Dr. Amanda Holden continues her Five Pillars of Aging series with a deeper look at Pillar Three: volume loss. While wrinkles often get the blame when someone feels they look older, the real shift may be happening underneath the surface.

As we age, collagen declines, facial fat pads shrink and descend, bone support changes, and the structure of the face gradually softens. These changes can make the cheeks look flatter, the temples more hollow, the jawline less defined, and the face more tired overall. Dr. Holden describes volume as the framework of the face. Just like a home needs a strong structure beneath the paint and design, the face needs support beneath the skin.

This is where treatments like Sculptra, filler, and other biostimulators come into the conversation. Sculptra stimulates collagen production gradually, with results that build over several months. Filler can create more immediate contour, structure, and refinement. Dr. Holden explains that these treatments are not necessarily competing options. In many cases, they can work beautifully together when guided by an experienced injector who understands anatomy, timing, and the patient’s goals.

She also discusses Radiesse and the broader shift in aesthetics away from simply filling lines and toward supporting regeneration, collagen stimulation, and long-term facial harmony. The goal is not to chase youth or try to look 25 forever. The goal is alignment between how someone feels and what they see in the mirror.

Volume loss is only one piece of the aging process, but when addressed thoughtfully, it can be a powerful part of an intentional aging plan.