Why Your Face Loses Volume After 40 (And the 3 Treatments That Actually Work)

If your face has started to look hollower, more tired, or just different from how it used to, even though your weight has not changed, you are likely experiencing facial volume loss. It is one of the earliest and most significant drivers of an aged appearance, and it starts earlier than most people expect. Here is what is actually happening, and what can be done about it.

In this article

• What causes facial volume loss?
• What does volume loss look like?
• When does it start?
• 3 treatments that genuinely restore facial volume
• Which treatment is right for you?
• Frequently asked questions

What causes facial volume loss?

The face is not just skin and bone. It contains multiple layers of fat compartments, each sitting in a specific location. As we age, these fat pads reduce in size, shift downward, and separate from each other, creating hollows and shadows where there used to be fullness and smooth contours.

Alongside the fat changes, the underlying bone structure also changes. Research published in journals including Plastic and Reconstructive Surgery has shown that the facial skeleton shrinks and reshapes with age, particularly around the eye socket, the cheekbones, and the jaw. This loss of bony support means the soft tissue above it has less to rest on, accelerating the appearance of sagging and deflation.

Collagen and elastin, the proteins that give skin its firmness and bounce, also decline from the mid-20s onwards, accelerating significantly after 40. By the time most people notice the change in their face, significant structural loss has already occurred beneath the surface.

What does volume loss look like?

The signs are often subtle at first and become more noticeable over time. Common indicators include:

• Hollow or flat cheeks where there used to be fullness
• Temples that have become visibly sunken
• Deepening lines from the nose to the corners of the mouth (nasolabial folds)
• A flattening of the mid-face, making features look less defined
• Shadows under the eyes that skincare cannot fix
• A general sense of looking tired or unwell despite feeling fine
• The lower face beginning to look heavier relative to the upper and mid-face

Many people in this situation try to address the issue with skincare, which helps with surface texture and hydration but cannot replace volume that is no longer there. The changes are structural, and the solutions need to be structural too.

When does it start?

Volume loss is not an overnight change. It begins gradually in your late 20s and early 30s, often going unnoticed because the changes are small year on year. The pace typically accelerates after 40, and again after the menopause, which causes a significant drop in oestrogen, a hormone that plays a direct role in collagen production and skin thickness.

Weight loss can also accelerate facial volume changes, since the fat deposits that support the face are among those reduced during significant weight loss. This is why some people find that after losing weight, their face looks older even as their body looks better, sometimes called “weight loss face.”

3 treatments that genuinely restore facial volume

There are three treatments at SIX1 that address facial volume loss at a structural level. Each works differently and suits different patients, and your practitioner will advise which is most appropriate for you.

1. Sculptra, collagen stimulation that rebuilds from within

Sculptra is a collagen stimulator made from poly-L-lactic acid. Rather than adding volume directly, it signals your body to produce new collagen over three to six months. The result is a gradual, natural improvement in facial structure that typically lasts two to three years.

Sculptra works particularly well for generalised mid-face volume loss, the hollowing of cheeks, flattening of temples, and loss of facial structure that comes with age. Because the result comes from your own collagen, it integrates naturally with your face and avoids the over-filled look that some people worry about with injectable treatments.

2. Dermal fillers, targeted volume with immediate results

Hyaluronic acid (HA) dermal fillers add immediate, targeted volume to specific areas of the face. They are ideal for addressing particular concerns such as sunken temples, hollowing under the eyes, or flattening of the cheeks, with precision and control.

Results are visible immediately and typically last nine to eighteen months depending on the area treated and the product used. Unlike Sculptra, HA filler can be dissolved if needed, making it a more flexible option for people who are newer to aesthetic treatments or who want the ability to reverse a result.

Dermal fillers and Sculptra are often used together. Sculptra rebuilds the overall structure of the face, and filler handles specific, targeted areas that benefit from precise volume placement.

3. iPRF (2nd gen of PRP), your own plasma to stimulate skin renewal

Injectable platelet-rich fibrin (iPRF (2nd gen of PRP)) uses a concentration of your own blood plasma, rich in growth factors, to stimulate collagen production and improve skin quality. It is sometimes described as the second generation of PRP (platelet-rich plasma), using a more advanced processing method that preserves more of the growth factors responsible for skin renewal.

iPRF (2nd gen of PRP) does not add structural volume in the same way as Sculptra or fillers, but it improves skin thickness, texture, and quality, reducing the crepiness and dullness that often accompanies volume loss. Many patients combine iPRF (2nd gen of PRP) with Sculptra or dermal filler for a comprehensive result that addresses both structure and surface quality.

Which treatment is right for you?

The honest answer is that it depends on what is happening in your face specifically. Volume loss is rarely the same from one person to the next. The areas affected, the degree of change, your skin quality, and your aesthetic goals all affect which treatment or combination of treatments will get the best result.

A good practitioner will assess your face before recommending anything. At SIX1 Aesthetics, we look at the face as a whole, considering bone structure, fat distribution, skin quality, and what has changed over time, and build a treatment plan around what will actually make a difference for you. We will never recommend a treatment you do not need, and we will always tell you if something is unlikely to achieve what you are hoping for.

Frequently asked questions

At what age does facial volume loss start?

Volume loss begins gradually in the late 20s and early 30s, becoming more noticeable after 40. It accelerates again following the menopause due to a reduction in oestrogen, which supports collagen production and skin thickness.

Can you stop facial volume loss?

You cannot fully stop it, as it is a natural part of ageing, but you can slow it down and address the changes that have already happened. Protecting skin from UV damage, maintaining good nutrition, and avoiding smoking all help. Aesthetic treatments can restore volume that has been lost and stimulate new collagen to slow further decline.

Does losing weight make facial volume loss worse?

It can. Significant weight loss reduces the fat deposits that support the face, which can cause the face to look more hollow or aged. Treatments like Sculptra and dermal filler are particularly effective for people who have experienced this kind of facial change after weight loss.

What is the best treatment for loss of volume in the face?

For generalised volume loss across the mid-face, Sculptra is often the most effective option because it builds collagen over time and produces a natural, long-lasting result. For targeted areas, dermal filler gives more immediate and precise results. Many patients benefit from a combination of both.

Can skincare fix facial volume loss?

No. Skincare can improve surface texture, hydration, and skin quality, which helps the overall appearance of the face. But it cannot replace structural volume that has been lost. Volume loss is a physical change in the fat pads and bone structure beneath the skin, and it requires a structural solution.

How long do facial volume treatments last?

Dermal filler typically lasts nine to eighteen months. Sculptra results last two to three years on average. iPRF (2nd gen of PRP) results for skin quality are typically maintained over six to twelve months, with many patients having maintenance sessions annually.