**2. The aging process**

One of the primary advancements in cosmetic facial surgery has been the realization of volume loss in aging and volume replacement via cosmetic surgery [3-6]. The abundance of midfacial volume is one of the main reasons that makes a person look young, which means having the right amount of fat in the right areas of the face. The loss or shift of this fat is a main contributor to facial aging [7]. Loss of volume and volume shift occur in all regions of the face and neck and are the reasons for aged appearance [5, 6].The youthful midface has voluminous and

superiorly positioned malar fat pads. The malar fat pad is a triangular structure with its base against the nasolabial fold and its apex over the malar region. Due to actinic skin changes as well as gravity, fat atrophy, and deep connective tissue laxity, the malar fat pads lose volume and descend lower into the face with age. The sum of these aging changes frequently yields a hollow midface.
