Volume loss in the face is caused by a number of factors most commonly the breakdown of collagen and other proteins which provide structure to the skin.

Collagen and elastin are key building blocks to healthy skin, and as we age production begins to decrease, leading to volume loss in face key areas such as cheekbones, the under-eye area and cheeks.

As we lose fullness in these areas It can make other certain areas appear heavier, such as the jowls and neck, which can lead to sagging skin and may sometimes alter the structure and shape of our whole face.

Hormonal changes can also lead to volume loss by changing the quality and location of fat in face. This can be exacerbated by the reduction of  hyaluronic acid which keeps skin hydrated. 

External factors that impact tissue volume and fullness are environment, diet, stress and weight loss/gain.