What causes sagging skin?

Facial aging occurs not just in the skin, but in all the soft tissues. The skin loses its elasticity, and the connective tissues and muscles elongate and sag. As this happens, the skin actually grows and fat shifts -- it appears in areas like the neck but disappears from the mid-cheek.

The end result is sagging. The eyebrows head south, the upper eyelids droop, sometimes interfering with vision, and the lower lids drift downward, sometimes even pulling away from the eyeball. And as this happens, troughs appear below the eyes, and the skin of the mid-cheek mounds up between the nose and the mouth, creating nasolabial folds and marionette lines.

And further down the cheek, tissue that once resided high in the face sinks down to form the jowls. In the neck, the loose skin fills with fat and becomes reminiscent of poultry as two stark bands become visible. The constellation of sagging and stretching of the tissues is treated differently than the fine wrinkling in the skin.

Here, we need bigger procedures that are designed to lift tissue and remove excess skin and fat.

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