Understanding Facial Volumisation — A Layered Approach

Last updated: 5 March 2026

What Is Facial Volumisation?

Facial volumisation is a sophisticated approach to facial rejuvenation that goes beyond simply filling wrinkles. It involves strategically restoring volume to multiple layers of the face — bone, deep fat pads, superficial fat, and skin — to recreate the youthful facial contours that are lost through the natural ageing process. This layered approach represents a paradigm shift in aesthetic medicine, moving from two-dimensional line-filling to three-dimensional facial reshaping.

At Axiom Aesthetics, our practitioners are trained in advanced facial anatomy and volumisation techniques, ensuring that treatments restore natural-looking fullness whilst avoiding the overfilled appearance that can result from poorly planned filler placement.

The Anatomy of Facial Ageing

Understanding why the face loses volume requires knowledge of the changes occurring at every structural level:

Bone Resorption

From our mid-thirties onwards, the facial skeleton undergoes progressive resorption (bone loss). Key areas affected include:

• Orbital rim — the eye socket enlarges, contributing to under-eye hollowing and lid hooding
• Maxilla — the upper jaw recedes, leading to flattening of the midface and deepening of nasolabial folds
• Mandible — the jawline loses definition, particularly at the chin and pre-jowl area
• Pyriform aperture — the nasal opening widens, contributing to an aged appearance of the nose and upper lip

Fat Pad Descent and Atrophy

The face contains distinct fat compartments that sit in predictable anatomical locations. With ageing:

• Deep fat pads deflate — the deep medial cheek fat pad, sub-orbicularis oculi fat (SOOF), and buccal fat diminish, removing structural support
• Superficial fat descends — gravity and loss of supporting structures cause superficial fat to migrate downwards, creating jowling and nasolabial fullness
• Compartmental separation — the boundaries between fat compartments become more visible as volume differential increases

Skin and Soft Tissue Changes

Collagen and elastin degradation, combined with reduced hyaluronic acid production, leads to thinner, less elastic skin that no longer drapes smoothly over the underlying structures.

The Layered Treatment Approach

Modern facial volumisation addresses ageing at each structural level, working from deep to superficial:

Layer 1: Deep Structural Support

Restoring deep volume provides the foundation upon which other treatments build:

• Cheek augmentation — placing robust HA filler (e.g., Juvéderm Voluma, Restylane Lyft) on or near the zygomatic bone lifts the midface and reduces nasolabial fold depth without directly filling the fold
• Temple volumisation — restoring temporal hollowing creates a more youthful convexity and can lift the lateral brow
• Chin and jaw projection — enhancing the mandibular contour provides lower face structure and definition

Layer 2: Mid-Depth Volumisation

Medium-density fillers placed in the subcutaneous layer address fat pad deflation:

• Mid-cheek restoration — replenishing the deep medial cheek fat pad
• Pre-jowl sulcus — filling the depression that forms between chin and jowl
• Marionette line support — providing structural support to reduce the appearance of downturned oral commissures

Layer 3: Superficial Refinement

Softer, more pliable products address fine lines and skin quality:

• Tear trough correction — carefully placed filler to address under-eye hollowing
• Lip volumisation — restoring age-related lip thinning with natural-looking enhancement
• Nasolabial fold softening — direct treatment of residual fold depth after deep support has been established
• Skin boosters — HA skin boosters improve skin hydration and quality across the entire face

Products Used in Facial Volumisation

Different areas and layers require different filler properties:

• High G-prime (firm) fillers — for deep structural support on bone (cheeks, chin, jaw). Examples: Juvéderm Voluma, Restylane Lyft, Teosyal Ultra Deep
• Medium G-prime fillers — for subcutaneous volume replacement. Examples: Juvéderm Volift, Restylane Defyne
• Low G-prime (soft) fillers — for superficial placement in delicate areas. Examples: Juvéderm Volbella, Restylane Kysse (lips), Teosyal Redensity II (tear troughs)
• Skin boosters — non-cross-linked or lightly cross-linked HA for skin quality. Examples: Profhilo, Restylane Skinboosters, Juvederm Volite

The MD Codes and Facial Assessment

Dr Mauricio de Maios MD Codes represent a systematic approach to facial assessment and treatment planning. This system identifies specific injection points based on emotional attributes rather than simply chasing lines and wrinkles. The approach considers how volume loss affects facial expression and emotional perception — for example, midface deflation can make someone look tired or sad, even when they are not.

At Axiom Aesthetics, we use a comprehensive facial assessment that considers the face as a whole, rather than treating individual areas in isolation. This prevents the common pitfall of addressing one area whilst inadvertently highlighting volume loss elsewhere.

Treatment Planning and Staging

A full facial volumisation programme is typically staged over multiple appointments:

1. Session 1: Deep structural support — cheeks, temples, and/or jawline
2. Session 2 (4-6 weeks later): Assess results and address mid-depth concerns — nasolabial folds, marionette lines, pre-jowl area
3. Session 3 (4-6 weeks later): Superficial refinement — lips, tear troughs, fine lines, skin boosters
4. Annual maintenance: Top-up treatments to maintain results as products gradually metabolise

“The art of facial volumisation lies not in how much product you use, but in where you place it. A small amount of filler in the right location can achieve more than large volumes placed incorrectly.” — International Master Course on Aging Science (IMCAS)

Frequently Asked Questions

Summary

Facial volumisation is both a science and an art. By understanding the multi-layered nature of facial ageing and addressing it systematically from deep to superficial, skilled practitioners can achieve natural-looking rejuvenation that restores youthful contours without the tell-tale signs of treatment. At Axiom Aesthetics, our approach prioritises facial harmony, patient safety, and results that enhance your natural beauty.