Facial Volume Loss

Optimal volume distribution and increased volume deficits

It is inevitable that with age the condition of the skin gets worse. Fine lines, wrinkles, and crow’s feet all develop due to the decrease of collagen and elastin in the skin that is natural with age. The ‘volume’ of the face, which materializes in the plumpness of the skin and lips and the elasticity of the skin, gets worse with age. Thankfully, there are a plethora of treatments for improving facial volume.


Before getting into the procedure itself, let’s break down the roots of skin aging. With age, the density of elastin and collagen in the skin decrease. Collagen makes up most of a person’s skin, and thus is vital as a structural protein not only there, but also in muscles and bones. Elastin, as it’s named, is responsible for the skin’s elasticity. When we’re young, we can furrow our brow, or smile, and when we stop, our face goes back to its normal position. It's the effect of these two proteins that allows this snap-back property of the skin. The body produces less and less of these proteins with age, however, so the snap-back effect goes away and the grooves from smiling and raising eyebrows don’t go away anymore. Another important chemical present in the connective tissue is hyaluronic acid, and helps keep the skin moist and plump. Levels of hyaluronic acid decrease along with collagen and elastin. While this decrease is natural with age, other factors such as smoking and sun damage also speed up this ‘aging’ of the skin.


Dermal fillers, as they are named, are injections of hyaluronic acid into the dermis of the affected area. Hyaluronic acid is a natural component of the extracellular matrix in our bodies, and thus naturally assimilates into the body over time. It’s important due to its ability to bind water molecules and fill space. Aging skin is loose due to the loss of its stretchiness, and is also dry due to a decrease in hyaluronic acid levels. Thus, these injections of hyaluronic acid tackle both issues simultaneously and produce fuller, younger- looking skin.

Another way to improve facial volume is a thread lift. The PDO thread lift uses needles loaded with polydioxanone (PDO) threads. The needles pierce the skin and insert the threads, which lift the loose skin immediately. The small sutures made by the needles cause a mild healing response from the body, resulting in increased production of collagen and other fibers that contribute to the skin’s elasticity. Why polydioxanone? These threads that create a controlled healing response inside the dermis naturally dissolve over 4-6 months, so no measures need to be taken after the treatment. The results last much longer than the threads, as well. Due to the sustained collagen production, results last for over a year. What’s also special about this procedure is that PDO is biodegradable, so in 4-6 months the chemical is absorbed by the body and disposed of naturally. 


If you have any questions about this treatment, or want to schedule an appointment, call our office at (609) 587-9944 or e-mail us at info@sleep-wellness.org.










Papakonstantinou E., Roth M., Karakiulakis G. Hyaluronic acid: A key molecule in skin aging. Dermato-Endocrinology. 2012;4:253–258. doi: 10.4161/derm.21923.







Tirtho Banerjee Tirtho Banerjee is a Johns Hopkins undergraduate studying to become a doctor. He believes medicine should be available to everyone and hopes that educating the public is the first step to realizing that.

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