Non-surgical anti ageing treatments

Volume loss and treatments


Why does volume loss matter?

Over time, your face changes in many ways. This is part of the normal aging process, but genetics and environmental factors can also play a role.

You may notice a change in the appearance of your skin, typically in the form of deepening parentheses lines and wrinkles.

But what may be less obvious is age-related midface volume loss.

What are the signs of volume loss?

Your cheeks may flatten, and the skin may begin to sag.

There are many injectables on the market to improve facial volume loss eg. Juvaderm which you can read about lower down. The first one I will discuss is to use your own body fat to add volume where you need it.


What Is Microlipoinjection/Autologous Fat Transfer?

Microlipoinjection , also called autologous fat transfer, is a procedure in which an individual’s own body fat is used to plump up sunken or emaciated areas of the face or to add volume where desired. The word “autologous” simply refers to the use of one’s own tissues or fat. Because the patient’s own fat is used, autologous fat transfer requires three steps. The first step involves the gentle liposuction of some excess fat (such as that found in the jowls, abdomen, thighs, or buttocks). The second step involves the isolation and cleansing of the fat cells. The third and final step involves the injection of the fat cells into the targeted facial areas (i.e., the fat cell transplantation).


Facial fat injections can eliminate aspects of facial “wear and tear” that often appear with age, such as smile lines, frown lines, marionette lines (running from the sides of the mouth down to the chin), wrinkles and furrows, and hollows in the face (such as under the eyes or under the cheekbones). Lips that have lost volume may also be treated through fat transfer as can scars or depressions in the face from scars (such as those from acne). Individuals with one or more of these conditions may be good candidates for autologous fat transfer.

Ideal Fat Transfer Candidates

In general, candidates for fat transfer are adults who would like to diminish or eliminate the appearance of wrinkles, creases, furrows, smile lines or frown lines, marionette lines, or depressions in the face. Fat injection may also be used for lip augmentation. Younger patients may be eligible for fat transfer in some cases.

A fat transfer via injection is also often used in patients who have experienced lipoatrophy, which is loss of the layer of fat in the face that forms the contours of the cheeks and jawline. A fat transfer can fill in the hollow areas and restore pleasing contours to the face.

The safety of the autologous fat transfer technique ensures that there are no restrictions associated with allergies. However, at your first appointment, you should be sure to disclose all of your medical history and current habits such as smoking and use of blood-thinners, medications, birth control pills, or supplements, so that your dermatologist or cosmetic surgeon can accurately determine whether you’re a good candidate for fat transfer.

What Areas of the Face Can Be Treated with Fat Injections?

The facial areas that can be improved with fat injection treatment include creases in the forehead or in between the eyebrows, and hollows under the eyes. Fat injection can also plump up or improve the contour around the nose, the area between the upper lip and the nose, the jawline, and the temples. Indeed, fat transfer can correct scars, sunken or hollow areas, and any place on the face or neck where fat has been lost.

Some of these facial areas need only one fat injection for noticeable and long-lasting improvement, whereas others will require more than one fat transfer to be adequately corrected.

Fat Injections vs. Other Dermal Fillers

The most important difference between autologous fat injection and other types of dermal fillers is that fat transfer doesn’t introduce a foreign material into the body. This aspect of fat transfer is particularly beneficial for people who are allergic or sensitive to products such as collagen or Hylaform® .

Another factor that sets facial fat injection apart from other dermal fillers is the length of time that the volume enhancement provided by a fat transfer lasts. Generally, the effects of fat injection can last from several months to two years or more. In some cases, the effects last indefinitely. By contrast, dermal fillers that contain hyaluronic acid, such as Restylane®, break down and disappear over the course of several months, making additional treatments necessary.

Injectable fillers are used to plump out wrinkles; fill defects such as tear trough hollows beneath the eyes, nasolabial folds from the nose to the mouth or marionette lines coming down from the corner of the mouth, or to fill lips and other areas requiring extra volume. Fillers are frequently combined with botox or dysport as the two are complimentary. Fillers may be temporary or permanent.


Before, after her first filler injection and then more was wanted, so after her second filler injection

Permanent fillers such as injectable silicone and others are no longer regarded as safe. They can cause granulomas, permanent deformity and other problems which are exceedingly difficult to correct. Today most plastic surgeons will only consider using temporary fillers.

Collagen, although a temporary filler, is not commonly used anymore either. It was derived from cattle products (bovine collagen) and, as such, allergic reactions were common. Also, collagen was not very long lasting and required frequent toping up.

Modern fillers are made from a long chain, naturally-occurring body sugar called hyaluronic acid (HA). Previously derived from animals (rooster combs), modern HA based fillers are synthetically made and are called NASHA – non animal derived stabalised hyaluronic acid. HA based fillers are hydrophilic and work by attracting water into the treated area to give a soft, gentle fullness. Most fillers will last 9-18 months although this will depend on the type of filler used and the site into which it is injected. The two commonest types of fillers are Juvederm and Restylane.


JUVÉDERM® is the #1 selling collection of hyaluronic acid fillers in the US. Each product in the JUVÉDERM® collection of fillers adds volume to a different area of the face to lift cheeks, smooth parentheses lines, or plump the lips. The results are natural looking and long lasting.Fillers can usually be done at the time of consultation. Usually the procedure is done under topical anaesthetic cream. The cream is applied and takes about 30-40 minutes to make the skin numb. This will not take away all the pain of injection – you will still feel the product going in – but it will deaden some of the pain of the needle. Sometimes I give local anaesthesia similar to that which a dentist might use. The modern fillers also contain lignocaine to further help lessen the pain of injection.

Injection takes a few minutes and you can see the result immediately. There may however be some post injection redness, swelling and bruising. Bruising may take a week to settle, but does not always occur. Swelling and redness is common, but is usually much reduced within a day or two. Lumpiness can occur with fillers, but with the modern fillers this can usually be managed with pressure and massage to dissipate the filler in the tissue. If this does not work, then hyalase can be injected to dissolve the filler. Fillers provide a quick, relatively inexpensive way to rejuvenate and improve the facial appearance.


If you have considered undergoing a facial rejuvenation procedure but don’t think you’re ready for a face lift or other form of facial plastic surgery, you may wish to investigate facial fat injections. This injection method of facial fat sculpting, also called microlipoinjection, can restore attractive contours to your cheeks, chin, and under-eye area, and add volume to your lips.


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