What Happens to the Face After 40 – and How Dermal Filler Can Help

Ageing of the face is not just about wrinkles. In fact, lines are often the last thing to appear. The most significant changes after 40 happen deeper — in the fat pads, bone structure, and overall shape of the face.

Understanding these changes helps explain why the face can start to look tired, heavy, or “fallen”, even when the skin itself is in reasonable condition — and why dermal filler, when used correctly, can temporarily restore a more youthful structure.

Facial ageing is structural, not superficial

From our late 30s onwards, the face undergoes predictable anatomical changes:

1. Loss of facial fat pads

The face contains multiple distinct fat pads (cheeks, temples, under-eye, jawline). With age:

• Fat pads shrink, descend, and redistribute

• The midface flattens

• Hollows appear under the eyes and in the temples

• Nasolabial and marionette lines deepen secondarily

This is why simply “filling a line” often gives poor or heavy results — the real issue is loss of support above.

2. Bone resorption (yes, the bones change too)

After 40, facial bones gradually lose volume, particularly:

• The maxilla (midface)

• The orbital rim (eye socket)

• The jawline and chin

As the underlying scaffold shrinks:

• Soft tissue has less support

• The face loses projection

• Jowls and sagging become more apparent

This is a major reason the face can look shorter, wider, or bottom-heavy with age.

3. Skin quality changes (the visible layer)

On top of these deeper changes:

• Collagen and elastin production slows

• Skin becomes thinner and less resilient

• Gravity has a greater effect on unsupported tissue

But again — skin ageing is often a consequence of volume loss beneath, not the primary problem.

The “Golden Triangle” of youth

In a youthful face, volume is concentrated in the upper and midface, forming what is often called the golden triangle:

• Broad at the cheekbones

• Narrowing towards the chin

This distribution gives:

• Lifted cheeks

• Bright, open eyes

• A defined jawline

What happens with ageing?

As volume is lost and descends:

• The triangle inverts

• Fullness shifts to the lower face

• The face appears heavier at the bottom

• Jowls and folds become more prominent

This inversion is one of the most recognisable signs of facial ageing after 40.

How dermal filler can help (when done properly)

Dermal filler does not stop ageing — but it can temporarily replace lost volume, rebalance facial proportions, and restore structural support.

When used strategically, filler can:

• Rebuild cheek projection

• Support the midface and reduce heaviness below

• Improve under-eye hollows indirectly

• Reduce the appearance of nasolabial and marionette lines without directly overfilling them

• Recreate a more youthful facial shape

The aim is restoration, not augmentation.

Why full-face assessment matters

Treating individual lines in isolation often leads to:

• Overfilled areas

• Puffiness

• An unnatural or “done” look

A medical approach focuses on:

• Facial anatomy

• Structural support

• Balance and proportion

By restoring volume higher in the face, we can often achieve a fresher, more lifted appearance using less product overall.

Subtle, temporary, and individual

Dermal filler results are:

• Temporary (typically 12–24 months depending on product and area)

• Tailored to your anatomy

• Best done gradually

The goal is not to look younger than you are — but to look like yourself, well-rested and supported.

In summary

After 40, facial ageing is driven primarily by:

• Fat pad volume loss

• Bone structure changes

• Redistribution of soft tissue

Dermal filler, when used by a medically trained practitioner with a full-face approach, can temporarily restore lost structure, rebalance the face, and soften the visible signs of ageing — without chasing lines or trends.

If you’re considering treatment, a comprehensive consultation is the most important first step.