Sagging skin and what to do about it
Sagging Skin
The Primary Culprit: Genetics, weight loss, and UV damage.
Sun damage accounts for most of the signs of aging but seeking out the culprit for
our sagging skin is a little more complicated and may require a quick look at the family photo album. Look at photos of your parents when they were younger. Which of them do you look most like? If there is a clear answer, then take a look at them now or pictures of them later in life. Notice the areas where they droop and where they showed a loss of volume. Now you have an idea as to what you are up against. However, this does not have to be your future my friend! Recent weight loss can also lead to excess skin and sagging. This too, can be managed.
Level 1 skintervention: Mild Prevention
Oral peptides, Retinoids, Sun Protection
I know, mild prevention doesn't sound very sexy, but this is one of the tougher challenges to overcome so I am just setting expectations here. Sagging skin is a little tricky to manage at home without a device but do whatever you can to build up your collagen and fibroblast cells, especially in your challenge areas that you have already identified by looking at your parent.
Retinoids
Beginning a Retinoid routine is essential here and will help to slow the sag but you should not expect any reversal. Still, your future self from this universe will thank you for using them.
Oral Collagen Peptides
When it comes to collagen peptides, I myself, have been skeptical in the past, HOWEVER, peer reviewed studies keep popping up that suggest that they do make a marked improvement in areas such as skin hydration, elasticity, and firmness. Hey who am I to argue with the scientific method? I sure did go out and buy me some.
Sunscreen
I am not "mansplaning" sunscreen to you. Just wear some. mkay?
Level 1 and 2 skintervention: Prevention and Some Correction.
Oral peptides, Retinoids, Sun Protection
AND
Home devices: RF, and HIFU
Home devices aren't substitutes for professional-grade equipment found at a plastic surgeon's office. However, they can be helpful and serve as excellent supplemental tools. But first, you'll need to arm yourself with some knowledge before hunting for a home device. Basically, there are two technologies out there that can treat saggy skin: RF (radiofrequency) devices and HIFU (high-frequency ultrasound devices).
Both of these devices have their pros and cons, but they work by generating heat deep in your dermis. This heat causes our fibroblasts to contract, initiating a healing response. RF devices generate “general heating” of the tissue, whereas HIFU devices provide “targeted heating” at a specific depth.
Unfortunately, if you Google these terms, you'll be bombarded with thousands of ads for devices claiming to work miracles, complete with "Benjamin Button-style" before and after photos. Take a step back, manage your expectations, and look for reputable device dealers rather than the devices themselves. Opt for dealers who sell to professionals and check the contact info in the footer of their site to ensure they have valid, stateside contact information. This doesn't mean the device isn’t made overseas (almost all of them are), but if something goes wrong or you need guidance, you’re more likely to get help from a stateside customer service rep without having to fork over $500 in shipping costs for repairs.
Level 1, 2, and 3 skintervention: Effective prevention and advanced correction.
Oral peptides, Retinoids, Sun Protection
AND
Home devices: RF, and HIFU
AND
Professional treatments.
So, you’ve got your radiofrequency device, you're using your retinoids, and taking your collagen peptides, and now you want to step it up a notch. This is where the pros come in. There are four main professional services you should consider if you’re noticing sagging skin, depending on where your skin doth sag.
For the upper eyelid:
Blepharoplasty. This quick in-office procedure removes excess eyelid skin. If your upper lids sag enough to impair your vision, check with your insurance company; they might cover some or all of the procedure.
For jowls and waddle:
Ultherapy. If HIFU is a tremor that breaks some windows, Ultherapy is the earthquake that levels the city. It sounds extreme, right? By liquefying that much collagen at once, your body discards the old blueprints and builds a completely new network of fibroblasts, revealing a firmer, younger, bouncier face. However, you must do three things:
- Expect some pain. Pain tolerance varies, but you might need laughing gas for this one.
- Give it time. A conscientious tech will refuse to retreat you before the six-month mark for a good reason. Don't go asking for another treatment after four weeks at a different practice. You can permanently damage the cells responsible for keeping your face held together!
- Support your body post-treatment. Avoid refined sugars and alcohol, as they can glycate and interfere with the rebuilding process. Sleep well—the majority of recovery occurs at night. Eat some meat or take collagen peptides to provide your body with the materials it needs to rebuild. If you're vegan, well, um… consider smaller, more frequent treatments, or wait for synthetic collagen options? Just using some rational thought here.
One downside of Ultherapy is that it can cause lipolysis, which might not be desirable for everyone, especially if you don't want to look gaunt. Practitioners will likely avoid treating the malar (upper cheek) region for this reason.
For the midface:
Treating the midface is challenging. There are many ways to reintroduce volume to the cheeks, but sagging, especially around the mouth and jawline is another story altogether. This is because the fibrous tissue between your skin and your ligaments known as the SMAS (Super musculoaponeurotic) becomes weakened so that everything that is connected to it falls down and forward.
Surgical lifts: If there is enough laxity, a surgical lift may be recommended. Do not be frightened of these procedures, they are performed all of the time, and 99% of the work walking around out there looks natural. There is a mass misconception that after undergoing any plastic surgery, you're going to look like the cat lady. I'm here to tell you that you are looking at plastic surgery all the time, you just do not know it because most of it is natural looking. Moving on
Lasers, ultrasound, RF among many others effectively firm and renew upper layers, surgical lifts reposition the deep framework of the face, but until recently there wasn’t a targeted approach for SMAS revision (although Ultherapy can help some).
EM Face: This is a newer device that bridges the gap in comprehensive facial rejuvenation. It combines electromagnetic and radiofrequency energies to help firm up the connective tissue underneath your skin. Cool stuff huh? Just be ready to fork over some moolah. It's new and it's the only device like it on the market so far so I can only imagine how much the machine costs. A series of treatments should run around $4k but you might be able to push back that facelift a decade or so.
Temples, forehead, upper cheek area, periorbital zone, or anywhere else with volume loss and sagging:
Sculptra: While Sculptra technically is a filler, it acts differently from traditional fillers. It consists of poly-L-lactic acid (yep, the same material used in dissolvable stitches and 3D printers). Once injected, it triggers a controlled inflammatory response, activating fibroblasts and collagen production. Over the next 3-5 months, your body essentially creates its own filler, providing both volume and a moderate lift that can last for years. But here are a couple of things to keep in mind:
- Your practitioner is going to tell you that you need to massage the injection area at least five times per day for the next 5 days or longer depending on the amount injected. You are going to be sore, and you are not going to want to do this, but you need to because polylactic acid is a foreign substance to the body and your immune response will attempt to quarantine it. If the Sculptra coalesces in one spot, then you might eventually have a lump of collagen in that spot. A vigorous massage will ensure that the Poly-l-lactic acid stays spread out nicely and evenly ensuring a smooth end result down the road. Suck it up and do it!
- Avoid anti-inflammatory medication whenever possible the first few weeks after getting a Sculptra injection. There isn't really any definitive proof that drugs like ibuprofen reduce the effectiveness of a sculpture injection, but common sense tells you that if you reduce your body's ability to create inflammation and that response is what leads to the formation of new collagen…. I’ll leave it there.
- Look for a provider that uses Sculptra regularly. The injection protocol is different for Sculptra aesthetic. Ask your provider how often they use it on their patients. Here is a hint: If your provider recommends Sculptra before you ask about it, there is a pretty good chance that they are experienced with it.
Managing the sag effectively requires exploring and researching the options and setting yourself realistic expectations. Whether using home devices or professional treatments, the right approach can rejuvenate your appearance. Embrace the journey, as each skin's needs are unique, and patience is key to achieving lasting results.
Now I insist that you go and have yourself a quality day!
MBM
