You slept well. You feel fine. And yet someone at work asks if you are tired, again.
Maybe you noticed it in a photo first. Your cheeks look flatter than they used to. There is a hollow under your eyes that concealer cannot hide. Your face seems thinner, even though the scale says nothing has changed.
If this sounds familiar, you are not imagining it, and you are not alone. Losing facial volume is one of the most common changes women notice from their mid-thirties onwards. The good news is that it has clear causes, and today there are gentle, natural-looking ways to address it.
Facial volume loss means the soft, full areas of your face slowly become flatter or more hollow. It usually shows up in the cheeks, under the eyes, at the temples and around the mouth.
When volume drops, the skin has less support underneath. That is why a face can look tired, sad or older without a single deep wrinkle.
For years, ageing was explained mostly by gravity: skin gets loose and drops. Researchers now know it is more layered than that. Facial ageing involves changes in the fat under the skin, the bone underneath, the skin itself and the muscles, all at the same time.
The fat in your face is not one even layer. It sits in separate small “pads” or compartments. Studies from plastic surgeons Rohrich and Pessa showed that because these compartments are separate, the face does not age as one block. Some areas deflate earlier than others.
That explains why one woman notices hollow under-eyes first while her friend notices flat cheeks.
This surprises most people. Research using CT scans found that facial bones slowly recede with age, including around the eye sockets, the cheekbones and the upper jaw. When the foundation becomes smaller, the skin and fat above it lose their support.
Collagen is the protein that keeps skin firm and thick. As it declines, the skin becomes thinner and less able to hold its shape over the fat and bone below. We explain this in more detail in our guide to collagen loss in women after 35.
Two reasons stand out in the research.
First, studies of facial bones found that women lose facial bone volume at a younger age than men, which means the signs of ageing can appear earlier. Researchers link this partly to menopause, since women tend to lose bone faster during that time.
Second, hormones affect the skin directly. Dermatology research estimates that women lose about 30% of their skin collagen in the first five years after menopause. Some of the key work on this link between oestrogen and skin collagen comes from researchers at the University of Malta.
So if your face seems to change faster in your forties and fifties, there is a real biological reason behind it. It is not a lack of effort on your part.
Sun is one of the biggest outside causes of collagen breakdown, and Malta has sunshine for most of the year. Years of UV exposure weaken the skin’s support, which makes volume loss look more obvious. Read more in our article on sun damage in Malta.
Daily sunscreen will not bring volume back, but it helps protect the collagen you still have, and it protects the results of any treatment you choose.
A good skincare routine improves the quality of your skin: hydration, glow, texture and fine lines. It is worth doing. But no cream can replace lost fat or bone underneath the skin.
That is why the most natural-looking results usually come from combining two things: gently restoring volume where it was lost, and improving the quality and firmness of the skin on top. Plastic surgery researchers describe this same two-part approach as the most effective way to refresh an ageing face.
Every plan starts with a face-to-face consultation, because the right treatment depends on where you have lost volume and how your skin looks today.
Our medical team uses Plurvel Switzerland hyaluronic acid fillers to softly replace volume in areas such as the cheeks, and to define contours like the jawline and chin. Hyaluronic acid is a substance your skin already contains, and the aim is a rested, natural look, never an “overdone” face.
Discover Dermal Fillers and Face Contouring
When the skin itself has become thinner, treatments that encourage your own collagen help the face look firmer and more lifted. At BDR these include:
See Microneedling, Rejuvenation and Lifting treatments
For women who want to improve skin quality from within, the Morphiya exosome facial supports the skin’s own renewal, with gradual results over several weeks. It pairs well with fillers, because good skin quality makes restored volume look more natural.
We will look at your face from every angle, talk about what bothers you most, and explain which options fit your goals and budget. Pricing is always confirmed at your consultation, based on your personal plan. There is no pressure to book anything on the day.
Many women start to notice it in their mid to late thirties. It often becomes more visible in the forties and around menopause, when collagen loss speeds up.
They are connected but not the same. Volume loss is about less fat and bone support. Sagging is about looser skin. Most women have a mix of both, which is why a combined plan usually works best.
Not when they are placed carefully and in the right amount. The aim is to replace what was lost so you look rested, like yourself on a good day.
It depends on the area and the product. Many results last 6 to 12 months or longer. Your practitioner will tell you what to expect for your plan.
Collagen-stimulating and regenerative treatments can improve firmness and skin quality, which makes the face look fresher. They do not replace lost volume in the same way fillers do. A consultation helps you choose.
Weight loss can make the face look thinner, but many women notice volume loss with no change in weight at all. That is the natural ageing process described above.
If your reflection looks more tired than you feel, a professional assessment is the best first step. Our team in Birkirkara will help you understand what is changing and which treatments make sense for you.
Book your facial volume consultation at BDR Noon Clinic Malta
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