As we age, our faces lose some of the natural structure that keeps a face looking young, supple, soft, and taut. Volume in the face is not only lost, but also falls or droops downward due to the effects of gravity in a process known as volume descent. This loss or drooping volume can make our faces look sunken or tired. The areas that typically lose volume are the cheeks, the under eye area, the eyebrows, and the lips. As the face loses volume, the skin begins to sag causing: wrinkles, furrows, folds, jowls, sagging neck skin, deep circles under eyes, laugh lines, and marionette lines to form.
Volume loss / Volume descent issues:
- Sunken Cheeks (Drawn Face) are the result of volume descent within the cheek itself, causing deep circles to appear under the eyes (that can also appear dark), jowls and saggy neck skin. Treatment for sunken cheeks involves a combination of Ultherapy® and Injectable Fillers.
- Marionette Lines are the result of volume descent, which causes lines or folds to form at the bottom of the mouth and sides of the chin. Dermal Fillers, such as Juvederm® or Restylane® minimize the appearance of these lines.
- Thin or Thinning Lips may be caused by genetics or a loss of skin collagen. This issue is largely treated with a Dermal Filler such as Juvederm® or Restylane® to attain a fuller appearance. Belotero® is an effective filler for individual lipstick lines.
- Smile / Laugh Lines (Parentheses), or nasolabial folds, form at the sides of the nose and run to the corners of the mouth. They are the result of volume descent in the cheeks. Patients between the ages of 35 and 45 who have not yet developed the degree of volume descent to manifest sunken cheeks can often have early developing prominent nasolabial folds. Treatment for these patients includes the use of HA Fillers, such as Juvederm® or Restylane® to soften the area and reduce the appearance of nasolabial folds. In patients over the age of 45, nasolabial folds are often seen with sunken cheeks. Thus, treatment for these patients includes Ultherapy® to lift sunken cheeks and the application of a filler to restore check bones and cheek volume. With this course of treatment for sunken cheeks, direct treatment of the nasolabial folds is often unnecessary.
- “Deep Circles,” also known as “Tear Troughs,” under the eyes are the hollows under patients’ eyes that can make them appear fatigued. This is a common result of the loss of fat and collagen that occurs with aging, though lifestyle factors may contribute to the issue. Dark Circles are treated with HA Dermal Fillers, such as Belotero®, Juvederm® or Restylane®.