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."




