Skin conditions
Facial volume loss is the deflation of the face with age, as fat, bone and collagen decline and the skin drapes over less support. It reads as flat cheeks, hollow temples, under-eye shadows and a softer jawline, often while the skin still looks smooth.
Physician led. Burnaby and Richmond. Every skin tone since 1996.
Book a complimentary consultationA physician assesses which areas have deflated, matches the treatment to your face, and builds your plan before you decide anything.
Understanding the condition
Facial volume loss is a deflation of the face that happens as the fat, bone and collagen that give it fullness and support decline with age, so the face looks flatter, more hollow and more tired even when the skin itself is still smooth.
The old idea that the face simply sags with gravity is only part of the story. Much of what reads as ageing is the face losing volume from the inside and deflating, like air leaving a cushion, so the covering skin no longer has a full frame to sit over. Volume loss is not the same as loose skin, and telling the two apart is the first job of the consultation.
What drives it
Facial fat sits in separate compartments. With age the deep pads that prop up the midface lose volume while the superficial fat loosens and drifts down, so the cheek flattens and the folds deepen.
The facial skeleton resorbs over time. The eye socket widens and the jaw loses height, and less bone means less scaffold under the soft tissue, so the face reads as sunken.
The skin makes less collagen with age and loses it faster, with a marked drop after menopause. Thin skin drapes rather than fills, so the deflation underneath shows through more plainly.
The retaining ligaments stretch and the deeper support layer descends. This is laxity, a different problem from lost volume that usually arrives with it, and telling the two apart is the first job of the consultation.
Flat cheeks, hollow temples, under-eye shadows, deeper folds, a softer jawline and thinning lips, down to the backs of the hands. These areas are connected, which is why filling one line rarely looks right.
The cheek is a structural pillar. Rebuilding the deep midface supports the skin that was draping over an empty frame and softens the folds below, so a physician often treats the cheek to improve a fold rather than injecting the fold.
The BioPlus difference
Volume loss is where honest product selection separates a considered plan from a default syringe. The core decision is simple to state and takes judgement to get right: match the product to the problem. A physician works out what has actually deflated, whether you want to see the change today or have it build gradually over months, and which tool fits your face, rather than reaching for the same syringe for every patient.
Not everything offered for an ageing face adds volume. The real volumisers are three: hyaluronic acid fillers, Radiesse and Sculptra. Ultherapy lifts, and PRP and PRF improve skin quality. Neither of those fills, and we say so.
Hyaluronic acid filler and Radiesse restore projection the same day, for a defined event or a specific hollow. Sculptra rebuilds volume as your own collagen over three to six months, for diffuse deflation and a change no one can point to.
Firm products rebuild projection over bone, along the cheekbone, jaw and chin. Soft hyaluronic gel suits the lips and under-eye in small amounts, and it is the only option here that can be dissolved if the result is not right.
Volume can be overdone, and more product is not a better result. When a face has heavy laxity rather than deflation, filler alone weighs it down instead of lifting it, and the honest recommendation is tightening, or a surgical opinion. When a dark circle is pigment rather than a hollow, filler cannot change it. A good plan sometimes restores less than a patient expects, and treats the whole face in balance rather than filling every line.
Knowing when not to inject is thirty years of experience talking.
How your visit works
The plan is decided at the consultation, and it is complimentary. A physician assesses your face and explains your options before you decide anything.
A physician assesses the whole face, the cheeks, temples, under-eye, folds, jawline, chin, lips and hands, and works out where volume has actually been lost and how the areas relate.
We separate lost volume from laxity, weigh an immediate correction against a gradual rebuild, and match the product to the problem, factoring your skin tone, your history and whether reversibility matters to you.
Injectable work sequenced to the plan and restored conservatively, in balance across the face rather than one line at a time, because volume is easier to add than to take away.
We photograph at a standard angle and lighting, review the result at two to four weeks for any top-up, and plan the maintenance that keeps it, because the face keeps ageing.
How care is built
No two volume plans are the same, because the plan follows your face: what has deflated, how much support it needs, and your skin tone.
Restore projection where the face has deflated, over the cheekbone, the midface, the jaw and the chin, so the covering skin has a full frame to sit over again. This is the work of the volumisers.
Soft, low-spread hyaluronic gel in small amounts for mobile zones like the lips and the under-eye, placed conservatively and chosen partly because it can be dissolved if the result is not right.
Where skin is thin and crepey, biostimulators and PRP thicken and firm it from within, and a lift like Ultherapy supports lax tissue so restored volume sits on a firmer frame.
Treatments we may use
Grouped by what they actually do. Three restore volume, and two support the result without adding any, which the descriptions state plainly. Which appear in your plan depends on your face, your skin tone, and whether you want an immediate or a gradual change.
Hyaluronic acid, immediate
Injectable gels of hyaluronic acid, a sugar the body already makes, that add volume the same day and support the tissue above. Gels vary in firmness, so a firmer one suits the cheek and jaw and a soft one the lips and under-eye.
Why this oneImmediate, visible volume, and the only tool here that can be dissolved if needed.
Learn more →Calcium hydroxylapatite
Calcium hydroxylapatite microspheres that restore volume immediately and then stimulate your own collagen over the following months. Firmer than most gels, so it suits structural support along the cheekbone, jaw and chin, and it is a standard treatment for the backs of the hands.
Why this oneImmediate structural support with a collagen benefit. It cannot be reversed.
Learn more →Poly-L-lactic acid, gradual
Poly-L-lactic acid that prompts your own skin to build new collagen, so volume returns over three to six months as your own tissue rather than as a gel. The core treatment for diffuse, all-over deflation and for thin skin that needs thickening.
Why this oneA gradual, natural rebuild for the patient happy to wait. It cannot be reversed.
Learn more →Your own blood, skin quality
Your own blood, prepared and reinjected in a single visit, to improve tone, texture and fine crinkling. These are skin-quality adjuncts, not volumisers. Injectable PRF can give a brief plumping measured in days, and it does not replace a filler or a Sculptra plan.
Why this oneSupports the plan with better skin quality. It does not add lasting volume.
Learn more →Microfocused ultrasound, lifting
Microfocused ultrasound that lifts and tightens lax skin along the jawline and under the chin, rebuilding collagen over two to six months. Ultherapy does not add volume, and no ultrasound device replaces lost fat or bone. It is the lifting complement to volume, for a face with both deflation and early laxity.
Why this oneFirms the lax tissue that travels with deflation, so restored volume sits on a better-supported frame. It is not a volumiser.
Learn more →BioPlus by the numbers
What to expect
Hyaluronic acid filler is often a single session with a review at two to four weeks. Radiesse is usually one to two sessions. Sculptra is a course of two to three, four to six weeks apart. PRP runs about three sessions, and Ultherapy is one.
Injectable treatments are low-downtime. Expect the possibility of swelling and bruising for a few days at the injection sites, a little more under the eye. Ultherapy has no real downtime beyond possible tenderness for a day or two.
Hyaluronic acid filler and Radiesse show immediately, then settle over one to two weeks. Sculptra builds over three to six months by design. PRP builds over four to twelve weeks, and Ultherapy lifts over two to six months.
Avoid heavy exercise, alcohol and, where advised, blood thinners for a day or two to limit bruising. After Sculptra, follow the short massage routine your physician gives you. Sunscreen every day.
None of these is permanent, because the face keeps ageing. Hyaluronic acid filler commonly lasts nine to eighteen months, Radiesse about twelve to eighteen, and Sculptra up to about two years. A plan includes maintenance, and a physician restores conservatively and reviews at two to four weeks, because volume is easier to add than to take away. Results vary from person to person, and your physician will tell you what is realistic for your skin.
A deflated face is not a sagging one, and it has its own answer. We restore the frame in balance, rather than filling one line.
The BioPlus approach to volume
Questions patients ask
Facial volume loss is the deflation of the face that comes with age, as fat, bone and collagen decline and the skin drapes over less support. The deep fat pads shrink and slide downward, the facial bones recede so there is less scaffold underneath, and the skin thins as collagen drops. The result is flat cheeks, hollow temples, under-eye shadows, deeper folds and a softer jawline, often while the skin surface still looks smooth. Because several layers are involved, a good plan restores the frame rather than filling one line.
Hyaluronic acid dermal fillers commonly last nine to eighteen months, depending on the product, the area and how mobile it is. Firmer gels placed on bone tend to last longer than soft gels in mobile areas, and filler under the eye can persist considerably longer, which is one reason it is dosed conservatively there. Radiesse lasts about twelve to eighteen months, and Sculptra results can last up to about two years. None of these is permanent, because the face keeps ageing, so a plan includes maintenance.
Dermal filler adds volume immediately, on the day, and hyaluronic acid filler can be dissolved if needed. Sculptra adds almost nothing on the day and instead prompts your own skin to build collagen gradually over three to six months, so the volume that appears is your own tissue. Filler suits a specific hollow or fold and a patient who wants to see the result at once. Sculptra suits diffuse, all-over deflation and thin skin, and a patient happy to wait for a gradual, natural change. Sculptra cannot be reversed, and it is sold as a course of two to three sessions.
Dermal fillers have a long safety record when placed by an experienced medical injector, and most side effects are minor and temporary, such as swelling or bruising. The serious risk is rare and specific: filler entering a blood vessel can block it, which is why anatomy knowledge and injector skill matter most. A review of the world literature found most severe vascular events arise from injections around the nose, glabella and forehead. Hyaluronic acid filler has a further safety advantage, it can be dissolved with the enzyme hyaluronidase, which a well-run clinic keeps on hand. The choice of injector, not the product, is the safety decision that counts.
Both stimulate your own collagen, but they behave differently. Radiesse adds volume immediately through its gel carrier and then builds collagen over the following months, and it is firm, so it suits structural support along the cheekbone, jaw and chin. Sculptra adds almost nothing at first and builds volume gradually over three to six months as diffuse collagen, so it suits all-over deflation and thin skin. Radiesse is usually one to two sessions; Sculptra is a course of two to three. Neither can be reversed, so both are placed conservatively.
Restoring volume can lift the overlying skin to a degree, because rebuilding the cheek supports the tissue that was draping over an empty frame and softens the folds below it. A liquid facelift is the term for restoring facial volume with injectables, and it is not the same as a surgical facelift. It does not remove loose skin or reposition the deep structures the way surgery does, and it will not fix heavy laxity. It refreshes a deflated face and improves balance. When the main problem is loose skin rather than lost volume, the honest answer is tightening or a surgical opinion, and the physician will tell you which your face needs.
No. Ultherapy is a lifting and tightening treatment, not a volumiser, and no ultrasound device replaces lost fat or bone. It uses focused ultrasound to firm and lift the lax tissue that often accompanies deflation, especially along the jawline and under the chin, so that restored volume sits on a better-supported frame. On a volume plan it is a complement to fillers and biostimulators, used when a face has both deflation and early laxity. If the concern is purely lost volume, the volumisers do that job.
Filler looks natural when the plan restores what was lost and treats the face in balance, rather than overfilling one area. The overdone look comes from too much product, or from filling a single line while ignoring the deflation around it, not from filler itself. A physician who assesses the whole face, restores conservatively, and reviews the result places less than many patients expect, which is what keeps it looking like you rather than like treatment. Hyaluronic acid can be dissolved if a result is ever heavier than you wanted.
Yes. Fillers and biostimulators do not target pigment, so their mechanism does not depend on skin colour and they do not carry the pigmentation risk that pigment-seeking lasers can in deeper skin. Trials in skin of colour and in Fitzpatrick IV to VI skin found no keloid formation and low or no rates of pigment change from the products, with the small risk of temporary pigmentation linked to needle punctures rather than the filler. BioPlus manages that with careful technique, fewer punctures and cannula delivery where suitable. A keloid history is worth raising at consultation. BioPlus has treated skin across every tone since 1996.
Cost depends on the treatment, how much product your plan needs, and how many areas are treated, so it is quoted for you after assessment. Hyaluronic acid filler is commonly priced per syringe, Radiesse per syringe, and Sculptra per vial as a course, so a single-area correction is priced very differently from a full-face restoration. Your complimentary consultation includes an honest price for the plan the physician recommends. Our services are private esthetic services and are not covered by MSP.
Related concerns
Wrinkles and texture
The broader ageing face, including the wrinkles and texture that volume alone does not treat.
Loose skin
Loose skin that has lost its firmness. It travels alongside deflation and is treated by lifting and tightening rather than by volume.
Tear trough
Dark circles, hollows and tear-trough shadows, where filler is one careful option among several.
Complimentary consultation
A deflated face is not the same as a sagging one, and it has its own answer. A physician assesses which areas have lost volume, tells volume loss apart from laxity, and matches the treatment to your face, an immediate correction, a gradual rebuild, or a lift to support the result. We restore the frame in balance rather than filling one line, and we have treated skin across every tone since 1996.
Book a complimentary consultationExplore treatmentsOur services are private esthetic services and are not covered by MSP.