Hollowing of the face is a common occurrence with ageing. As we get older, the layer of fat tissue just beneath the skin (subcutaneous) decreases. The contours of the face take on an aged appearance as the volume beneath the skin is lost. Fat loss is the main culprit of decreased volume in the face, but there are other factors that can contribute to how noticeable this volume loss is. When the supporting collagen and elastin fibers in the skin get damaged it leads to poor skin quality and the skin can sink which leads to areas of fat loss and form hollows and wrinkles on the face.

A loss of facial volume can have a profound effect on our appearance. Most people can see that they are looking older but do not recognize that volume loss is the reason that their face is beginning to “sink” with a more skeletal, sunken facial appearance.

Common areas of facial volume loss include:

• Temples : With age, the subcutaneous fat and tissue in the temples decrease, causing the temples to appear sunken. This concavity can give a tired and gaunt appearance.
• Cheeks (Malar) : The cheekbones and cheeks are key areas for facial fullness in youth. However, with age, the subcutaneous fat and tissue in these areas gradually decrease, leading to sunken cheekbones and cheeks, resulting in flatter or thinner facial lines.
• Nasolabial Fold : The nasolabial folds (lines running from the nostrils to the corners of the mouth) also show the effects of aging. With age, the skin and tissue in this area loosen and sag due to gravity, forming wrinkles of varying depths.
• Marionette Lines : The skin and tissue around the corners of the mouth are also prone to loosening and sinking with age. This indentation is commonly referred to as marionette lines, making the corners of the mouth appear droopy, giving an impression of sadness or depression.
• Jawline : Indentation in the jawline and submandibular area can obscure the entire jawline, causing a loss of facial contour clarity. This indentation is often associated with the loss of facial fat and tissue.