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Facial aging and sagging


Sagging of the skin and the tissues of the face is an inevitable consequence of aging. No matter what your sex, ethnicity or health status is, we will all experience a gradual sagging of the face as time goes on.

What makes our faces sag?

As the face ages, all four of the main facial layers change:

- the skin loses collagen and it's elasticity

- the smiling (lifting) muscles get weaker whereas the lower face muscles (down-pulling) get stronger

- the cheek and midface fat pads lose volume leading to reduced support and shape in the upper face

- the lower face (jowl) fat pads get heavier leading to increased heaviness of the lower face

- the bony platform of the face shrinks, leading to less support and structure overall 

How can sagging be treated?

The cardinal sign of aging is a slow and continual change is the various tissues of the face - leading to hollows, less plumpness and a visible 'drooping appearance'. The upper face loses volume leading to a reduced shape of the cheeks and the appearance of under eye hollows. At the same time, the lower face gets heavier leading to jowling, a less defined jawline and the neck shape also changes.

We can treat the face holistically with deliberate and targeted fillers to counteract the signs of hollowing, sagging and deflation.  By reversing the sagging effect, we can create a brighter, more contoured, more youthful look.

It's important to say that as the degree of sagging worsens, the less useful fillers and non-surgical treatments are. There will come a point where the degree of sagging and loose skin is too advanced. In this scenario you'll be advised that fillers can't be used and if you wish, you can be referred to a trusted plastic surgeon for consideration of surgical techniques including facelifts and neck lifts.

What areas need to be treated for sagging?

By understanding the typical patterns of facial aging, we can predict and devise treatment plans to counteract them. It's important to understand that improve the symptoms of sagging, we need to treat the entire face to maximise the improvement of the tissues and soften the signs of heaviness. This is why sagging treatments almost invariably need larger volumes of filler as the whole face is typically treated in combination (although this can be broken down into several more manageable stages)

Sagging treatments might include:

1) The lateral & anterior aspects of the cheek - the cheek bones & the 'apple' of the cheek

2) The lateral aspect of the face (pre-auricular) - the area under the cheek bones & in front of the ears

3) The nasolabial lines - the deep grooves running from the corner of nose to the corner of the mouth

4) The marionette lines - the extension of the nasolabial lines, from the corner of the mouth down to the jawline

5) The chin & jawline combined - aging of these two keys areas contirbutes to jowls and a loss of contour

6) Fat dissolving of the double chin or jowls - the saggy look is often worsened by heaviness of these two areas


7) The skin - treatments like skin bio-modelling fillers can help to improve mild skin laxity

 (Other modalities include radio-frequency needling, ultrasound skin tightening or

'HIFU'- both of these are offered in the clinics that Dr Jake works in)

The loss of volume in sagging faces is often substantial - so doing focal treatments with small volumes of filler often doesn't lead to any tangible results. But if all of the symptoms of visible sagging are treated together, we can generate better support for the face,  re-volumise areas and restore harmony to the facial proportions.


With a skilled injector, it's hard to look 'overdone' with fillers when treating feature of sagging. The significant contributor to the sagging is the degree of volume loss and so in reality, the limiting step to achieving good results is usually too little filler being used.

Every face is different and so there's no such thing as a set price for any fillers.  Instead, your face will be examined during your consultation to diagnose how best to improve your signs of sagging and the minimum amount of filler to make a difference. For treatments like this can need anything from 6-15ml of fillers and so it's recommended to break up the treatment into two or sometimes more sessions.

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