"I look saggy and sad" - Our signature FFA explained
“I look sickly, like I am unwell.”
“My life is great, but I look sad.”
“I have always had a slim face but now I just look gaunt.”
“I got asked the other day if I have cancer.”
We covered the first of our triad, “I look mad, bad, sad” here (hyperlink to the relevant blog page pls)
The second part of my FFA triad is volume loss in the face.
An example of a beautiful but gaunt looking face.
The ageing process leads to a predictable deflation of fat pads in the face.
Photos attributed to: KevinCease
This may occur as early as your 20s if you are of very slim build, or have genetic deficiencies around the eyes and mouth.
What is Volume Replacement?
Volume replacement is one of the most crucial phases in the aging face to help you age on your terms.
It is also the process that scares people the most, many of whom say no before even understanding what is involved.
Why?
We’ve all seen those faces over the last decade or so and coined terms to describe them:
- Trout pout
- Chipmunk cheeks
- Duck lips
- Maleficent
- Avatar
Most of the women who come in to see me, are TERRIFIED of looking fake, frozen, or done. They’re terrified of no longer looking like themselves, or looking wrong.
The biggest reason for their hesitation? The many many faces we see around us, who look just WRONG.
Photos attributed to: DrRachelHo
So, many of them decide, wrongly, that they only have one of two choices.
- ageing the way nature intends
- risking looking plastic, fake, done.
While AI now allows us to create mockups without hurting actual humans’ feelings, the reality is we see these faces all around us, and sometimes, in clinic too.
AI simulated volume replacement
AI simulated volume replacement
Over time, when these are the faces we see around us and on social media, we become desensitised to them. They begin to look normal, desirable, even.
How do you treat an overfilled face?
By the time someone presents in real life with a face like this, there is no easy solution to fixing a problem they have created, one appointment and one injector at a time, often while clinic hopping and price shopping.
“Perception drift is the gradual shift in how a person perceives normal, often due to repeated exposure to altered appearances. This phenomenon is common in aesthetic medicine”
At Skin Essentials, our belief is firmly that we aim to do it right, first time and everytime, barring unexpected complications.
So who needs volume?
Per Dr Joshi’s model, there are two main categories of patients who would benefit from volume for best results.
- The genetically challenged younger patient
Some of us are born with weaker bone structure. This can commonly lead to
- genetic hollowing around the eyes even as children;
- dental issues & a weaker lower face.
A weak lower face
A weaker lower face is often due to dental problems, many of which can only be corrected by orthodontics and/or surgery.
Photos attributed to: ResearchGate
Milder cases may be amenable to treatment non surgically for subtle improvement.
Hollowing around the eyes
Here is a normal tear trough area in a young face.
Photos attributed to: ResearchGate
Photos attributed to: ResearchGate
This can be expected to worsen as they get older.
Many of these young people present having been teased their whole life, called “Eyebags” in school and feeling like they can never go out without makeup/ concealer.
The ageing process over time, leads to its own set of problems.
Photos attributed to: ResearchGate
Depending on what the problem is, the solution may be to:
- do nothing
- do something, carefully if suitable
- refer for surgery
These are conversations we have in clinic, and assuming you opt for option 2 and are suitable, we talk about this as part of our signature FFA.
2. The ageing woman
The ageing face undergoes a series of predictable changes with age, hormonal changes and weight changes. This leads to deflation of the fat pads in the face and movement of some of them into the lower face.
Photos attributed to: KevinCease
In recent years everyone is afraid of volume, largely due to bad work visible everywhere.
Yet done well, replacing volume loss carefully is :
- necessary &
- can restore many of the issues we see in the ageing face before surgery becomes the best/only option.
I remind patients who would benefit from volume that even if they had surgery, volume by way of fat transfer would still be needed for best results.
Volume is a non negotiable aspect of youthful contours in a face, without exception.
The beauty of volume done well is it looks like nothing has been done & it improves many of the “breaks” in the skin.
This is why in our FFA volume makes up 1/3 of the triad. It’s a rare patient who doesn’t benefit from it- initially & then ongoing by way of collagen induction to delay or avoid surgery altogether.
It’s not possible to restore youthful contours without thoughtful volume replacement that will last for years to come, and careful maintenance.
Read on for our final third of the triad – skin quality.
Ready to apply for your own FFA? You can do so here.