Why faces lose volume
People notice it in different ways: the cheeks look flatter, the temples have hollowed, the face looks thinner or more tired than they feel, or a fold beside the nose has deepened for no obvious reason. Volume loss is rarely one thing. Fat, bone and skin all change, at different rates in different faces, and the treatment that will work depends on which of them has changed.
i
Deep cheek fat
i
Deep cheek fat
The cheeks are held up from beneath by deep pads of fat. As these thin with age, the cheek flattens and the skin over it loses support, so the folds beside the nose and mouth deepen. It often looks like sagging when the skin has barely dropped, which is why putting support back can do more for it than tightening would.
What might work: Dermal Fillers to restore the cheek's support on the day, or Biostimulators (HarmonyCa or Sculptra) to rebuild it gradually.
ii
The temples
ii
The temples
Hollowing at the temples is one of the earliest changes of ageing, and in leaner faces it can come sooner. It narrows the upper face and makes the outline of the brow bone more visible.
What might work: Dermal Fillers.
iii
Changes in the bone
iii
Changes in the bone
The bone beside the nose and around the eye socket slowly recedes, and some faces were never strongly projected to begin with. Less framework means less support for everything above it, and a face with a lighter skeleton can show ageing earlier as a result.
What might work: Dermal Fillers.
iv
Weight loss
iv
Weight loss
Significant weight loss, for whatever reason, takes fat from the face as well as the body, most noticeably from the midface, and the change can be sudden if the weight came off quickly. Treatment can help at any stage. While your weight is still shifting, the plan moves with it, adding support in steps as your face finds its new shape.
What might work: Dermal Fillers, or Biostimulators for fullness that returns over months, each paced with your weight.
v
Thinner skin
v
Thinner skin
Some of what feels like lost volume is the skin itself thinning, which makes a face look less full even where the fat beneath has changed little. That is a change in skin quality rather than volume, and it is treated differently.
What might work: Polynucleotides.
vi
A naturally lean face
vi
A naturally lean face
Some faces have always carried little fat, and people who are very lean or train hard can show hollowing earlier, particularly at the temples and cheeks. In studies of identical twins, the leaner twin tended to look older after 40.
What might work: Dermal Fillers where structure is needed, or Biostimulators for a change that builds slowly.
Treatments for lost volume, and when each one fits
Volume can be restored in two ways: straight away, with dermal fillers, or gradually, with a biostimulator that prompts your own tissue to build support. Which suits you depends on the area, how much support is wanted, and whether you would rather see the change on the day or over months.
Dermal Fillers
For structure where it has gone
Dermal fillers are hyaluronic acid gels placed beneath the skin, usually close to the bone, to restore support where fat or bone has been lost: the cheeks, the temples and the side of the face. The gel usually carries its own local anaesthetic. You'll see a difference straight away, and any swelling, tenderness or bruising is usually mild and gone within two weeks. The gel and where it sits set how long it lasts, commonly 6 to 18 months. Where some looseness is part of the change as well, tightening can be planned alongside it.
Biostimulators
For a slow, subtle return of fullness
Biostimulators prompt your tissue to build its own collagen, so fullness returns over weeks and months rather than on the day. For lost volume the choice is usually Sculptra, a poly-L-lactic acid (PLLA) placed deep across the cheeks over two or three sessions some weeks apart, or HarmonyCa, which pairs hyaluronic acid with microspheres of calcium hydroxyapatite and lifts a little at once, then keeps working as the collagen response gets going. Juläine PLLA is used along the nose-to-mouth folds that deepen as the cheek flattens. Profhilo, the fourth biostimulator here, is for thin, lax skin rather than lost volume. Any fullness in the first days after PLLA is the water it is mixed with, and it fades before the real change begins. These suit people who want the difference to be gradual enough that nobody can pinpoint when it happened.
Sometimes part of the plan
Skin Boosters
A skin booster places hyaluronic acid within the skin for hydration and smoothness. Its work happens in the skin itself, so where the skin over the cheeks has dried and roughened as the fullness went, a booster can sit alongside the support. About Skin Boosters
Polynucleotides
Thinner skin is a change in quality, and polynucleotides are one of the treatments used to improve it, working in the skin while fillers or biostimulators restore what lies beneath. About Polynucleotides
Endolift® and XERF
Where loosened skin sits alongside lost volume, tightening may be part of the plan as well. Tightening & Lifting
How we restore volume without a filled look
Most people who come to us about volume have one worry above all: looking filled, puffy or unlike themselves. That look has identifiable causes, and each of these rules exists to prevent one of them.
Support first, then look again. Restoring the deep support of the cheek often softens the folds below it on its own, so we rebuild structure first and reassess before treating any line directly. Filling a fold without restoring what holds it up is how faces start to look heavy.
Areas in proportion, not lines one at a time. A face is planned as a whole, so temples, cheeks and jaw stay in proportion with each other and with your features. Chasing one line at a time is how volume ends up where it doesn't belong.
Questions about volume and hollowing
Will I end up looking puffy or overdone?
Not if the plan is right, and preventing it is the point of the rules above. An overdone look comes from filler in the wrong place or layer, from too much of it, or from treating one line at a time, and it shows most when the face moves. We restore support in proportion, look at the result with you once it has settled, and add more where you both feel it would help.
Filler or a biostimulator: which suits me?
Filler gives structure you can see on the day and suits areas that need defined support, such as the cheekbone or the temple. Sculptra and HarmonyCa build fullness gradually and suit people who prefer a slower change across a broader area. Some plans use both, and you settle the mix with your practitioner once your face has been assessed.
Will I still look like myself?
Yes, and that is the measure we use. The aim is to put back what has gone, in proportion with your features, so people see you looking well rather than different. Before anything is done, you'll see what each part of the plan will change and what it leaves exactly as it is.
What if I only want a subtle change?
Then that is what we plan for. A small amount of support placed where it matters most can change how a face reads without anyone noticing a treatment, and more can be added later if you want it. How far to go, and when, stays your decision.
I've lost a lot of weight. When should I think about treatment?
Whenever it suits you: treatment can help at any stage. If your weight is still changing, the amount and the timing are planned around it, so your face is supported step by step as it settles.
Is it painful?
Most people find it very manageable. The gel in most fillers carries a local anaesthetic, so what you feel is a brief pinch and then gentle pressure, and HarmonyCa numbs the area as it goes in. After temple treatment, chewing can feel a little tender for a day or two. If you're anxious, tell us, and we'll take it slowly.
Is it one appointment or several?
Filler is often one appointment, with a review once any swelling has settled, when a little more is sometimes added. Sculptra and Juläine are usually two or three sessions some weeks apart, while HarmonyCa is usually one visit, looked at again after roughly four weeks. Your practitioner sets out every appointment in the plan before you begin.
How long does it last?
Filler commonly lasts 6 to 18 months, depending on the gel, the area and the person. It also tends to remain in the tissue longer than its visible effect, which is why a returning patient often needs less than before. The collagen built by a biostimulator develops over months, and the makers report 12 to 18 months for Juläine and around two years for Sculptra.
Who is volume treatment for?
Adults in good general health whose face has lost fullness, whether with time, after weight loss or because it has always been lean. What is checked first is your medical history, any medicines, and any filler you've had before; treatment waits during pregnancy and breastfeeding, or while a skin infection in the area clears.
Do men lose volume the same way?
Largely, yes: the temples and cheeks hollow in men too, often leaving the face looking tired or thinner. Placement is planned for a male face, keeping the structure angular so the result doesn't soften it.
For men
What are the risks?
Swelling, tenderness, some firmness and bruising are common, mild, and usually settle within about two weeks. Serious complications are rare, and you'll cover them with your practitioner ahead of any treatment, including the particular care taken at the temples, where exact placement matters most. With PLLA, the effect to know about is small lumps under the skin.
What does it cost?
Dermal filler starts at £500 for 1 ml, and biostimulators for volume at £550 a treatment (HarmonyCa), with Sculptra from £700 a session and Juläine from £800. How much product your plan needs, and where, sets the fee, and it is agreed at your consultation. There are no promotions: the plan decides the price.
All prices
I've had cheek or temple filler before. What happens now?
Earlier filler often outlasts its visible effect, so the first step is seeing how much of it remains and where it has settled. From there, a little more may restore the balance, or support placed somewhere new may do more for you. Details of the product and the date help, if you have them.
Where filler goes matters more than how much
How volume looks is decided mostly by placement: the layer the filler sits in, how close it is to the bone, and the anatomy each injection is planned around, particularly at the temples and beside the nose. That is why treatment here starts with a doctor-led assessment of what has changed and why, and why the plan is built for your whole face rather than for the line you pointed to.
Dr Priya Verma founded ART Clinic with a particular interest in regenerative and collagen-stimulating treatment, and in plans that combine approaches. Fillers and biostimulators here are given by the clinic's doctors, Dr Priya and Dr Michelle Emett, to the planning standard Dr Priya set.
Dr Priya and the teamConcerns that often sit alongside this one
Lost volume rarely travels alone. If what you've noticed is more about loose skin, the eyes, the skin's surface or the jaw, start with one of these.
An assessment, before any volume is added
A comprehensive diagnostic consultation: a thorough assessment leading to a truly bespoke treatment plan, created by you and your practitioner. You don't need to know which treatment you want, or how much. Tell us what has changed and what you'd like to keep, and we'll show you which layer has changed, how it can be put back, and where to begin. You won't be sold to, and you won't be pushed.
Request a consultation Before your first appointment