# Volume *loss.*

> Facial volume loss explained: bone resorption, fat loss, connective tissue, typical signs by region, why volume is treated before lines and how much…

- Source: https://www.vivaderm.de/lexicon-volumenverlust-en.html
- Language: en
- Publisher: VIVA DERM, Privatpraxis für ästhetische Medizin, Rosastraße 6a, 45130 Essen, Germany, +49 1520 8367711
- Responsible physician: Katayoun Mostaghimi (Fachärztin für Allgemeinmedizin)
- Updated: 2026-10-05

The decline of fat, bone and connective tissue in the face from the mid-thirties. It explains shadows, lines and contour loss better than 'sagging skin'.

## A closer look.

The face ages in all layers: bone recedes at the eye socket, cheekbone, upper jaw and jaw angle, the deep fat compartments shrink, the connective tissue loses tone. In the end the skin is often 'too big' for the scaffold underneath – it folds not because it is lax but because it lacks support.

Typical signs: shadows in the tear trough, flatter cheeks, more pronounced nasolabial and marionette lines, a softer jawline, thinner lips and a receding chin. Depending on face shape they start in the mid-thirties and accelerate in menopause.

That is why modern treatment replaces volume precisely where it was lost – deep, in small amounts, over several sessions – rather than filling lines at the surface. One to four millilitres per session are realistic; 'eight millilitres at once' are not.

This lexicon entry is general information and does not replace the medical consultation required under German law (§ 630e BGB).

## At a glance.

- **Affected:** bone, fat, connective tissue
- **Onset:** from the mid-thirties
- **Signs:** shadows, lines, contour
- **Treatment:** deep volume, step by step

## Frequently asked questions.

**Is a facelift the solution?**

A lift tightens skin and connective tissue but does not replace volume. For many, volume is the more suitable first step.

**How do I know if volume is missing?**

Photos from ten years ago often show it most clearly – or the physician in the consultation.

## Related pages.

- [Fat compartments](https://www.vivaderm.de/lexicon-fettkompartimente-en.html) – Lexicon
- [Cheeks & mid-face](https://www.vivaderm.de/cheeks-mid-face-en.html) – Treatment
- [Hyaluronic acid](https://www.vivaderm.de/hyaluronsaeure-en.html) – All areas

## Sources

- [NHS: Dermal fillers – patient information](https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/dermal-fillers/)
- [MPDG – German medical devices act (fillers are medical devices)](https://www.gesetze-im-internet.de/mpdg/)
- [BfArM – Federal Institute for Drugs and Medical Devices](https://www.bfarm.de/)
- [DGPRÄC – German Society of Plastic, Reconstructive and Aesthetic Surgeons](https://www.dgpraec.de/)
- [§ 630e BGB – duty to inform before treatment (German Civil Code)](https://www.gesetze-im-internet.de/bgb/__630e.html)
- [DGBT – German Society for Aesthetic Botulinum Toxin Therapy](https://www.dgbt.de/)
- [AWMF – German clinical practice guidelines](https://www.awmf.org/)

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This page is general information and does not replace medical consultation and informed consent (§ 630e BGB). No guarantee of results. Prices are guide prices per GOÄ. Quoting with attribution (VIVA DERM, Essen) is expressly permitted.