Facial Volume Loss & Contour Enhancement in London – Consultant Dermatologist

Ageing isn’t just lines—it’s volume shifts, contour softening and light that no longer bounces evenly. At Skinhorizon Clinic we design consultant-led plans using dermal fillers, skin boosters, thread lift and exosome rejuvenation to restore balance and definition while keeping you recognisably you.

Introduction

Facial volume changes happen at several layers—bone resorption, deep fat pad descent, superficial fat thinning and skin quality shifts. The result can be hollowing at the temples or midface, deeper nasolabial folds, flattening of the cheeks, a tired under-eye, or a jawline that blends into the neck. The goal isn’t to “inflate”, but to rebalance structure, soften shadows and guide light so your face looks rested and harmonious in daylight and on camera.

Our consultant dermatologist maps your features in motion and at rest. We then choose a sequencing plan: dermal fillers to support structure, skin boosters to improve skin quality and reflectance, thread lift for vector support where mild descent blurs contours, and exosome rejuvenation as a regenerative adjunct. When texture, pigmentation or redness are amplifying shadows, we coordinate with Skin Texture, Pores & Tone and Redness & Vascular. For lower-face heaviness, see Jawline Lifting & Double Chin Reduction.

Ready for natural-looking lift and definition with a plan built around your features?

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What is facial volume loss & when do contours change?

“Volume loss” describes how cheeks, temples, under-eyes and lips look flatter or more hollow with time, stress or weight change. Bone remodels, deep fat pads shift, superficial fat thins, and skin quality changes—so light catches the face differently. The edges that defined youthful contour (zygoma, jawline, chin–neck angle) soften; shadows under the eyes or at the nose-to-mouth area may deepen. Lifestyle and genetics matter; some faces hold volume longer, others thin early around the eyes or temples.

We also account for skin quality. Rough texture, visible pores, or redness can exaggerate hollowing by scattering light or adding colour contrast. That’s why our plans often pair structural support with surface work (see Texture, Pores & Tone). Under-eye concerns may overlap with pigment or thin skin—see Under-Eye Rejuvenation.

A realistic goal is a rested, balanced face—not a different face. Small adjustments in the right places can create a global lift in how the face reads.

Diagnosis & Assessment at Skinhorizon

Consultant history: weight change, sleep, stress, dental or orthodontic plans, previous aesthetics, medications (e.g., anticoagulants) and downtime tolerance.
3-layer mapping: bone landmarks, deep fat support (malar, lateral SOOF), and superficial compartments; dynamic vs static volume issues.
Skin-tone & safety: Fitzpatrick type guides product choice, needle vs cannula, and cadence; pigment-aware protocols for higher skin tones.
Photography: standardised front/oblique/side + animation (smile, frown) to judge balance and asymmetry.
Plan selection: staged approach prioritising support first (midface/temple/chin), then refinement (lip shaping, tear-trough safety checks), and skin quality (boosters/exosomes).

Personalised Treatment Options We Offer

Dermal Fillers (Hyaluronic Acid – Structural Support & Refinement)

Medical-grade hyaluronic acid (HA) fillers can replace lost support and guide light by subtly lifting key points: cheek structure, temple hollowing, marionette/mentolabial lines, chin projection and jawline definition. With contemporary techniques the aim is not “more”, but better balance: placing small, firm scaffolds where bone and deep fat once held shape, then blending with softer gels for transitions.

Approach: needle or cannula based on anatomy and goal; depth chosen for structure vs blend.
Look & feel: modern HA integrates with tissues; results should move with expression and soften over months.
Areas we commonly support: midface, temples, chin, jawline; selective perioral work to soften shadows without stiffness.
Reversibility: HA can be enzymatically dissolved with hyaluronidase if clinically required.

Safety note: Filler work carries rare but serious risks including vascular occlusion. We use anatomical planning, appropriate technique and have protocols and hyaluronidase on-site. You’ll receive red-flag guidance and direct contact routes.

Skin Boosters (Hydration & Texture – Glow, Not Bulk)

Skin boosters are micro-injections of soft, hydrating HA or bio-stimulating blends placed very superficially to improve the look and feel of skin—more light bounce, less crepe, smoother make-up lay. They are not the same as volumising fillers; think quality over quantity. Great for face, neck and hands, boosters are often timed between structural work to keep the surface looking fresh.

Typical course: 2–3 sessions, 3–4 weeks apart, then periodic top-ups.
Pairs well with non-ablative/texture protocols for enhanced reflectance.
Low downtime—pinpoint marks that settle within hours to a couple of days; pigment-aware timing for higher skin tones.

Thread Lift (Vector Support for Mild Descent)

A thread lift places dissolvable barbed threads under the skin to provide vector support where soft tissue descent blurs contour—commonly along the midface and jawline. Threads can sharpen the transition from cheek to lower face and soften early jowling. They create an immediate mechanical effect and a slower collagen induction as threads resorb. We map vectors to avoid a “pulled” look and adjust activity in the early settling period.

Best for early descent with good ligament support; not a substitute for surgery in advanced laxity.
Synergises with fillers placed for support first (cheek/temple/chin), then threads for direction.
Downtime: temporary dimpling/tightness and bruising are possible; we provide clear settling tips.

Exosome Rejuvenation (Regenerative Adjunct)

Exosome therapy is used as a supportive adjunct in our practice—layered after microneedling or as part of post-procedure care to nurture a favourable environment for skin renewal. While exosomes are not fillers and do not replace structural support, patients often report improved glow, comfort and a smoother look when exosomes are included in a structured plan.

Ideal alongside microneedling or light energy protocols.
Suitable across skin tones with pigment-aware scheduling.
Low downtime; skincare timing provided to protect barrier.

Supportive Elements (Optional)

To keep results natural and long-lasting, we often pair structural work with evidence-based skincare (soap-free cleanser, daily SPF, phased retinoid), and selective texture/tone therapies. For asymmetry exaggerated by muscle pull, we’ll discuss appropriate options and sequencing. For hollows accentuated by redness, see Redness & Vascular.

Your Care Journey

Map & measure: consultation, photos and animation to capture your baseline in motion and rest; agree priorities.
Support first: place discreet, structural filler where it makes the biggest difference (midface/temple/chin), or plan threads if vectors are the main need.
Surface next: add skin boosters for reflectance and comfort; consider texture/tone if light scatter/pigment amplifies shadows.
Regenerate & maintain: exosome adjuncts, skincare cadence, and clear timelines for reviews and top-ups.
Refine: tiny adjustments once swelling settles; photos under comparable lighting to judge change accurately.

We aim for steady, natural improvement that fits your diary—not sudden, obvious change.

Special Situations

Skin of colour (Fitzpatrick IV–VI): pigment-aware protocols; careful product selection; staged escalation; strict sun care around threads or microneedling.
Previous filler or migration: we may recommend hyaluronidase to dissolve unwanted product before rebalancing.
Autoimmune conditions / allergies: individual risk assessment and product choice; some treatments may be deferred.
Anticoagulants/aspirin: increased bruise risk; technique and aftercare adapted accordingly.
Dental work & travel: schedule procedures with enough buffer to avoid swelling clashes; we’ll plan with your calendar.
Pregnancy/breastfeeding: we defer injectables/threads; focus on skincare and comfort-first options.

Aftercare & Maintenance

After fillers: expect mild swelling/tenderness; occasional bruising is possible. Avoid strenuous exercise, saunas and alcohol for 24–48 hours; keep the area clean; no firm pressure or facial massage unless advised. After skin boosters: tiny blebs fade within hours to a couple of days—make-up timing provided; stay gentle with actives for 2–3 days. After a thread lift: avoid wide mouth opening and heavy exercise briefly; sleep elevated; any dimpling typically settles; we give specific guidance. With exosome adjuncts: follow our barrier-first routine and sun care; avoid harsh products until settled.

Maintenance is personalised: structural areas often last many months; skin boosters benefit from periodic top-ups; threads settle and then soften over time; exosome sessions can be timed around seasons or events. You’ll receive a written plan with expected timelines and when to review.

Safety & Risks

We use the least-burdensome effective plan. Common, short-term effects include redness, swelling, tenderness and bruising. Less common risks—discussed in consultation—include vascular occlusion with fillers, infection, delayed swelling, nodules or asymmetry; with threads, transient dimpling, puckering, contour irregularity or rare thread exposure; with skin boosters, temporary visible micro-blebs; with any adjunct microneedling, transient redness or post-inflammatory hyperpigmentation (PIH) risk in higher skin tones without sun care. We mitigate with anatomical planning, sterile technique, pigment-aware protocols, written aftercare and a direct line for urgent advice.

Expected Outcomes

Our aim is a rested, balanced look that reads well in daylight and on camera. Subtle cheek support can lift the midface and soften folds without adding width; gentle temple filling reduces the “tired” cut-out at the hairline; considered chin and jawline work improves facial thirds and the side profile; skin boosters add light bounce so make-up sits evenly; threads can give a modest, natural lift in suitable candidates; exosomes support comfort and glow. Improvements appear immediately for some elements (fillers/threads), then refine over days to weeks as swelling settles and collagen remodelling begins. We’ll show before/after progress in consistent lighting so you can judge change confidently.

Patient Experience

“I looked tired on every video call. We started with cheek and chin support, then skin boosters and a light thread vector. Friends keep saying I look ‘rested’—not different, just fresher.”
— Verified Skinhorizon facial balancing patient

Why Choose Skinhorizon for Volume & Contour?

Consultant-led assessment: we map structure, movement and skin to decide what to treat—and what to leave alone.
Full toolkit: structural HA fillers, skin boosters for glow, thread vectors for mild descent, and exosome support.
Pigment-aware safety: protocols tailored to all skin tones; staged escalation and sun-care education.
Natural outcomes: support first, refine second—so you look like you, on your best day.
Clear aftercare: written plans, red-flag guidance and a direct line for advice.

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Get a personalised, consultant-led plan to restore balance and refine your contours—safely and predictably.

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Frequently Asked Questions

Fillers vs skin boosters — what’s the difference?

Fillers give structure and shape; boosters improve skin quality and glow. We often use both—support first, surface next.

How long do results last?

It varies by area and product. Structural fillers often last many months; skin boosters need periodic top-ups; threads gradually soften as they resorb; exosome support is timed around your plan. We’ll outline expected timelines for each site.

Is it safe for darker skin tones?

Yes—with pigment-aware protocols. We stage changes conservatively, choose techniques suited to your skin, and provide clear sun-care guidance to minimise PIH risk.

What if I don’t like filler results?

HA fillers can be dissolved with hyaluronidase when clinically appropriate. We prefer conservative first steps so adjustments are small and easy.

Will I look “done” or different?

Our aesthetic is rested and balanced, not overfilled. We support structure and soften shadow/texture so you look like yourself—on your best day.

When can I wear make-up?

Usually the next day after fillers/threads if skin is intact; for skin boosters or microneedling-adjacent work we may suggest waiting 24–48 hours. You’ll receive exact timings in writing.

This page was reviewed by Dr Mohammad Ghazavi, Consultant Dermatologist, last updated August 2025.

Disclaimer: The information on this page is provided for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Individual results vary, and all medical and aesthetic procedures carry risks and potential complications which will be fully discussed during your consultation. Suitability for treatment can only be determined following an in-person assessment with a qualified healthcare professional at Skinhorizon Clinic.

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