[Doctor's Column] What If Your Cheeks Are Sunken While Your Weight Remains the Same? : Why Facial Volume Changes with Age

[Doctor's Column] What If Your Cheeks Are Sunken While Your Weight Remains the Same? : Why Facial Volume Changes with Age

"My cheeks seem to have sunken in a lot lately. It's not like I've lost weight."

You may feel that your facial impression has changed because your cheeks look sunken even though your weight remains the same. However, sunken cheeks cannot be explained solely by weight changes.

For facial volume bone, fat layer, skin and soft tissue These factors are involved. While weight loss can be a cause, structural changes due to aging and the overlapping of existing facial features can have an impact.

---

Q1. I haven't lost weight, so why are my cheeks sunken?

Facial volume is largely maintained by three structures working together.

1) Bone (facial bone)
2) fat layer (Deep fat + shallow fat)
3) Collagen · Elastic fibers

The degree and location of change according to age vary from person to person.

first Changes in the skeleton In a CT study comparing 60 age groups, some mid-face angles changed with age [1]. A review of facial bones also explains that skeletal changes in specific areas can affect the structures supporting soft tissues [3]. This does not mean that all facial bones shrink at the same rate.

The following is Changes in the fat layer Facial fat is divided into several compartments. In a study comparing mid-face CT scans of 19 subjects at average intervals of 11.3 years, deep fat decreased by an average of 18.4% and superficial fat by 11.3% [2]. These figures are the results of that specific study group and cannot be applied to everyone or the temple area.

Changes in fat volume and changes in tissue location can have an impact together. Cheek hollowing is not explained simply as “fat moving downwards.”

Image: Produced by Maypure Doctor Column

finally Changes in skin and soft tissues Changes in elasticity due to aging and UV exposure can make volume loss appear more pronounced. It is not assumed that this process proceeds uniformly starting from a specific age.

---

Q2. Are there different types of sunken cheeks?

front cheek, side cheek, temple, etc. Where it looks like it's gone You can distinguish and examine them. However, it is not a diagnostic classification that confirms the cause based solely on location.

・Front cheek: Checks the volume and the location of the surrounding tissues together.
・Side Cheeks: Check the existing facial shape and the condition of fat and soft tissues.
・Temple: The volume and structure of the corresponding area are evaluated separately.

For example, even with the same sunken cheeks, the details to be checked differ between someone who has recently lost weight and someone who has had the same facial shape for a long time.

---

Q3. How can sunken cheeks be improved?

Differentiate between lack of volume and loss of elasticity, and select only the necessary approach. It is not explained that the procedure reverses skeletal changes caused by aging.

▶ Volume Enhancement
At our Yeonsinnae branch, we perform cheek, temple, and cheek fillers, as well as PLLA-based Olydia. The suitability of the product and the treatment area is determined through a consultation. For Olydia, we provide individualized treatment plans based on a series of procedures spaced at least four weeks apart.

It cannot be concluded that sagging will inevitably occur with fillers alone, or that other procedures must necessarily be combined. It is important to avoid excessive injection and to determine the areas and amounts that are needed.

▶ When you have concerns about both elasticity and skin texture
You can consult separately regarding the suitability of firming treatments such as CoolSonic and Density, or skin texture improvement treatments such as Livishine and Livicol. These treatments do not fully restore lost volume. When planning to use energy devices and heat-sensitive injectables together, the energy device is used first, in accordance with the treatment sequence principles of our Yeonsinnae branch.

※ Swelling, bruising, and nodules may occur after filler or injection procedures. Although rare, serious complications such as skin necrosis due to vascular occlusion or vision impairment can occur with fillers. For PLLA procedures, you must consult about the risk of delayed nodules and granulomas. Effectiveness and suitability vary from person to person.

---

Q4. Can I manage this at home?

· Apply sunscreen consistently. Ultraviolet rays are the main cause of the breakdown of collagen and elastic fibers.
· Avoid rapid weight loss. If you lose a significant amount of weight in a short period, facial fat will also decrease, which can make sunken cheeks more noticeable.
· Maintain sufficient hydration and a balanced diet. Protein is the basic raw material required for collagen synthesis.
· It is best to avoid smoking as it accelerates collagen breakdown.

---

Skin concerns vary from person to person. After a consultation, we will guide you to the most suitable treatment based on your records.

Maypure Clinic Yeonsinnae Branch
3rd Floor, Metro Tower, Directly Connected to Yeonsinnae Station (856 Tongil-ro, Eunpyeong-gu, Seoul)
02-389-9980

Chief Director Sim Dong-gyu of Maypure Clinic Yeonsinnae Branch
Graduated from Korea University
Graduated from Korea University School of Medicine

▼Get a free real-time consultation with Maypure right now▼

References
1. Shaw RB Jr, Kahn DM. Aging of the midface bony elements: a three-dimensional computed tomographic study. Plast Reconstr Surg. 2007;119(2):675-681. PMID: 17230106
2. Boehm LM, Morgan A, Hettinger P, Matloub HS. Facial Aging: A Quantitative Analysis of Midface Volume Changes over 11 Years. Plast Reconstr Surg. 2021;147(2):319-327. PMID: 33165293
3. Mendelson BC, Wong CH. Changes in the Facial Skeleton With Aging: Implications and Clinical Applications in Facial Rejuvenation. Aesthetic Plast Surg. 2012;36:753-760. PMC3404279

※ This post is intended to provide general information about the procedure, and the effects and recovery period may vary depending on individual skin conditions.
※ Please be sure to consult thoroughly with medical staff before the procedure. Swelling, bruising, and redness may temporarily occur after the procedure.

#YeonsinnaeDermatology #HollowCheeks #HollowCheeks #YeonsinnaeFiller #EunpyeongguDermatology