Pigmentation is seldom subtle: when you see a freckle or melasma, you see it in its entirety, stark and unchanging. This leads many people to focus on their pigmentation issues while a more fundamental change begins to affect their very facial structure.
Nothing ages our faces more obviously than saggy skin
It’s natural that most people focus on pigmentation issues before combatting the effects of sagging skin. After all, most of us, especially women, are used to concealing blemishes with makeup. Pigmentation is something we’re used to noticing and practising at fighting. Medical treatment is simply a more permanent solution to a problem that most people have been dealing with in one way or another since they were teenagers.
Sagging skin, though, develops slowly. It changes our faces so gradually that we hardly notice its early stages. Fortunately, experienced doctors can address the effects of sagging skin even after it has progressed for decades.
Before we look at treatment options, let’s examine the causes of sagging skin, and the specific changes it causes.
What Causes Your Skin to Sag?
Collagen loss is the most common cause of sagging skin. Collagen is the most abundant protein in our bodies. In most of its forms, including the ones that contribute to facial structure, collagen is a strong, flexible, fibrous material: cartilage, for example, contains a great deal of collagen. In the face, collagen binds layers of skin together and gives them shape. It also keeps the top layers of skin taut and smooth when we are younger.
After age 30, collagen levels drop by 1-2% per year. Although men and women lose collagen at the same rate, the effects are less pronounced in men due to their generally thicker skin.
Collagen loss first presents itself as a series of fine lines around frequently used parts of the face. As more collagen is lost, the skin begins to sag and droop.
Eventually, collagen loss produces two major types of facial change: changes in your face’s shape and changes in expression.
Changes in Face Shape
While everyone expects some wrinkles and even some gentle sagging as they age, many of my patients become alarmed when collagen loss begins to affect their jawlines. By this point, the lower face can appear squarish, even when the underlying bone structure suggests an oval shape.
In profile, the same phenomenon can make a patient appear overweight, even when she is in good physical condition. Collagen doesn’t just fill out parts of the face: it binds different types of tissue together. As collagen is lost, the skin between the chin and the neck is especially prone to sagging.
Changes in Facial Expression
Facial skin may sag most significantly at the jawline and behind the chin, but the most dramatic effect of collagen loss is often the changes it makes to a person’s resting expression.
When skin sags, one’s brows become a bit lower and the corners of one’s mouth may begin to point downward. The result can be a face that carries a downcast or angry expression, even at rest. This can lead to confusion and even hurt feelings among patients and their colleagues and loved ones.
New Hope for Ageing Skin
While genetic factors affect the way our skin ages, nearly everyone can take steps to better protect their skin against additional threats. Avoid sustained exposure to the sun, stay away from cigarettes and other sources of frequent smoke exposure, and be careful about radical departures from a healthy diet.
Apart from a healthy lifestyle, you may want to consider a proven medical treatment for sagging skin. Facelifts are no longer the only option; some would say that they are already outdated.
My clinic offers several different medical treatments addressing saggy skin, none of which involves surgery. Instead, they use a variety of methods to strategically damage some of the body’s existing collagen, which prompts the body to produce more collagen than it otherwise would. To achieve this, doctors have access to a wide variety of approaches, including radio-frequency (RF) therapies and a variety of non-ablative lasers, but my choice for most cases is high-intensity focused ultrasound or HIFU.
Stimulating Your Body’s Natural Collagen Growth
Like radio-frequency and laser treatments, HIFU works below the skin’s surface to stimulate your body’s own natural collagen growth. It does so by superheating tiny areas of collagen, which spurs your body into producing more. The result is an overall gain in collagen versus pre-treatment levels. To external appearances, this approach tightens skin and smooths wrinkles without the use of fillers or the pain and inconvenience of facelift surgery.
In case this sounds unlikely, consider your bones. Our skeletons stop growing when we reach maturity, and most of us begin to lose bone mass long before middle age. But regardless of age, when we suffer a fracture, our bodies are able to produce new bone again. The same is true of collagen: we may be losing it under normal circumstances, but our bodies are still able to produce more when necessary.
I tend to prefer HIFU for this purpose because it works more deeply than lasers and targets a more focused area than RF. This allows it to address the collagen-rich superficial muscular aponeurotic system (SMAS) while conveying benefits similar to those of fractional lasers.
HIFU is approved by major health regulatory bodies throughout Asia and the world: HSA (Singapore), KFDA (Korea), and CE (Europe). A single HIFU treatment can last up to a year; it incurs little to no downtime and minimal discomfort. When averaged out, a complete face treatment costs less than $150 a month.