As we age, the skin starts to lose its firmness due to the loss of two important proteins called collagen and elastin, the building blocks in the dermis that are responsible for keeping the skin firm, supple and youthful looking. While elastin gives skin elasticity, providing firm skin with the ability to bounce back when stretched, collagen is that which helps to firm and tighten the skin.
Laxity in skin results in sagging skin and a saggy face – one of the major concerns of skin aging in women. Saggy skin is also often associated with the loss of fat. People who have lost significant amounts of weight and rapidly, are also more susceptible. Other factors like certain medical conditions may also cause saggy skin.
Skin that’s firm can stretch and snap back into place easily and swiftly. However, skin that loses collagen also loses the ability to bounce back. This is when skin starts to sag. Saggy skin can happen almost anywhere on the body - besides cheeks being the most visible area that sag, other common areas include eyelids, chin, jowls, throat, upper arms and stomach.
Types of sagging facial skin
When your cheeks lose its fullness, it is no longer plump and smooth (which are what gives the appearance of youthfulness) but have flattened instead. This is due to the weakening of the underlying muscles when elastin is damaged.
As you grow older, the skin from your cheeks down to your jawline loses much of its collagen and elastin. Collagen is a protein that makes up the connective tissue in your body. Elastin is another connective tissue protein that lets your skin return to its normal shape even after being stretched. As these proteins are lost, the cheek skin surrounding your mouth also loses its firmness and tightness. Over time, gravity causes it to droop and sag on both sides of your mouth and chin.
Double chin fat, also known as submental fat, can affect both men and women of all ages and weight. In fact, skinny people may also get double chin. This is because you accumulate double chin fat when metabolism slows down due to skin aging. Another reason why you may develop double chin or sagging neck skin is due to a loss of collagen. Loose under-chin and neck skin also cause the appearance of double chin. Genetics also play a part where Asians tend to have what’s called a “small” or receded chin.
For treatments of double chin fat, you don’t have to resort to liposuction fat reduction surgery. It can be reduced or you can contour weak jawline or tighten loose, saggy skin under the chin through various non-invasive aesthetic options.
Downturned mouth corners
Your mouth starts to take on a downturned appearance when there is a volume loss, and loosening of the ligaments around the mouth. The muscle known as the Depressor Anguli Ori (DAO) that connects the corners of the mouth to your jaw bone, will result in a pull down on the sides of the mouth as it is primarily used for facial expressions such as frowning.
Dos & Don’ts
Do exercise more regularly
Saggy skin due to moderate weight loss or pregnancy can be improved through exercise. This is why any movement that builds muscle mass or tightens muscles can reduce the look of minor skin sagging. A sedentary lifestyle coupled with an unhealthy high-fat, high caloric diet will also result in an increased accumulation of fat – such as the worsening of double chin.
Don’t sleep on your side
Sleeping with your face pressed against a pillow every night can possibly cause sagging jowls. Try to sleep lying on your back as much as possible. If that’s difficult then try investing on a softer or memory foam type pillow.
Do protect your skin from UV damage
Daily exposure to the ultraviolet rays without any protection can lead to damage of skin’s elastin. This is why people who spend many hours sun tanning have older, more wrinkly and saggier skin. This damage unfortunately will only surface much later when you are older.
Don’t allow stress to get the better of you
Research suggests that there is a link between stress to shorter telomeres, a chromosome component and a protective casing at the end of a strand of DNA. Every time a cell divides, it loses bits of telomeres. Although enzyme telomerase will replenish it, chronic stress and cortisol exposure will eventually diminish your telomeres supply. When telomeres reduce, the cell will die and become prone to inflammation. This is how the aging process and its associated health risks begin.
Do watch your posture
Hunching and extended usage of your smartphone where you are constantly bending your head forward to stare down at your phone for long periods of time increase the gravitational pull on the jowl area, leaving you with a drooping jawline. On top of sagging skin, constant neck bending can also cause creasing above the clavical.
Do invest in proper skincare early
It’s never too early to start taking care of your skin. People start to show signs of aging from as early as their 20s. Know which products work best for you and be consistent in using them. As the saying goes, ‘there are no ugly women, only lazy ones’.
Depending on the severity of laxity in skin, surgical procedures may not be required. Although results may not be as drastic, there are many options to consider that can help improve the appearance of sagging skin.
There are many over-the-counter (OTC) creams, lotions and serums that contain ingredients such as retinol that’s been said to improve skin elasticity. Prescriptive retinoids such as tretinoin and retin-A, are also good for boosting collagen production. These will usually produce more significant results compared to their OTC counterparts.
Light Based Treatments:
Laser beams sends heat deep into the skin to help tighten loose, sagging skin or smoothen lines and wrinkles, without injuring the upper layer of the skin. Several types of laser therapy treatments can help boost collagen production and improve overall skin tone. Laser therapy can be beneficial for firming but will require multiple treatments over the course of a few months.
Ablative laser resurfacing is a highly effective procedure that uses laser to remove the upper layers of the skin and send heat deep into the lower layers. This is why it is sometimes referred to as “laser peeling”. It is more invasive than any other laser therapy and it has a longer recovery time, typically around two weeks.
Non Light-Based Treatments:
Fillers are made of a material called hyaluronic acid, a naturally-occurring substance (glycosaminoglycan polysaccharide) that is found in the skin to help draw and bind water to itself and the surrounding skin. It can be injected into your chin and neck to fill in jowls and make them look less saggy. Whether temporary or semi-permanent, injectable fillers are also used to help achieve a stronger jaw-line, as well as stimulate collagen production. Temporary fillers are most popular because they can replace loss of volume.
Radiofrequency uses a handheld device to deliver heat into the skin but at a more superficial lever to trigger collagen production. A popular brand name for this treatment is Thermage which is often used to tighten the skin around the neck and chin. The latest generation being Thermage FLX which delivers much faster and longer lasting skin tightening results.
There’s really little to no downtime with very low risks of complications or side effects, including infections. This collagen rebuilding process and improvement in skin quality will continue over the next six months. A touch-up treatment is generally needed within the year to help you maintain the results.
With Ulthera being the most popular brand name under ultrasound treatments, it uses ultrasound energy to heat the skin at a much deeper depth. This triggers your body’s natural healing process to use its own collagen to rebuild the skin. Ulthera delivers heat to the tissues and muscle leading to more prominent skin tightening and lifting effects, as well as improving the appearance of sagging skin. HIFU is another procedure that uses ultrasound energy that penetrates deep into the skin to help with the production of elastin and collagen, leaving you with almost the same results as a surgical facelift. This can also be used for double chin removal by providing an added skin lift and contour. With these treatments, results are only visible from the third month followed by gradual improvements over the months. Touch-up treatments are only needed a year later.
For those who do not wish to go under the knife, consider treatments like thread lift, the non-invasive face lift that uses absorbable silk protein threads and therapeutic serum infusions of hyaluronic acid and peptides, to give you the effects close to that of a face lift without any down time. This non-invasive treatment helps to give the face a slight lift, intensely hydrate and plump the skin, in turn diminishing the appearance of fine lines to give you instantly lifted and firmer facial contours. Other treatments to consider include IDS Aesthetics Dual Lift Treatment which combines a series of steps such as microdermabrasion, radio frequency and potent ampoules to firm and rejuvenate the skin.