As people age one of the most important factors that contribute to an old or tired appearance is loss of volume. This concept has only recently been widely understood and accepted by facial plastic surgeons. The loss of volume comes from loss of the cheek fat pad, loss of skin thickness and even thinning of the cheek bones. This volume loss leads to the midface tissue falling towards the floor and accentuates the laugh lines and the marionette lines and also contributes to jowl formation.
The correction of this problem will depend on each person’s particular anatomical findings. Treatment options include fillers, fat injections, midface lifting and cheek implants. All of these options have their place and all can be very effective if they are done on the right person.