What is “pillow face”?

The term describes a face that has been overfilled — usually by repeatedly chasing surface lines with filler rather than addressing the underlying anatomy. It is what we explicitly aim to avoid. The clinic’s preference is restoration of natural proportions, not maximisation of volume.

What about claims that fat grafting “reverses cellular ageing”?

Some marketing claims of this kind appear in the wider industry. We do not make them. Autologous fat grafting (Seffiller) provides volume; specific claims about cellular ageing are not language we use.

How is the plan decided?

At consultation, Dr Garara assesses the proportions of your face, the specific zones where volume has been lost, the quality of the surrounding skin, and your goals. The plan is built around what would produce a natural-looking restoration, not a generic protocol.

How long do results last?

HA filler typically lasts around 12–18 months. Biostimulator results following a course last around 12–18 months. Seffiller is variable — a proportion of transferred fat integrates and provides long-lasting volume; results vary. Skin-quality treatments last around 6–12 months with a course.

Is treatment painful?

Topical numbing or local anaesthetic is used where appropriate. Discomfort is mild for most injectable treatments; Seffiller (which involves both harvesting and transferring fat) is the most invasive option and has the longest recovery.

Can I have just skin-quality treatments without volume restoration?

Yes — for patients with relatively well-preserved underlying volume but skin-quality changes, regenerative skin treatments alone may give the result you want. The consultation decides whether structural support is genuinely indicated.

Facial Volume Loss Treatment in London

Q: Is Seffiller permanent?

No. A proportion of the transferred fat integrates and provides long-lasting volume; the rest is reabsorbed by the body. Results vary between individuals. We do not describe it as permanent because retention is partial and variable.

What it is

What Is Facial Volume Loss?

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Facial ageing has often been described as a deflating balloon, but a more accurate model is re-shaping: bone subtly remodels, fat pads atrophy and descend, and skin loses elasticity. Each contributes to the loss of the smooth convexity that characterises a youthful face — high cheekbones, a supported under-eye, and a clear separation between the lower face and the neck.

When the deeper structures are reduced, the visible result is often the surface concern that brought the patient in: deepening nasolabial folds, jowls, hollow tear troughs, descending brows. These surface changes are usually downstream of the volume loss; treating them directly without addressing the underlying anatomy often produces a heavier rather than refreshed result.

Dr Bhavin Garara’s approach is foundational. The aim is to restore structural support to a natural degree, not to create artificial volume. A face that has been treated well looks like a rested version of itself, not a different face.

Where it shows

Where Does Volume Loss Show?

Volume loss tends to appear in predictable zones. Most patients have changes in two or three at once.

Temples
A subtle hollow at the side of the eye that affects how the whole upper face sits.
Cheekbones / mid-face
Flattening of the malar prominence and descent of the malar fat pad — the central driver of jowl and nasolabial fold formation.
Under-eyes / tear trough
A depression at the lid-cheek junction casting under-eye shadow — see our hollow eyes page.
Jawline / pre-jowl sulcus
A small hollow just in front of the jowl, sharpening the visual edge of jaw descent.
Chin
Reduced projection contributing to profile imbalance — see our weak chin page.
Lips
Reduced lip body and definition — see our ageing lips page.

What causes it

What Causes Facial Volume Loss?

1
Bone resorption
The facial skeleton gradually loses volume from roughly the mid-thirties onward. The eye sockets widen, the maxilla recedes, and the mandible loses density.
2
Fat-pad atrophy and descent
Facial fat is organised into distinct pads. They shrink and migrate downward over decades — hollows form where they used to sit (temple, mid-face), and heaviness forms where they accumulate (lower face).
3
Decline in dermal collagen and elastin
The skin envelope loses thickness and elasticity, draping rather than holding the soft tissue beneath.
4
Sun damage
UV light accelerates collagen breakdown and fat-pad atrophy.
5
Lifestyle factors
Significant weight loss, chronic stress, smoking, and very high-intensity endurance exercise can accelerate fat-pad loss. None are causes you should feel blamed for; they are simply factors that can be modified or supported.
6
Genetics
Family pattern shapes how the face ages — bone shape, fat-pad distribution, and skin quality are all partly inherited.

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Dr Garara's approach

How Dr Bhavin Garara Treats Volume Loss

The clinic’s preference is restoration, not inflation. Many patients ask for or expect more volume than would be ideal; the clinical position is that good treatment looks rested, never “done.”

At the clinics in London, Dr Garara carries out a structured facial assessment at consultation — proportions, bone projection, fat-pad position, skin quality, and how each zone of the face is contributing to the overall picture. The plan addresses the underlying anatomy zone by zone, leading with structural support where genuine volume has been lost, then layering in skin-quality treatments.

Anatomy-led assessmentTreatment plans built around your unique facial structure and movement.
Personalised planCombinations chosen for your skin, goals, and lifestyle — not a one-size-fits-all protocol.
Natural resultsA refreshed, well-rested version of you — never a frozen or over-treated look.

Features

Treatment Options for Volume Loss

Structural support first — autologous (Seffiller), HA filler, or biostimulators — then skin quality and tightening. Surgical referral where appropriate.

Seffiller — autologous regenerative treatment

The clinic’s autologous fat-grafting treatment using the patient’s own tissue via the SEFFI / microfat technique. Retention is partial and variable; not described as permanent.

Hyaluronic acid (HA) filler — structural use

Dense, cohesive HA filler placed deep on the bone in zones of genuine volume loss. Reversible with hyaluronidase. Specific product choice decided at consultation.

Collagen biostimulators

PLLA or CaHA preparations (including HA + CaHA hybrids) build collagen progressively over weeks and months — volume and firmness that develop rather than appear immediately.

Regenerative skin treatments

Polynucleotides (Rejuran®), PDRN, skinboosters (Profhilo, Sunekos, NCTF, klardie), and autologous PRP / platelet-derived exosomes to support the skin envelope.

Radiofrequency microneedling

Sylfirm X tightens the skin envelope once volume has been restored. Device choice and settings are tailored for skin type.

See SkinPen microneedling →

Surgical referral

For very advanced volume loss combined with significant skin redundancy, surgical lift may be more appropriate. The clinic does not perform surgery.

Treatment is layered: structural support where volume has genuinely been lost, then skin-quality treatments to refine the envelope above. Plans are built around the patient’s anatomy, not a generic protocol.

Seffiller — autologous regenerative treatment

Best for: Selected patients with significant volume loss; autologous preference
Downtime: 5–10 days of swelling
Lasts: Variable — a proportion of transferred fat integrates and lasts; results vary

For patients suited to it, Seffiller is the clinic’s autologous regenerative treatment using the patient’s own fat via the SEFFI / microfat technique. Seffiller is autologous — it uses the patient’s own tissue, not a manufactured product — and is used for facial and skin volume restoration. A proportion of the transferred fat integrates and provides long-lasting volume, while the rest is reabsorbed by the body; results vary between individuals.

Seffiller is not described as permanent because retention is partial and variable. It is not a polynucleotide and not an off-the-shelf HA filler. Suitability is decided carefully at consultation; not every patient is a candidate, and Seffiller is one option within a wider plan rather than the only option.

Hyaluronic acid (HA) filler — structural use

Best for: Targeted volume restoration in specific zones; reversible
Downtime: 1–3 days of swelling
Lasts: Around 12–18 months

Dense, cohesive hyaluronic acid filler placed deep on the bone in zones of genuine volume loss can restore mid-face support, cheekbone projection, chin projection, and temple volume. HA filler is reversible with hyaluronidase. Specific product choice is determined at consultation.

Hyaluronic acid filler is reversible. See our filler removal and dissolving page.