Dermal Filler · Volume Sculptra JUVELOOK Volume

How are areas needing volume diagnosed?

The healthcare provider examines your facial expressions and overall facial balance, uses palpation to distinguish between volume loss and sagging, and then plans the appropriate amount for the areas that need it. Comparing current photos with ones from 5–10 years ago allows them to see which areas have changed and how much, improving diagnostic accuracy.

How Do You Identify Areas of Volume Loss?

The basic approach is to observe the shadows that form under lighting from multiple angles, including front, side, and oblique views. Areas with volume loss cast a hollow shadow when light comes from above, so the depth and boundaries of shadows are checked in order on the forehead, temples, under eyes, anterior cheeks, around the nasolabial folds, and along the jawline. Comparing a neutral expression with a smiling expression allows you to see how the hollowing changes with the movement of facial muscles.

In addition, palpation—pressing the skin and lifting it up—is used to evaluate skin elasticity, the thickness of the fat layer, and the degree of bony support. If you bring photos from the past (5–10 years ago), it is possible to compare which areas have changed and how much due to aging, which increases diagnostic accuracy. Through this comprehensive evaluation, it is important to find not simply "the area that looks hollow" but "the area causing the hollowing."


How Do You Distinguish Sagging from Volume Loss?

Comparing the changes in your face when lying down versus sitting in front of a mirror can help identify the general direction. Sagging often involves a shift of tissue downward, so changing position frequently results in noticeable differences. Hollowing, on the other hand, involves a decrease in volume itself, so the sunken feeling tends to remain relatively unchanged with positional changes. However, in the actual aging process, hollowing and sagging often occur together, so the exact cause and their proportions are determined based on a comprehensive evaluation of skin condition and facial structure.

CategoryHollowing (volume loss)Sagging (looseness)
CauseDecrease in tissue such as fat and boneWeakening of support from ligaments and skin
When lying downThe sunken appearance remainsAppears significantly improved
Primary approachVolume replenishment (dermal filler or collagen stimulator)Lifting (ultrasound, radiofrequency, etc.)

This distinction is important because the solution differs depending on the cause. If hollowing is the main issue but only lifting is performed, or if sagging is the main issue but only volume is filled, satisfaction may be low. If both factors are present, planning a step-by-step combination of lifting and volumizing may be helpful.


Can Tools Like 3D Diagnostic Devices Help?

Yes, 3D facial imaging equipment helps to assess the volume status with numerical values and images. It records the three-dimensional shape of the face to visually show asymmetry or the volume of hollow areas, and is also used to check changes before and after treatment.

However, the treatment direction is not determined solely by the equipment results. Changes with facial expressions, skin elasticity and texture, and the natural impression the patient desires must all be evaluated together through the specialist's observation, palpation, and consultation.

Ultimately, 3D analysis is a tool that assists in diagnosis, and a more balanced treatment plan can be established when combined with the Dermatologist's clinical judgment.


How Do You Consider Overall Facial Balance?

The principle of volume treatment is to assess not just one area but also the ratios of the forehead, midface, and lower face, as well as the lateral facial line. For example, even if the concern is nasolabial folds, if the cause is volume loss in the anterior cheek and cheekbone area, injecting only into the folds rather than considering the balance of the midface could lead to less natural results.

The injection site, layer, and amount are designed taking into account left-right symmetry, harmony between the frontal impression and the lateral profile, and volume shift when smiling. Volume treatment is not simply about filling hollow areas, but a process of adjusting the overall balance of the face. Therefore, rather than focusing on one area, it is important to adopt an approach that distributes an appropriate amount across the necessary areas.


How Do You Plan Conservatively?

A safe principle is to not try to achieve everything in one session, but to start with the minimum necessary amount and supplement it step by step. Especially for treatments that induce collagen production, such as Sculptra and JUVELOOK Volume, the effects appear gradually over several weeks. Therefore, adjusting the dose for the next session after checking the results can help prevent overcorrection.

For HA Filler, it is also more natural to adhere to the appropriate amount per area and add more after 2 to 4 weeks if needed, rather than injecting a large amount from the start. Before the procedure, please share your desired impression (such as definition or softness) in detail, and thoroughly discuss the step-by-step plan and expected changes suggested by the Dermatologist. Since the appropriate amount and sequence vary depending on an individual's facial bone structure and tissue condition, a consultation with a specialist is recommended.


References

Kim Sujeong

Dermatologist · Heal House Suwon Branch

Believing that beauty begins with healthy skin, we will be with you and care for you every step of the way.