Volume Loss Treatment
A youthful face is full in the right places: rounded cheeks, smooth temples, a soft transition from the lower eyelid to the cheek, and a defined jawline. As we age, the fat pads that create that fullness shrink and shift, and the bones of the face slowly lose volume too. The result can be hollow temples, flat cheeks, deeper folds, and a tired look under the eyes. Patients from Beverly Hills, Encino, Pacific Palisades, and across Los Angeles come to Parsa M.D. to restore volume in a way that looks like their younger self rather than a filled face.
Restoring volume around the eyes and midface is the foundation of several procedures Dr. Kami Parsa developed. The Trifecta Lift™ combines lower eyelid and midface rejuvenation, the Quadfecta Lift® adds upper eyelid rejuvenation, NanoStem® pairs nanofat with energy-based skin treatment, and the Duplex® Procedure combines radiofrequency microneedling with CO2 resurfacing. He lectures on Facial Fat Grafting: Principles and Applications and brings more than 20 years of clinical experience as an oculoplastic and reconstructive surgeon.
“Volume should go back where it was lost, in the amount that was lost. Most overfilled faces come from chasing lines instead of rebuilding structure. When the cheeks and temples are supported, the folds and hollows often soften on their own.” — Dr. Kami Parsa
What Causes Facial Volume Loss?
Several changes contribute to a hollow or deflated appearance:
- Fat pad shrinkage and descent: The deep and superficial fat compartments of the face shrink and slide downward with age.
- Bone remodeling: The eye sockets widen and the cheekbones and jaw lose volume over time, reducing the framework that supports the skin.
- Collagen loss: The skin thins and loses elasticity, making hollows more visible.
- Weight loss: Significant weight loss, including with GLP-1 medications, often thins the face faster than the body.
- Genetics and lifestyle: Some people have naturally hollow temples or under-eye areas, and endurance exercise, smoking, and sun exposure can accelerate facial thinning.
- Medical causes: Some medications and conditions, such as HIV-associated lipoatrophy, cause facial fat loss that is treated medically as well as cosmetically.
Where Volume Loss Shows
Volume loss typically appears in the temples, under the eyes as a tear trough or hollow, in the cheeks and midface, around the mouth as deepening folds, and along the jawline. Around the eyes, hollowing can make the eyes look sunken, and the upper and lower eyelid areas are covered in detail on our Fillers for Upper Eyelid Hollows and Fillers for Lower Eye Bags pages.
How Volume Loss Is Evaluated
Dr. Parsa or a licensed member of his clinical team will assess the face at rest and in motion, from the front and in profile, and review earlier photos if you have them to see where volume has changed. Prior filler treatments are reviewed carefully, since filler that remains from earlier sessions can change the plan and, in some patients, contribute to under-eye swelling described on our Malar Edema page. Team members are described on our Our Providers page.
Volume Restoration Options in Beverly Hills
Each linked page explains the product or procedure, its FDA status, and recovery:
- Hyaluronic acid fillers: Voluma, the Restylane family, and Fillers for Cheek Augmentation restore volume immediately and can be dissolved if needed.
- Collagen stimulating injectables: Sculptra and Radiesse build volume gradually by stimulating the body’s own collagen and are not used around the eyes.
- Fat transfer: Facial Fat Grafting uses your own fat to restore volume. A portion of transferred fat is usually reabsorbed, but the fat that survives can be long lasting.
- Combined eyelid and midface surgery: The Trifecta Lift™ & Quadfecta Lift® combine eyelid rejuvenation with midface volume restoration.
- Cheek support: Cheek Lift or Augmentation offers surgical options when injectables are not enough.
- Nanofat with energy treatment: NanoStem® combines processed fat with radiofrequency or laser treatment for skin quality. Nanofat is not an FDA-approved stem cell product, and its effects are still being studied.
Filler results are visible right away, while collagen stimulators and fat grafting settle over weeks to months. Most plans restore volume in stages, which helps keep results natural.
Risks and When to Seek Care
Swelling, bruising, and tenderness are common after injectables and fat grafting. Other possible effects include lumps, asymmetry, filler visible under thin skin, and, with Sculptra, small nodules. Fat grafting can lead to uneven results or partial loss of the transferred fat. Filler can rarely block a blood vessel, which is most serious around the eyes and nose. Call the office right away and seek emergency care if you notice vision changes, severe or worsening pain, or skin that turns pale, blotchy, or dusky after treatment.
Why Choose Dr. Parsa for Volume Restoration
- Filler Complication Expertise: He coauthored a 2023 study on persistent eyelid swelling after hyaluronic acid filler and lectures on avoiding periocular filler complications.
- Overfilled Face Experience: His lectures include The Overfilled Face: Evaluation and Treatment, focused on restoring natural proportions.
- Surgical and Nonsurgical Options: Fillers, collagen stimulators, fat grafting, and eyelid and midface surgery are all available.
- Fellowship Training: He completed his fellowship in oculoplastic and reconstructive surgery at the Bascom Palmer Eye Institute.
- Teaching Appointment: He is an Adjunct Clinical Professor at the Keck School of Medicine of USC.
Schedule a Volume Loss Consultation in Beverly Hills
Your consultation takes place at our office at 465 N Roxbury Dr, Suite 1011, in Beverly Hills. Dr. Parsa and his team will map where your volume has changed and recommend a staged plan that keeps your results natural. Contact our office to request an appointment.
Medically reviewed by Kambiz K. Parsa, M.D. on
