Collagen and elastin of the skin decreases along with bone and fat reabsorption, leading to a loss of firmness and volume in the face. Areas of greatest susceptibility are the under eyes and cheeks. The main causes of this volume loss are hormonal changes that occur with age, environmental factors, and extreme diet and exercise.
Hormonal changes of aging often cause the fat that supports our cheeks to diminish, causing them to look depressed or sunken in. The loss of fat, along with the decrease in collagen production, can cause thinner skin that doesn’t retain its original plumpness.
While the use of a daily moisturizer and avoidance of smoking and sun exposure will help prevent further decrease in volume, the best way to reverse existing loss of volume in the cheeks is through the use of fillers.