Subcutaneous face volume loss - confirmed by plastic surgeon

Hey guys,

Have followed the forum for years and wanted to share my experience in particular with subcutaneous fat loss and plastic surgery.

Took fin about 10 years ago for two years. Had sexual sides while on it, but never after and I never had the PFS “crash,” so I know I am extremely lucky compared to many on this forum. I stopped (at age 22) because i began struggling with physical stress-like symptoms that I would later spend years trying to control (poor sleep, constant feeling of stress, need to clench my fists, no relief from exercise, poor focus, trying to improve cortisol levels/HPA axis imbalance).

I really noticed during the second year or taking it that my face looked different, and while no one ever seemed willing to confirm what I was saying, I felt the my cheeks had fallen or I looked older. Looking back at pictures, changed definitely occurred while I was on the drug - my smile was not the same, I looked tired around my eyes. For the following 8 years after stopping, it never came back. I think I slowly continued down this path of volume loss, perhaps at the normal rate starting from where I left off after propecia, or perhaps at an accelerated rate. Last year (age 30) I felt I looked so old and tired, I started investigating options.

I ended up meeting with a leading plastic surgeon in the field of fat grafting, who has written many respected articles on aging and fat grafting. He (and the other doctors I met with) all remarked that I had lot of tissue volume loss in my mid face, but somehow not around my lower face as much. It was a unique pattern of facial volume loss that he could only theorize occurred perhaps because I had an umbilical cord wrapped around my face as an embryo. But showing him pictures of myself when I was 20 (before fin) he was really surprised and said he had not heard of a rapid aging or degenerative condition like this.

I decided to go ahead and do the fat transfer (despite the high price, it was a priority for me). During the surgery, the doctor discovered that the tissue and bone loss was even worse than he thought. There was virtually no tissue at all present. He had to graft 70 ML of fat — the amount he said he would typically use for someone in their 60s or 70s undergoing this procedure.

The recovery took months. The doctor was completely shocked by the level of swelling that occurred, saying he had not seen fat grafting heal like that in 40 years in the field. Finally, the swelling went down. Now, I sort of have the facial volume similar to what I did before taking fin 10 years ago. My skin has also improved a little in terms of thickness. Who knows if it will last! Its definitely a major improvement.

The Dr.’s main take away from my long recovery was that I had no vascular system in my cheeks - that it had effectively dried up - and that the fat grafting took a long time to heal because it basically had to regenerate the entire system of vascularity. Perhaps damage to the vascular system is the mechanism behind this side effect of Propecia? I’m not a medical expert and hesitate to theorize too much.

I share all this not to suggest everyone should go spend thousands of dollars on plastic surgery. Moreso just to share that a leading plastic surgery confirmed that my facial fat loss was real and unprecedented for someone my age and in the pattern it occurred in his significant experience.

Happy to discuss further or chat of PM.


My husband’s condition is not so good. He looks more tired and aged because of the loose skin. One of his friends suggested]undergoing facial cosmetic surgery from a clinic in Mississauga but he is very much worried to go for any treatment. He says all this pain he is suffering is because of taking dutasteride for hair loss. He doesn’t want to go for any other treatments as it may make his situation even worse. I don’t know if I could convince him. But I think I could share your post with him. Since it gives a positive feel. Thanks!!

Has anyone else done this? And did the same problems appear?

I am considdering getting lipofilling done. Another question is, if the transplanted fat would melt in the state of pfs like the original one. Or is there a chance that it stays because it comes from places where the fat doesnt get lost while aging, like the belly?

Hello Tonster. I have had extreme problem with melting fat all over my body. And i have reserched it alot. I was first thinking about lipofilling but after i read about Sculptra i choiced to do that instead. I have Done to section and i must say Im very pleased with the result. Its not close to before but alot better. I dont Know how long it Will last but it have almost been one year and it seemes to last stil. For me it felt like a safer and easier treatment then lipo. For about 1 month ago i also have Done a hifu treatment and must say Im very pleased with the result also.I still have alot of problem but atleast something have changed for the positiv. I wish you all the best in battling this terrible syndrom!

1 Like

Hey Patrik,

thank you very much for sharing.

Gonna research it for sure (more). At first look i found a german dr. who writes on his homepage, that he doesnt use sculptra anymore, because in some cases it causes noodles, sometime they appear only after years. Is there really no concern about that?

Thank you. I wish you only the best as well. Hoping very much for baylor and melcanci…

My face began to recover/reverse for a couple hours during a temporary recovery I had from getting sick. I mean the skin especially the cheeks and below the eyes. I could see myself changing in front of the mirror and becoming more healthy looking.

So if you have this side-effect know it’s not permanent, if some of it is irreversible you can still get back some of what you had naturally without surgery. You just have to find a way to trigger it


Yes its true that there are risk with Sculptra also. It took long time before i decided to do it. I went to a very experience doktor. He sad that there was a 10% risk of develop some form of noduels but they were never so you coulde see them only feel them and he had made about 1000 treatments. I just think that its easier to get a god result because fat is a more unpredicible substans. But i dont say that one thing is better then the other i just tell you my experience. The most important is that you see a very experience doktor because its really a form of art work.

As much as i would like to believe that subcutanous fat loss is reversible, i am not capable of doing so. Tho, i can imagine dry, thinning, pale and maybe even sagging skin is reversible.

Tanks for your input guys, i keep recherching…

Just imagine this as a syndrome that artificially causes premature aging. And when the cause is removed, the body returns to normal functioning of your age.

1 Like

Well, the way i heard is that subcutanious fat loss is a one way street. There is no rebuilding mechanism. Once its gone its gone.

But who knows, i am open for a fortunate surprise :slight_smile:

We also heard male hairloss and penis size was totally predetermined by genetics and soy beans is a great gym protein source and many other things that have been disproved in the last several years.

Hi. i saw a doctor (plastic surgery) who never heard about pfs but even told me that maybe the fat will come back.

Did you recover from pfs? Did all the other symptoms disappear?

Does anyone know which specific facial surgeon the OP is talking about?

That under eye fat loss, specifically, sure sounds common around here. I had tear duct plugs put in to help with dry eyes and wondered if that had in some way contributed to the under eye skin… highly unlikely.

Anyone try botox every 6 months or so? What scares me about plastic or any surgery is just what OP described… us not healing as normal people.

1 Like