Preventing facial fat loss after energy-based treatment 

Picture this: you’ve just emerged from the latest energy-based facial treatment [1] session, feeling hopeful and invigorated by the prospect of firmer skin and a more youthful appearance. But what if beneath the surface, amidst the buzz of energy waves and the promise of rejuvenation, lies a potential side effect that’s not often discussed?

In Singapore, energy-based treatments have revolutionised the skincare industry with their ability to target specific concerns and stimulate collagen production. However, these powerful treatments can inadvertently lead to facial fat loss or face volume loss through several mechanisms.

rf microneedling
Energy-based facial treatments such as radiofrequency microneedling can result in facial fat loss.

When energy-based treatments are administered, they often generate heat to target tissues beneath the skin. If not properly controlled, this heat can damage or destroy fat cells, resulting in their gradual breakdown and removal by the body. Additionally, the inflammatory response triggered by these treatments can contribute to the breakdown of fat cells, which may further exacerbate the loss of facial volume. Moreover, excessive collagen remodelling stimulated by energy-based treatments may affect the distribution and support of fat cells in the treated area, leading to a sunken or hollow appearance. 

Unfortunately, once facial fat loss occurs, it is difficult to reverse. Unlike gaining weight in other areas of the body, regaining lost facial fat can be challenging, especially as one ages. The loss of facial fat is a primary contributor to a gaunt and aged appearance, which is why its preservation plays an important role in one’s anti-ageing skincare journey.

While energy-based treatments offer promising results in skin rejuvenation, it is essential to understand the potential risks, including facial fat loss, and to consult qualified professionals to ensure safe and effective treatment outcomes.

Facial fat loss
Energy-based treatments can inadvertently disrupt facial fat cells, resulting in facial fat loss.

How do energy-based treatments impact facial fat? 

Energy-based treatments, such as radiofrequency (RF) treatments, can potentially cause facial fat loss because of the underlying mechanisms involved in these treatments: 

Thermal damage

Some energy-based treatments, like certain types of RF devices [2], generate heat to target specific tissues beneath the skin. When these treatments are not properly administered or if the heat is too intense, it can damage the targeted tissues and the surrounding fat cells, leading to their destruction or degradation.


Apoptosis, or programmed cell death, can occur in response to certain energy-based treatments. This can lead to the targeted fat cells undergoing cell death [3] and subsequent removal by the body’s natural processes. If the treatment is too aggressive or not adequately controlled, it can result in excessive fat cell death and subsequent fat loss in the treated area.

Collagen remodeling 

Some energy-based treatments are designed to stimulate collagen production and remodelling in the skin. While this can benefit skin tightening and rejuvenation, excessive collagen remodelling may inadvertently affect the distribution [4] and support of fat cells in the treated area, which can cause fat loss or redistribution.

However, the extent of fat loss and other side effects varies depending on factors such as the type of energy-based treatment used, the expertise of the practitioner administering the treatment, the settings used during the procedure, and individual patient factors. Therefore, it’s crucial to undergo these treatments only under the supervision of qualified healthcare professionals who can ensure safety and optimal outcomes.

RF device and facial fat loss
Improper use of RF devices may induce excessive heat, triggering facial fat cell degradation. 

Types of energy-based treatments associated with facial fat loss

Several types of energy-based treatments are commonly implicated in facial fat loss. Understanding these treatments and their side effects is essential for making informed decisions about skin care procedures.

Radiofrequency (RF) treatments

RF treatments like Thermage and RF microneedling deliver controlled energy to the skin’s deeper layers, stimulating collagen production and tightening the skin. However, excessive heat generated by RF devices can lead to thermal damage [5] to fat cells, resulting in their destruction and subsequent fat loss. 

Ultrasound therapy

Ultrasound therapy, such as High-Intensity Focused Ultrasound (HIFU) and Ultherapy, uses focused ultrasound energy to lift and tighten the skin by stimulating collagen production. While this non-invasive procedure is generally safe and has minimal side effects, it can inadvertently affect fat cells in some cases when improperly performed. The heat generated by ultrasound energy may damage fat cells; as a result, it may contribute to volume reduction and changes in facial contours [6]. 

Minimising risks and maximising benefits of energy-based aesthetic treatments

While energy-based treatments offer promising results in skin rejuvenation, it’s essential to approach them with caution to minimise the risk of facial fat loss. Here are some strategies to consider:

Choose a qualified and experienced practitioner

Selecting an aesthetic doctor who specialises in energy-based treatments and has extensive experience is necessary. A skilled practitioner will have a thorough understanding of facial anatomy and the complexities of each treatment modality, which will help ensure safe and effective outcomes. Before undergoing any procedure, take the time to research potential providers, inquire about their credentials, and ask to see photos of previous patients.

Prioritise safety and precision

When determining treatment parameters, such as energy levels, pulse durations, and treatment intervals, prioritise safety over aggressiveness. An experienced and trustworthy aesthetic doctor understands the importance of this balance. Tailoring the treatment approach to each patient’s unique needs and skin characteristics is essential. This will help provide optimal results and minimise the risk of adverse effects, including facial fat loss. Collaborate closely with your aesthetic doctor to establish realistic expectations and develop a personalised treatment plan that aligns with your goals and skin condition.

Beware of falling into the trap of ‘more is more.’ Despite the allure of social media ads promoting super cheap treatments or high quantities of shots as offering more value for money, it’s crucial to realise that the number of shots does not equate to a better outcome. In fact, opting for excessive treatments can increase the risk of facial fat loss and other complications. Trustworthy aesthetic practitioners prioritise quality over quantity and ensure that each treatment session is carefully tailored to deliver safe and effective results. 

Open communication with your aesthetic doctor

Effective communication with your aesthetic doctor is key to achieving satisfactory outcomes from energy-based treatments. Be upfront about your concerns, treatment goals, and any medical history or medications that may affect the procedure’s safety and efficacy. Your doctor should take the time to address your questions and concerns while providing detailed explanations of the treatment process, potential risks, and expected outcomes. Establishing clear communication will promote trust and ensure you are well-informed and confident in your decision to undergo treatment.

Consider complementary treatments

In cases where facial fat loss has occurred following energy-based treatments or as part of the natural ageing process, complementary treatments such as injectable fillers or fat grafting [7] may be beneficial. These procedures can restore lost volume and enhance facial contours, which can help you achieve a more youthful and balanced appearance. 

For those seeking a less invasive solution than surgery or fillers, consider Bioremodulators such as Profhilo instead. Profhilo is a safe and effective alternative that can address facial volume loss while delivering natural-looking results. 

Profhilo [8] is an injectable treatment with a high hyaluronic acid concentration. The treatment works by stimulating the skin’s natural collagen and elastin production, improving skin quality and hydration. As a Bioremodulator, Profhilo does not add volume to specific areas but instead enhances overall facial contours, which makes it an ideal option for those seeking a subtle yet noticeable rejuvenation.

However, achieving optimal outcomes with Profhilo requires a specialised injection technique. The typical BAP (Bio Aesthetic Points) technique may be less effective for facial fat restoration. Professional aesthetic practitioners employ a proper injection technique to ensure even distribution and maximum diffusion within the skin layers while administering Profhilo. Therefore, make sure to consult an experienced and expert aesthetic practitioner who can achieve the best facial rejuvenation outcomes for you.  

Follow post-treatment care instructions

Following post-treatment care instructions diligently is essential for supporting optimal healing and minimising the risk of complications. Your aesthetic doctor will provide specific guidelines regarding skincare, sun protection, and activity restrictions following energy-based treatments. Adhering to these instructions can ensure successful outcomes and reduce the likelihood of adverse effects, allowing you to enjoy the full benefits of your treatment.

If you’re seeking energy-based treatments from a reliable practitioner or have concerns about potential facial fat loss, schedule an appointment with Harmony Aesthetics Clinic for guidance and personalised care tailored to your needs.


Energy-based treatments offer hope for those seeking rejuvenated, youthful skin. While these procedures hold the potential to address a myriad of skincare concerns, including wrinkles, sagging skin, and uneven texture, it’s crucial to acknowledge and understand the potential risks, particularly concerning facial fat loss. 

From thermal damage and apoptosis to collagen remodelling, energy-based treatments can inadvertently impact facial fat. Once facial fat loss or face volume loss occurs, it becomes quite challenging to reverse it. While traditional skincare products may offer temporary plumping effects, they cannot effectively address the underlying volume loss. Surgical interventions such as fat grafting or facelifts may provide more dramatic results, but they come with risks and downtime. 

Prevention and minimisation of facial fat loss involves adopting a comprehensive approach that includes skincare habits, lifestyle modifications, and only opting for targeted treatments under the guidance of an experienced aesthetician. Protective measures such as wearing sunscreen daily, staying hydrated, following a healthy diet rich in antioxidants, and avoiding smoking can help preserve collagen and fat tissue in the face as you age. 

For individuals already experiencing facial volume loss due to energy-based treatments, seeking professional guidance from qualified skincare doctors is crucial. Skincare experts can recommend personalised treatment plans that may include minimally invasive procedures like bioremodulators or other injectable fillers to restore lost volume and rejuvenate the appearance of the face.

Remember, the success of energy-based treatments lies in the synergy between patients and healthcare providers, where the healthcare professional constantly guides the patient in achieving their skincare goals with confidence and expertise while ensuring maximum safety. By making facial volume preservation a priority in one’s skincare regimen and seeking timely intervention when needed, individuals can maintain a youthful, balanced appearance and avoid the premature onset of a gaunt, aged look.


1. Ph.D, A. R., M. D. (2023, November 6). Overview of energy-based treatments in aesthetics. American Cosmetic Association. 

2. Li, Cong, et al. “Investigation on Thermal Damage Model of Skin Tissue in Vitro by Infrared Laser Welding.” Optics and Lasers in Engineering, vol. 124, Jan. 2020, p. 105807. ScienceDirect,

3. David, J Goldberg “Deletion of adipocytes induced by a novel device simultaneously delivering synchronized radiofrequency and hifem: Human histological study.” Journal of Cosmetic Dermatology, vol. 20, no. 4, Feb. 2021, pp. 1104-09,

4. Zöller, Nadja, et al. “Collagen I Promotes Adipocytogenesis in Adipose-Derived Stem Cells In Vitro.” Cells, vol. 8, no. 4, Apr. 2019, p. 302. PubMed Central,

5. Franco, Walfre, et al. “Hyperthermic Injury to Adipocyte Cells by Selective Heating of Subcutaneous Fat with a Novel Radiofrequency Device: Feasibility Studies.” Lasers in Surgery and Medicine, vol. 42, no. 5, July 2010, pp. 361–70. PubMed,

6. Byun, Kyung-A., et al. “High-Intensity Focused Ultrasound Decreases Subcutaneous Fat Tissue Thickness by Increasing Apoptosis and Autophagy.” Biomolecules, vol. 13, no. 2, Feb. 2023, p. 392. PubMed Central,

7. Marten, Timothy J., and Dino Elyassnia. “Fat Grafting in Facial Rejuvenation.” Clinics in Plastic Surgery, vol. 42, no. 2, Apr. 2015, pp. 219–52. PubMed,

8. Cassuto, D., Cigni, C., Bellia, G., & Schiraldi, C. (2023). Restoring adipose tissue homeostasis in response to aging: Initial clinical experience with profhilo structura®. Gels, 9(8), 614.