Why the face sags
Why faces sag over time — changes in skin, fat, the SMAS and bone, lifestyle factors that speed sagging, and ways to address it.
Facial sagging doesn't have a single cause: several layers — skin, fat, the SMAS and bone — change together. Which layer has changed most affects which approach suits.
Changes by layer
- Skin — becomes thinner and stretches as collagen and elastic fibres decrease
- Fat — facial fat shrinks or descends, so the cheeks hollow and weight gathers below the jawline
- SMAS and ligaments — the structures holding facial tissue loosen, so the tissue as a whole descends
- Bone — facial bone volume partly decreases with age, weakening the support for the tissue above
Factors that speed up sagging
- UV exposure
- smoking
- rapid weight changes
- lack of sleep and dry-skin habits
- inherited skin characteristics
The usual order
It often starts around the eyes and cheeks, then moves to nasolabial folds, marionette lines, a softening jawline and a sagging neck. The order and pace vary from person to person.
Ways to address it
Mild sagging is approached with skin care or non-surgical treatments; moderate or greater sagging with surgery such as a facelift. Where there is also hollowing, volume is sometimes restored with fat or filler.
Frequently asked questions
Can sagging be prevented? Sun protection, not smoking and avoiding rapid weight changes may help slow it. Ageing itself can't be stopped, though.