MY SKIN IS SAGGING

What causes skin sagging ?

Skin laxity is caused by several factors.

• Natural ageing : with age, collagen and elastin production declines, as do hyaluronic acid levels. This causes skin thinning, volume loss and gradual sagging. Young skin is rich in collagen fibres, elastin and hyaluronic acid, essential molecules for density and suppleness. Over time, their production declines while breakdown increases. Subcutaneous volume also changes. Deep fat diminishes or descends, changing facial anchoring points. Muscles may lose tone and shift position, worsening sagging.
• Sun and UV exposure : prolonged sun exposure is one of the main causes of skin laxity. UV rays damage collagen and elastin fibres, degrading skin structure. This is particularly visible on the face, neck, décolletage and hands, often the areas most exposed to the sun.
• Rapid weight loss : rapid or excessive weight loss can cause skin laxity, particularly if the skin has not had time to adapt.
• Smoking : chemicals in cigarette smoke damage collagen and elastin and narrow blood vessels, reducing the supply of oxygen and nutrients to the skin.
• Insufficient hydration and poor diet : well-hydrated skin is more resistant to laxity. Insufficient hydration, both internal (not drinking enough water) and external (lack of moisturising skincare), can accelerate sagging. A diet low in essential nutrients, such as vitamins C and E, omega-3 fatty acids and antioxidants, can also compromise collagen and elastin production.
• Genetic factors.
• Stress and lack of sleep : chronic stress and insufficient sleep increase cortisol production, a hormone that breaks down collagen and encourages skin laxity. Insufficient rest also limits cell regeneration, making the skin duller, less firm and more prone to ageing.

Signs of skin laxity : how can it be recognised ?

Skin laxity develops gradually, through changes in both skin quality and facial architecture. It is more than a loss of tone ; it results from deterioration of supporting fibres, changes in deep volume and reduced mechanical tissue tension.
Identifying early signs allows more targeted treatment and more natural, lasting results.
Skin may sag on the face, neck or other body areas. It looks less taut and looser, particularly during movement or when bending forwards. Simple skin traction tests assess responsiveness and the ability to return to the original position.
Volume loss in the cheeks and temples is common. It reflects deep fat resorption and descent of fat compartments. This volume change impairs natural facial support, creates a hollow (hollow face) or tired appearance and contributes to tissue laxity.
More pronounced skin folds or wrinkles, particularly around the mouth, eyes or nasolabial folds, are another sign. These folds directly result from weakened supporting structures and reduced elasticity, with the skin recovering less effectively after facial expressions.
Facial contours also tend to lose definition, particularly at the jawline and neck. This results from progressive tissue descent, often combined with reduced ligament support and dermal firmness. The jawline then looks less structured, with heavier, less even contours.

Treatments for skin laxity

Managing skin laxity often combines several techniques, selected according to its cause and the patient's morphology.

Results and scientific evidence

Results in skin laxity treatment are now strongly supported by extensive scientific literature confirming the effectiveness of volumising injections, collagen stimulators and laser technologies. For hyaluronic acid, several studies – particularly Eccleston et al. in the Journal of Cosmetic Dermatology in 2021 – demonstrate measurably improved structural support alongside a gradual lifting effect from volume restoration. This harmonious repositioning tightens tissues, redefines the jawline, reduces cheek sagging and improves lower facial laxity.
The effectiveness of Sculptra, based on poly-L-lactic acid, has also been documented for more than two decades. Beer and colleagues, in Dermatologic Surgery in 2007, demonstrated significantly increased dermal collagen and gradually improved firmness after several spaced sessions. More recent research, such as Vleggaar (2014), shows objectively measurable dermal thickening from poly-L-lactic acid, producing a lasting tightening effect, with results potentially maintained for several years when maintenance continues.
For fractional ablative lasers, Manstein et al. (Lasers in Surgery and Medicine, 2004) demonstrated their ability to intensively stimulate new collagen formation while preserving some healthy skin, allowing faster recovery than a medium peel. Improvements involve firmness, quality and dermal density, with clearly perceptible firming in the months following treatment. These lasers are particularly suited to moderate laxity when a natural, lasting tightening effect is sought.
The effectiveness of non-ablative photorejuvenation lasers is also well documented. Bitter's pioneering study (Dermatologic Surgery, 2000) demonstrated improved skin firmness and luminosity after a series of sessions. More recent publications, such as Negishi et al. (Lasers in Surgery and Medicine, 2018), confirm measurably improved dermal quality and moderate stimulation of collagen synthesis. As their tightening effect is more limited, non-ablative photorejuvenation lasers are mainly indicated for early skin laxity or as part of a combined protocol with stronger treatments.

Prices

The cost of treatments to improve skin laxity varies according to the technique used and protocol established during the initial consultation. Cross-linked hyaluronic acid injections start from 600 CHF per syringe, and Sculptra costs 900 CHF per vial. A fractional ablative laser session costs 900 CHF. Photorejuvenation laser sessions cost 500 CHF, Skinboosters 400 CHF per syringe and mesotherapy 300 CHF per session. Depending on laxity severity and intended goals, several sessions are needed. A regular maintenance plan to stabilise results is also established during the initial consultation.

Medical references on skin laxity and loss of firmness

• A histological study published in the Journal of Cosmetic Dermatology shows that a single monopolar radiofrequency session significantly increases dermal collagen fibre density and organisation. Biopsies performed 2 and 6 months after treatment confirm progressive tissue remodelling, explaining the lasting improvement in firmness.
• A prospective study published in the Journal of Cosmetic Dermatology including 32 patients reports that after monopolar radiofrequency treatment, 53,1 % of participants showed more than 50 % improvement in skin laxity after 2 months. Histological analyses also showed increased collagen and elastin fibre density, without serious adverse effects.
• A study published in the Journal of Cosmetic Dermatology demonstrated that treatment combining radiofrequency and muscle stimulation increased the area occupied by elastin fibres by 102,8 % after 3 months, alongside significant improvements in wrinkles and firmness compared with the control group.
• An expert review published in the Journal of Cosmetic Dermatology highlights that skin laxity is mainly linked to the gradual age-related decline in collagen, elastin and the extracellular matrix. It concludes that treatments stimulating new collagen formation (radiofrequency, focused ultrasound, fractional lasers and collagen stimulators) are now the main non-surgical approaches for lasting improvements in skin firmness.