and skull more visible, creating a sunken or gaunt appearance that is often associated with aging or weight loss. This loss of support can also contribute to the lateral eyebrows appearing to droop or drop.
The forehead also sees changes. While volume loss is less about fat and more about collagen and muscle action, the combination creates noticeable changes. The loss of underlying fullness causes fixed wrinkles and furrows to become more prominent, especially between the eyebrows (glabellar lines) and horizontally across the forehead from repeated facial expressions.
The Mid-Face: Cheeks and Under-Eye Area
The mid-face is one of the most prominent areas affected by volume loss and is often the first to show significant signs of aging. The youthful, rounded appearance of the cheeks gives way to a flatter or even concave look as the years pass. This happens for two main reasons:
Fat Pad Redistribution
Instead of a uniform loss, the facial fat pads that were once evenly distributed and high on the cheek begin to shrink and slide downward over time. This creates a double effect: a loss of fullness in the upper cheek and an accumulation of fat lower down, contributing to the formation of jowls. This shifting fat mass is a key factor in the “descent” of the facial features.
Bone Resorption
Beneath the skin and fat, the facial skeleton itself changes. The cheekbones (malar bones) and the upper jaw (maxilla) can gradually resorb, or decrease in size and density, with age. This reduction in underlying bone structure reduces the foundation that supports the overlying soft tissues, further accentuating the flattened cheek appearance and sagging skin.
Under-Eye Hollows and Tear Troughs
The delicate area beneath the eyes is another common site of volume loss. The thinning of the skin, combined with the loss of fat and changes in the underlying bone of the eye socket, can lead to a hollowed-out look. This creates shadows, resulting in dark circles and the appearance of tear troughs, which can make a person look tired and older than they are.
The Lower Face: Jawline, Lips, and Mouth
Changes in the lower third of the face dramatically alter the youthful, heart-shaped contour, often leading to a wider, squarer appearance.
Jowls and a Less-Defined Jawline
As the mid-face fat pads migrate downward, they accumulate along the jawline, creating sagging jowls. Simultaneously, bone resorption in the jaw can alter its shape and projection, further compromising a once-defined jawline. The combination of skin laxity and displaced fat results in a loss of crispness in the lower facial border.
Thinning Lips
The lips lose volume and definition over time. They tend to thin, and the corners can begin to droop. This loss of volume, combined with repetitive muscle movements, can lead to the formation of fine vertical lines around the mouth, sometimes called perioral lines or “smoker’s lines,” even in non-smokers.
Marionette Lines
These deep lines run from the corners of the mouth down toward the chin. They become more pronounced as volume loss in the cheeks and jaw area leads to a downward pull of the soft tissues.
The Culprits Behind Facial Volume Loss
Beyond the specific areas, several overarching factors contribute to the overall loss of volume in the face:
- Decreased Collagen and Elastin: These are the essential proteins that provide the skin with its structure and elasticity. Their natural decline with age makes the skin thinner, less resilient, and more prone to sagging.
- Fat Redistribution and Atrophy: The shrinking and shifting of the subcutaneous fat pads is a major driver of hollowing in some areas and accumulation in others.
- Bone Resorption: Changes to the facial skeleton reduce the foundation for overlying tissues, exaggerating the effects of fat loss and skin laxity.
- Hormonal Changes: For women, declining estrogen levels during menopause can significantly accelerate the breakdown of collagen and fat, leading to more pronounced volume loss.
- Lifestyle and Environmental Factors: UV exposure from the sun, smoking, and poor nutrition can all accelerate collagen breakdown and skin aging.
Addressing Facial Volume Loss: Options Compared
| Method | Mechanism | Longevity | Pros | Cons |
|---|---|---|---|---|
| Dermal Fillers | Injected gel (often hyaluronic acid) to restore volume. | 6-24 months | Immediate results, minimally invasive, adjustable. | Temporary, requires repeat treatments, possible bruising/swelling. |
| Fat Transfer | Uses your own fat, harvested via liposuction, to add volume. | Long-lasting | Natural material, long-term results possible. | Surgical procedure, initial swelling, unpredictable fat retention. |
| Collagen-Stimulating Fillers | Stimulates natural collagen production over time. | 18-24+ months | Creates gradual, natural-looking results, longer-lasting than HA fillers. | Not immediate, requires patience for results, potential for nodules. |
| Topical Skincare | Uses ingredients like retinoids and peptides to boost collagen. | Ongoing | Non-invasive, preventative, can improve overall skin quality. | Slower, less dramatic results for significant volume loss. |
| Microneedling with PRP | Creates micro-injuries to stimulate collagen and elastin production. | Depends on treatments | Addresses skin texture and tone, natural results. | Multiple sessions needed, results are gradual. |
Conclusion: A Multi-faceted Approach to Aging
Understanding where do you lose volume in your face as you age illuminates that it's a multi-layered process involving the skin, fat, and even bone. The youthful convexity of the face gives way to concavity in the cheeks, temples, and under-eyes, while fat shifts downward to create jowls. Fortunately, there are many proactive and corrective measures available. From lifestyle changes like sun protection to professional treatments like dermal fillers, addressing facial volume loss can help restore a more youthful and vibrant appearance. For more detailed information on facial aging and treatment options, consult an authoritative source like Harvard Health.
