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The 3 Levels of Facial Volumization

Posted: 6:00 a.m. Sunday, May 15, 2016

By Anita Mandal, M.D.
Question: At 62, my hollow face ages me more than my sagging jowls and neck. I look skeletal! A plastic surgeon advised a facelift but I don’t see how tightening my skin will fill in my hollows. Is there a better option?

Answer: You are amongst the wiser who recognize that a facelift won’t correct hollowing. Many people don’t realize that with age, we actually lose fat and bone in our face. On top of this, we lose collagen and elasticity in our skin layers. These skin, bone and fat losses can’t necessarily be corrected with a facelift. In fact, facelift surgery can increase your chances of a poor result, even giving a pulled look if you have volume loss.

Facial volume loss occurs at three different tissue levels. The skin or upper layer loses volume through loss of collagen and elastin, resulting in wrinkles, fine lines and deeper pores. Even acne scars or other facial scars can appear worse. The fat or middle layer consists of many discrete fat compartments. Since each person’s face is genetically different, we lose fat in a unique pattern. Some have hollow temples. Others hollow around the eyes or cheeks. The bone or deepest layer is similar to the spine in that it also loses bone with age and remodels to change shape, resulting in a droopy, narrow appearance to the upper face and eyes. Bone loss at our jawline worsens sagging jowls.

Facial sagging is not simply due to loose skin or collagen loss but also comes from volume loss in fat and bone. Facelifts tend to work best on younger patients who don’t have significant volume loss. With continued aging, facial volumization must be addressed at all three levels to restore a youthful, natural.

Restoration of volume loss in the skin can be effectively accomplished with Infini RF combined with skin growth factors. Volume loss due to facial fat and bone can be effectively corrected with long term volumization fillers such as Bellafill, the 5-Year filler, due to its cost-effectiveness. Unlike temporary fillers, Bellafill can be used off-label in nearly every area of the face and in multiple depth levels.



Kybella,10 Minutes: Permanent, minimal invasive neck fat removal for double-chin.

SculpSure, 25 Minutes: Permanent, non-invasive body fat reduction with skin tightening.

Infini RF, 40 Minutes: Non-Surgical Facelift for sagging jowls and neck with no downtime.

Bellafill, 90 Minutes: The 5-Year Filler. Dr. Mandal is a BellaDiamond physician in the top 1% of expert Bellafill injectors in the world.


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