Question: What is the best way to naturally replace collagen in my face below my cheek bones? I have developed hollow places in the past year. I'm 65, not overweight and in above average health. Can you recommend vitamins or something to regain fullness? Dr. Hibberd Responds: I wish I had the solution to this one! Hollow spots in our faces as we age reflect a local loss of tissue support, not just collagen. There may be a combination of elastin loss in our skin, atrophy of facial muscles (or wasting) and loss of local fat in the deep tissues of our skin and overlying muscles of our faces.
Natural tissue support requires a well-balanced diet, regular exercise and good health, but genetics also have a large effect. Our tissues loose their elasticity as we age, and there is no solution to reverse this other than using volume fillers, local injections and facial plastic surgery. There are no pills or supplements proven to reverse or prevent the hollowing of our appearance as we age, especially if we are not overweight.
I regard the condition of skin as a visible indication of overall health. A hollow-cheeked appearance is common in malnourished young patients, so be sure to seek consultation with your physician to review your general nutrition status to be sure you do not have a treatable or reversible medical or endocrine condition.
In the meantime, hydrating and moisturizing lotions and exfoliants are very useful for improving appearance of "mature" tissue, and adequate fluids (at least eight glasses daily) can help reduce the gaunt appearance that even mild dehydration often reflects in our faces. You might feel more comfortable with your appearance with some weight gain, or perhaps some minor "touch up," so seek your physician's advice.
Peter Hibberd is a medical doctor with over 28 years of outpatient and hospital-inpatient experience. He is board certified by the American Board of Emergency Medicine and is a member of the American College of Emergency Physicians. He also is a member and a fellow of the American Academy of Family Physicians.
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