“Why does my face look more saggy after contouring injections?”

The under-eye area and front cheeks have thin fat layers, and once volume is lost, it is difficult to restore, making these areas particularly vulnerable to fat-reducing procedures. This is because volume in these areas actually contributes to a youthful and firm appearance.

When volume in the front cheeks decreases, the boundaries above and below become more prominent, which can emphasize nasolabial folds and a sagging appearance. Similarly, when volume is lost under the eyes, shadows and hollows deepen, which can make you look tired and older.

For these areas, it is often more appropriate to preserve or add volume rather than reduce fat, so site-specific assessment before the procedure is essential.

Some low-cost contouring injections may contain steroid ingredients that can cause skin atrophy and depression, which can lead to sagging and hollowing. This is a side effect with a different mechanism from fat reduction.

Repeated local exposure to steroids can thin and weaken the skin and subcutaneous tissue. As a result, changes such as skin depressions, atrophy and dilated blood vessels may occur, and these changes can sometimes be difficult to reverse. Therefore, the cheaper the contouring injection, the more important it is to check its ingredients.

So before the procedure, it is a basic safety measure to check what ingredients are included and whether steroids or ingredients of unclear origin are present. We recommend verifying that genuine products with clearly stated ingredients are used.

Face shapes where sagging or volume loss is more prominent than fat should approach contouring injections with caution. In such cases, reducing fat further can emphasize an aged appearance.

For example, in faces where volume has already started to diminish or lines have loosened due to loss of elasticity, the cause of a larger-looking face is often sagging rather than fat. If only fat reduction is performed in this situation, the root cause remains while volume is lost, and the result may differ from expectations. Conversely, face shapes with clearly clumped fat and maintained elasticity are good candidates for contour refinement.

In other words, it is important to first determine whether the cause of a larger-looking face is fat, sagging, or volume loss. This differentiation should ideally be made through a specialist's diagnosis.

If sagging has occurred, the general approach is to first identify the cause, then either tighten the skin with a lifting procedure or restore lost volume. Since the response varies depending on the cause, diagnosis should come before self-judgment.

If the sagging is due to loss of elasticity, you may consider tightening the skin by inducing collagen regeneration using radiofrequency (Thermage® FLX, 10THERMA, Alltite) or ultrasound (Ultherapy PRIME®) devices. If the problem is excessive volume loss leading to a hollow appearance, it may be helpful to reinforce the deficient areas with dermal filler or collagen-stimulating procedures.

However, recovery from steroid-induced atrophy may be limited, so prevention from the start is important. If changes have already occurred, we recommend consulting a specialist to accurately assess the condition and develop a personalized recovery plan.