Sunken Cheeks and Volume LossWhat it is, and what we can do about it.

The face is built in layers, and all of them change

When people talk about looking older, they usually describe the skin. In fact the more consequential changes happen underneath it.

The face is supported by bone, which does not simply stay put. The eye sockets widen, the mid-face skeleton recedes, and the jaw loses height and projection over decades. Sitting on that bone are discrete fat compartments, not one continuous layer, each with its own shape and its own timeline. Some shrink. Others slide downward. Because they are separated by connective tissue, the boundaries between a deflated compartment and a fuller one become visible as a line or a shadow.

That is why volume loss looks the way it does. It is not uniform deflation like a balloon losing air. It is a patchwork, which is exactly why the folds and hollows appear where they do.

What you notice, and why

Flat or dropped cheeks. The midface fat compartments lose volume and descend. The high point of the cheek moves lower and outward, which changes the whole triangular proportion of the face.

Hollow temples. Temporal volume loss narrows the upper face and, subtly, makes the eye area look more skeletal.

Deeper nasolabial folds. These are usually not skin creases at all. They are the visible boundary where descended cheek tissue meets the fixed tissue beside the mouth. Injecting the fold directly is often the wrong answer; restoring the cheek support above it is frequently the right one.

Under-eye hollowing. As the orbital rim becomes more prominent and the fat beneath the eye diminishes, a shadowed trough appears. If this is your main concern, our page on under-eye hollows covers it in detail, including the situations where filler is not the answer.

A softer jawline. Bone resorption at the jaw plus descended tissue above it blurs the line between the face and the neck.

Weight loss and volume loss

Rapid or substantial weight loss reduces facial fat along with body fat, and the face is often where people notice the change first and like it least. This is increasingly relevant with medically supervised weight loss, and it is one reason we discuss facial support alongside our weight loss programme rather than treating them as unrelated services.

How we approach it

The assessment is structural. We look at where the face has lost support and in what order, rather than at which lines you can see in the mirror. Very often the line that bothers you is a downstream consequence of a hollow somewhere above it, and treating the cause produces a more natural result than treating the symptom.

Dermal fillers are used to restore support at specific points, most often in the midface, temples, chin and jawline. Precision of placement matters more than quantity.

Sculptra and Radiesse stimulate your own collagen production over a period of months, which suits generalised volume loss across a broad area and produces change that builds gradually enough that people around you tend not to identify what has been done.

PDO threads can reposition descended tissue where laxity accompanies volume loss, and they are usually combined with volumising rather than used alone.

What we will not do

We will not add volume to a face that does not need it, and we will not keep adding to a face that has reached its limit. If what you are seeing is primarily skin laxity or primarily skin quality, filler will not fix it and we will point you toward what will. Saying no is part of the job.