A youthful face is supported by several layers, including bone, deep and superficial fat compartments, muscle, connective tissues and skin. As we age, the facial fat compartments change in size and position. Some areas lose volume while other tissues descend. The underlying facial skeleton also gradually changes, and collagen and elastin within the skin reduce. Together these changes can create hollows, deeper folds, loss of facial contours and sagging.
Genetics, significant weight loss, illness, smoking and cumulative sun exposure can also influence how facial ageing develops.

Facial volume loss does not simply mean looking thinner.

Common signs of volume loss in the face include:

• hollowing of the temples
• flatter or less supported cheeks
• under-eye hollows
• deeper nose-to-mouth folds
• marionette lines
• reduced support around the mouth
• loss of jawline definition
• a more tired or drawn appearance
• greater visibility of the underlying facial skeleton

Sometimes patients initially ask us to treat a line or jowl when the underlying cause is actually loss of support elsewhere in the face.

There is no specific age at which facial volume loss starts.

Structural ageing develops gradually through adulthood, and the first visible changes vary considerably between individuals. Some people begin noticing subtle facial changes in their 30s, while others retain facial volume for much longer.

Genetics, facial anatomy, hormonal changes, body weight and lifestyle all influence the rate at which these changes become visible. We therefore treat what has changed anatomically rather than treating according to age.

Yes. Significant weight loss can reduce facial fat as well as body fat. This may create hollowness in areas such as the cheeks and temples and can make skin laxity or jowling more apparent because there is less underlying tissue supporting the skin.

The effect varies between individuals and is influenced by the amount and speed of weight loss, age, genetics and existing skin elasticity. Where facial changes follow weight loss, it is particularly important to determine whether the main issue is loss of volume, loose skin or a combination of both before choosing treatment.

Significant weight loss achieved while using medicines such as Mounjaro or Wegovy can sometimes make facial ageing appear more noticeable. This is because fat is lost from the face as well as the body, reducing some of the natural support beneath the skin.

As facial fat reduces, patients may notice the following:

• flatter or less supported cheeks
• hollowing around the temples
• more visible under-eye hollows
• deeper facial folds
• increased jowling
• looser or more crepey skin
• a more tired or drawn appearance

This is sometimes referred to as “Ozempic face”, although it is not a condition caused specifically by Ozempic. Similar facial changes can occur after any significant weight loss, whether achieved through medication, diet, bariatric surgery or other methods.

Weight-loss medications can make these changes more noticeable because some patients achieve substantial reductions in body weight. Mounjaro and Wegovy are medicines used for weight management in appropriate patients, while Ozempic is primarily licensed in the UK for the treatment of type 2 diabetes.

At Thames Skin Clinic, we assess whether the facial change is due primarily to loss of facial volume, skin laxity, reduced collagen or a combination of these. Treatment does not necessarily mean simply adding dermal filler. Depending on your anatomy, we may consider treatments such as the following:

• Dermal filler
• Profhilo Structura
• JULÄINE
• PRP filler
• Polynucleotides
• Skin-tightening treatments including Fotona, Secret RF, Secret PRO or HIFU

The aim is to restore appropriate support and skin quality while preserving natural facial proportions rather than replacing every area of lost fat or creating an overfilled appearance.

Yes. Loss of facial volume can contribute to the development of jowls because the tissues of the lower face depend partly on support from structures higher in the face.

As volume and structural support reduce in areas such as the cheeks, tissues can descend and the jawline may become less defined. However, jowls are rarely caused by volume loss alone. Skin laxity, changes in ligaments and bone and platysmal muscle activity may also contribute.

This is why simply placing filler directly into the jowl is not always the right treatment. We assess the face as a whole to identify which layers have changed.

Treatment depends on which structures have changed and how much restoration is required.

Facial volume loss treatment options at Thames Skin Clinic may include:

Dermal fillers
Hyaluronic acid fillers can be used to replace lost structural support and restore natural facial contours. Rather than filling every visible line, we often treat the areas responsible for supporting the face.

Profhilo Structura
Profhilo Structura can be considered where changes within the superficial facial fat compartments are contributing to ageing and tissue descent.

PRP filler
PRP filler uses components derived from your own blood and can be used where we want to combine regenerative treatment with subtle volume support.

JULÄINE
JULÄINE is a collagen biostimulator. It does not behave like a traditional volumising filler but stimulates your own collagen over time and can be useful where loss of collagen and structural skin support are part of the ageing process.

Polynucleotides
Polynucleotides are used to support regeneration and skin quality. They are particularly useful where thin or compromised skin accompanies volume loss, but they are not a substitute for structural volume replacement where significant volume has been lost.

Skin-tightening treatments
Fotona, Secret RF, Secret PRO or HIFU may be added where volume loss is accompanied by skin laxity.

Often the most natural result comes from treating several contributing layers conservatively rather than trying to correct the whole face with filler alone.

No. Facial volume loss does not automatically mean that you need dermal filler.

Depending on the tissues involved, treatment may include dermal filler, Profhilo Structura, collagen biostimulation with JULÄINE, regenerative treatments or skin tightening. Some patients benefit from a combination while others may not require filler at all.

It should not. Our aim when treating facial volume loss is restoration rather than enlargement.

Ageing changes the proportions and support of the face. Careful treatment aims to replace support where it has been lost while maintaining the patient’s natural facial shape, movement and expression. An understanding of facial anatomy is particularly important because the visible problem is not always the area that needs treating. For example, a fold in the lower face may improve when support is restored higher in the cheek rather than by filling the fold itself.

At Thames Skin Clinic, treatment is planned conservatively with the aim of helping you look fresher and more supported rather than obviously treated.

Although all three can be used within facial rejuvenation, they work differently.

• Dermal filler provides immediate physical support or volume using an injectable gel. It is particularly useful when a specific structural deficit needs replacing.
• Profhilo Structura is designed to work within the superficial facial fat compartments and may be considered where changes in these tissues are contributing to facial ageing.
• Collagen biostimulators such as JULÄINE work more gradually. Rather than primarily adding gel volume, they stimulate the patient’s own collagen production and improve tissue support over time.

These treatments are not interchangeable. The right choice depends on which tissue has changed and the result we are trying to achieve. 

The results of volume-restoring treatments can last for several months or longer, depending on the treatment used, the area treated and how your body responds.

• Hyaluronic acid dermal fillers commonly provide results for many months, and some structural fillers may last longer depending on the product, area treated and individual metabolism.
• PRP filler provides a combination of temporary volume and regenerative stimulation.
• JULÄINE works gradually through collagen biostimulation, so its effect develops differently from traditional fillers.
• Profhilo Structura also follows its own treatment protocol and maintenance schedule.

Whichever treatment is chosen, facial ageing continues. The aim is therefore not to create a permanent fixed result but to restore and maintain facial support naturally over time.

Facial volume loss cannot be completely prevented because changes in facial fat and bone are part of natural ageing. However, some lifestyle factors may help reduce additional factors that can accelerate facial ageing:

• Maintaining a stable weight
• Avoiding smoking
• Protecting the skin from excessive UV exposure
• Maintaining good skin health

Medical skincare can help preserve the quality of the skin, but it cannot replace facial fat or skeletal support that has already been lost.

Most volume-restoring treatments involve little downtime, although some redness, tenderness, swelling or bruising can occur.

Following dermal filler, Profhilo Structura, JULÄINE, polynucleotides or PRP filler, there may be temporary redness, tenderness, swelling or bruising around injection sites.

Many patients return to normal activities quickly, although visible swelling or bruising can occasionally last longer.

Energy-based treatments used alongside volume restoration have different recovery periods depending on the technology and intensity. Your expected downtime will be discussed before treatment so that you can plan appropriately.

The first step is establishing what has actually been lost. A hollow temple, flattened cheek, jowl and under-eye hollow may all appear to be separate concerns, but they can be connected through changes in facial support.

During a consultation at Thames Skin Clinic, we assess your facial proportions, skin, fat compartments, underlying structure and areas of tissue descent. We can then decide whether your treatment should involve direct volume restoration, collagen biostimulation, regenerative treatment, skin tightening or a combination. The goal is to restore balance and support while maintaining a natural result that still looks like you. 

Book a consultation to discuss your facial anatomy and treatment options with the Thames Skin Clinic team.