Sagging Skin

Sagging, thin, dry, ageing skin – what one thing should I try? I wear sun cream every day and take HRT. I lost a little weight and my neck skin looks crumpled and my face has started sagging with lines. I work for the NHS and am not wealthy but if...

Hiya, TTG editor Georgia here. It sounds like a course of injectable moisturiser injections on the face and neck would be your best bet. Have a look at some of the different brands here to get an idea of what they offer (they all differ slightly based on their ingredients and composition) – some are better at tightening sagging skin than others. All will smooth out the crumpling/ crepey texture that you mention and reduce your lines. You’ll also get a lovely, refreshed glow and ‘springier’ skin. And most importantly, use the Practitioner Finder to find someone we recommend near you who offers this treatment....

Hi Alice, can dermal fillers yield as good a result as threading or would I best to bite the bullet and go with the latter? I am unhappy with my sagging face and the pronounced nose-to-mouth lines as well as loss of volume in my cheeks and jawline....

You need to get your face in front of a great practitioner who can offer both fillers and threads and ask their opinion – they will probably suggest that you have threads and see how much difference that makes, and then perhaps use filler to add in any extra volume that would benefit your face after that.

Will thread lifting will help the drooping lines vertically from the corners of my mouth or should I go for a lower facelift? I am 75 but look much younger.

Hiya, TTG editor Georgia here. While we're a little wary of threads, you can get a great result if you go to a very experienced practitioner who really knows what they're doing. If you're thinking you might eventually go for a lower lift though, it's important to know that a lot of surgeons won't operate on a face that has previously been treated with threads. This is because they can create thickened lines of fibrous tissue though the skin, which makes the surgeon's job harder and puts you at risk of either having complications or just not getting a very good outcome. A surgical lift will give a more definitive result which will last much...

If money is not in abundance and you wanted to do a treatment, what would you say are the best ones to do? I’m 54 and recently have noticed I’m really ageing! Have a small amount of toxin on my 11s and forehead. But I’ve noticed lines on my...

Great question – the difficulty with answering it is that different tweakments work on different aspects of the signs of ageing that we see in our faces. So, yes, a small amount of toxin will relax the lines on your forehead. Creating a lift in the face usually needs filler, placed deeply to recreate the structure in the face that time is taking away (we lose volume from the bones in our skull as well as from the fat pads, so the skin starts to hang a bit looser, it's a bit like losing weight inside a dress that used to fit like a glove), plus skin-tightening treatments from devices such as laser, or ultrasound, or radiofrequency – and...

Hello, I'm in my mid-40's with increasing sagging (mainly drooping upper eyelids, jowls and marionette lines). I've had three Ultherapy procedures at a highly-regarded clinic over the past five years to lift and tighten my face and neck. The last...

Hi, I'm sorry to hear that you had no improvement from your last Ultherapy treatment – surgeons are not keen on it as, in pursuit of the skin, it can (as one put it to me), 'mash up' the layers under the skin which makes it more difficult for surgeons to work on – not impossible but it makes their job trickier. They see the same result from treatments like radiofrequency microneedling (Morpheus8 et al) though many surgeons will still use RF microneedling for non-surgical tightening as it is a safe and effective treatment for the right candidate. Thread lifts can reposition sagging jowls, but if cosmetic surgeons don't like...

Is Morpheus8 the best skin-tightening treatment to have at age 47, and the best value for money? Or are there any alternatives I should consider? Also, who would you recommend In London or Surrey please?

TTG editor Georgia here. Morpheus8 – or any RF microneedling treatment for that matter – is a fab treatment for skin tightening providing you're a suitable candidate, but there are loads of other options too, all at varying price points. Your best bet is to have a consultation with an expert practitioner and explore your options to find the best treatment for you. Use the TTG Practitioner Finder to search for a practitioner in your area whom Alice would trust with her face, and start from there....

Hello, I am 48 and really starting to look old, especially when I look at photos. What do you recommend as the most effective way to look fresher and better without Botox or filler? Is it HIFU or profound or another treatment? Or would I really need...

Hiya, TTG editor Georgia here. Dr Strawford will be best placed to answer all these questions for you once he's assessed your face and talked to you about your exact concerns. He is an expert practitioner with a great deal of experience. The tweakments you mention – HIFU, Profound (RF microneedling), toxin, and filler – all do different things that work towards making you look fresher and younger, but not in the same ways. Toxin for example won’t do anything about sagging skin but HIFU will, Profound will stimulate collagen production to tighten and plump the skin, but won’t replace lost volume in the ways filler will. So it all...

Can you recommend a surgeon who has good results performing lower face lifts in Surrey or the South East? I have tried a few different procedures with varying results, including filler along the jawline and chin, but feel results aren’t great.

Hi, The Tweakments Guide is all about non-surgical work, so I have very few cosmetic surgeons listed. Take a look at the facebook page of Karen Perrett aka Surgeon Sourceress, these may be helpful.

Hi Alice, I am 35 and have a 2-year-old child. I really feel like having a baby has aged me and want to look rejuvenated. I already have toxin and don’t want to alter my face contours with filler. What would you recommend?

Congrats, I bet your toddler is fab but I know what you mean. I'm tempted to say that you should start with a bit more sleep and time to yourself but suspect that you know that already, and those things are hard to do when you have a 2-y-o. What about an injectable moisturiser treatment which helps to remodel skin from the inside, and is great for skin that's beginning to lose its mojo? Also, ask your practitioner what they'd suggest, as they know your face already and may have some ideas.

I have lost a lot of weight and now have loose skin on my inner thighs. What would suggest?

Congrats on the weight loss – maybe a technology like radiofrequency microneedling or laser could help? I'd suggest booking a consultation with a great practitioner who does a good deal of work on the body, who can give you a realistic assessment of what sort of difference non-surgical treatments might make for you.

Does Emsculpt Neo work effectively on the upper arm/ tricep area for loose skin?

Hi, the EMsculpt Neo is good for muscle-toning and blasting fat that sits above the muscle that it's working on, but it doesn't work on loose skin. A couple of things that might: Profhilo can help tighten slack skin on the body but bear in mind that's 'help tighten' rather than 'make your skin look 25 again'. And there's a new machine coming out called the Evolve, from Inmode (the company behind Morpheus8) which tightens muscles, zaps fat AND tightens the skin too, so that might be worth a look, too....

Hi Alice, I've just watched your video on Secret RF. I'm having the treatment in a few weeks. Did you think it's worth the money for the results seen? Thank you.

I only had one round of Secret RF when filming it (at my age, I'd need about three sessions to see proper results) so I only saw a bit of skin-smoothing. But I know from practitioners who have the device that they absolutely love it for the results it gives, so yes, I'd recommend it.

Sofwave vs Ultherapy – what are your thoughts? I am 56 and looking at trying to refresh my skin.

Sofwave sounds really interesting. Rather than focusing ultrasound energy to a point like Ultherapy does (which creates tiny hotspots), it uses something called parallel beam technology to heat the deeper layers of the skin and I'm told it can't 'melt' fat in the face in the way that Ultherapy is often accused of doing. I've tried Ultherapy three times in the past decade and had good results from it – I've not tried Sofwave yet but I'm sure I will in due course.

Monthly Hydrafacial or monthly Caci? I’m 43 with skin in reasonably good condition but starting to notice some signs of ageing, so planning to treat myself to a monthly facial.

Hiya, editor Georgia here. In an ideal world, budget permitting, you'd do both! HydraFacials are more geared towards extractions and hydrating the skin, improving surface issues like breakouts or dry skin. You do get some collagen stimulation from the LED light element but if your main concern is signs of ageing then I’d go for monthly CACI treatments instead. CACI is specifically for combatting signs of ageing by stimulating the facial muscles using electrical microcurrent. If you're new to CACI, you'll be advised to book a course of treatment and to have the first few treatments a fortnight apart. Find out more here....

Hi Alice, which is better for skin tightening (especially around the eyes and nasolabial) – Morpheus 8 or ULTRAcel? Which will give longer lasting results and give a greater skin tightening effect please? Kindest regards.

Hiya, editor Georgia here. You’re probably looking at much of a muchness here and it may well come down to downtime and/ or budget. Both Morpheus8 and ULTRAcel use radiofrequency energy along with microneedles to lift, tighten and address fine lines and wrinkles. But, ULTRAcel also combines HIFU (high-intensity focused ultrasound) for a really souped-up treatment. This doesn’t necessarily mean all three technologies would be used on you though – that would be up to your practitioner to decide. Morpheus8 can be used safely under the eyes right up to the lower lid. Find a great practitioner, set up a consultation and get their expert...

Hi, can you recommend what a 73-year-old can have after 3 Profhilo treatments and 3 Skinpen treatments (alternate months)? As in RF or any other skin and jaw tightening treatment?

Hi, I'd be tempted to keep going with monthly microneedling for another three months, then leave it for a while because those needling sessions will go on delivering their benefits (in skin strength, smoothness and tightening) for several more months, particularly with all that Profhilo in your skin (which won't need doing again until six months after your first session of it).  See what your skin is looking like after all that before you step up to anything else. Yes, you could try RF – what does your practitioner suggest?...

I’m exploring a radiofrequency needling procedure and wanted to understand if the treatment has a side effect of reducing fat in the face? I have a slim face and have lost fat and don’t want to have a treatment which exacerbates this further.

Find a great practitioner and you'll be fine, seriously. Radiofrequency microneedling treatments are terrific for tightening and smoothing the skin. Yes, the ones with longer needles CAN go deep enough to give a fat-busting effect, but a good practitioner would only do that if it was needed, and after discussing and agreeing this with their patient.

I am looking for a device to tighten and lift my skin for my face and body. I have Profhilo, toxin and fillers and was wondering which of the following would work best for me: Lyma, Wellbox or Dermalux Flex? Does the Dermalux tighten and lift? I am...

I hate to say it but none of those will give you noticeable lift and tightening. The Lyma is highly unlikely to achieve anything, it doesn't have the power. I don't know the Wellbox. I love the Dermalux – it's a medically-certified device – and while this will help a lot with the condition of your skin, helping it regenerate from the inside and become stronger and better hydrated, reducing redness and helping pigmentation a little, your skin will look younger and smoother, but it doesn't make any claims for tightening and lifting. In-clinic treatment with something like radiofrequency microneedling is a better bet – find a great...

Hi Alice. Can you recommend a specialist facelift plastic surgeon in the UK, preferably deep plane technique? At 64 yrs old now tweakments alone cannot address my sagging skin.

I'd see if you can get an appointment with Rajiv Grover who is an outstanding facial plastic surgeon who is doing fab work with deep plane techniques.

Hi Alice. I know this isn’t a tweakments question, but could you recommend a good face & neck surgeon. I’m 64 and have used many tweakments but I have volume loss & laxity in my face and neck and I feel this is the only option left.

Hi, I'd suggest a consultation with Rajiv Grover who's an outstanding facial plastic surgeon, and see what he suggests.

Thinking about Ultherapy (I’m 50). I’ve just read that after age 57 there is no collagen left to stimulate. What are your thoughts on this? Is Ultherapy something you would recommend for the long term or is there an age it would stop working?

Great question. The really unfair thing about collagen-stimulating with energy-based tweakments (laser, radiofrequency, ultrasound) is that they work best on people who have more collagen in their skin, i.e. people in their 30s who barely need the treatments... and the older we get, the less collagen we have in our skin, and the less impressive a result we will get. We're losing collagen in the skin from the age of 25, and as women go through menopause our natural production of collagen tails off drastically (unless we take HRT). So it's not that you don't have any collagen left in your skin by the age of 57, but you'll have an awful lot...

Hi Alice, I would like to try a skin tightening treatment. I am 62 and regularly have Profhilo and have had fillers. With so many on the market which would you say is the most value for money with the least downtime?

I'd say your best bets are laser or RF microneedling of some sort. As to which brand and best value... it's hard to say. For me, it's more about the person who's using the device than the device itself, which is why I always suggest finding a great practitioner and seeking their advice because they'll be able to take a look at you and take your concerns and your budget into consideration, and advise whether you're a good candidate for a particular procedure. What you want is to get a good result, rather than just a cheap treatment. Having said that, clinics outside London are better value than those in Harley Street, where the overheads are...

Hi, just wondering if Profhilo would be a good match for me. I’m 64 with very thin saggy, dry skin. Would love to attain a dewy glow …. haha – can’t even recall what that’s like. Many thanks, Silvana

Hi Silvana, yes I'm sure that any injectable moisturiser treatment like Profhilo or Volite or Restylane Skinboosters would help. These treatments give skin a massive hydration boost, which helps the skin to regenerate itself from within and grow stronger and smoother and look more like it did when it was younger. You may need more rounds of treatment than average to achieve the results you're after – the older we are and the drier our skin, the more product it takes to work its magic on the skin. Follow this up with some high-quality skincare – there are lots of suggestions in the TTG shop....

I’m 49 with not many wrinkles but noticing a lack of firmness in my lower cheek and around my eyes. What treatment will give a great result but without losing fat?

Hi, I'd try radiofrequency microneedling which is great for smoothing, strengthening and tightening the skin, particularly in those areas.

I’m looking looking for a non-surgical face lift/ collagen, elastin-fibre boosting treatment following on from surgical menopause. I’m interested in Ultherapy, Ultracel and Morpheus8 but confused as to which treatment to go for. Many thanks in...

Ah, sympathies. I'd go for a radiofrequency microneedling treatment. There are several different brands of this treatment, including Morpheus8, Profound RF (which I tried last year – read about my experience here) and Secret RF, which give results more swiftly than ultrasound-based treatments and which improve skin quality, too, and follow this up with an injectable moisturiser/ skinbooster treatment such as Profhilo or Belotero Revive, to help get hydration back into your skin. Also, if you're up for/ able to access hormone replacement therapy, that will help your skin enormously....

Hi Alice, I'm keen to have some kind of skin tightening laser for my undereyes, however I'm worried about the metal eye shields they put in your eyes after the problems you had with your eyes! Any advice would be appreciated. Thanks, Debbie

Hi Debbie, you ought to be alright with the eye shields – so many surgeons and laser practitioners contacted me while I was recovering and said they were shocked because they'd been using the shields for years and years and had never had an issue like that. As long as the practitioner is familiar with using the shields, and uses enough lubrication drops as well as anaesthetic drops, you should be fine. The other alternative is to try a radiofrequency or RF microneedling treatment which can be used all around the eyes without requiring those shields....

What's your opinion on Exilis versus Ultherapy for skin tightening?

Exilis is a radiofrequency treatment which has a kind of 'shrink-wrapping' effect on the skin; Ultherapy uses focused ultrasound to achieve the same sort of damage-and-remodelling to the collagen in the skin... they're both good treatments that can produce great results on the right patient. My opinion would be to get your face in front of a great practitioner and ask them what they'd recommend for your particular concerns, and whether you're the right patient for either of these treatments....

What is the most effective filler for a 63 year old with a thin face and thin skin?

Hiya, editor Georgia here answering on Alice's behalf. One filler isn't necessarily more 'effective' than another. Each brand will have a range of filler products in its line that are better suited to various indications depending on their composition – like the lips vs. the jawline, for example – but what's best for your own face is impossible to say for anyone other than the practitioner assessing you. Use our practitioner finder to find a brilliant injector near you, and set up a consultation. They may even recommend a treatment other than filler. This is the only way to find out what will be most effective for your concerns....

I had moisture injectables in my neck region, is this a similar thing to Profhilo? I can’t remember the brand but it wasn't Profhilo?

Hiya, editor Georgia here answering on Alice's behalf. Without being able to say for sure as you can't remember the exact name of the product you had injected, Profhilo is categorised as an injectable moisturiser, yes. Other widely-used products in this category include Sunekos, Juvederm Volite, Restylane Skinboosters, Belotero Revive and Texone Redensity 1. If none of these ring any bells it would be a good idea to get back in touch with the practitioner who did your previous treatment and ask what product they used, and how much you had injected. It's always good to note down exactly what products you had injected in your face and when,...

Does Profhilo work?

Hiya – editor Georgia here answering on Alice's behalf. Yes, Profhilo works if you're a suitable candidate. However, no tweakment is 100 percent guaranteed to give you the results you're after – it's also about being realistic with your expectations. Some people try Profhilo and don't see much of a result, so go on to try another injectable moisturiser like Teosyal Redensity 1, Restylane Skinboosters, Juvederm Volite or Belotero Revive, and are satisfied. There are a few on the market so it may be worth finding a practitioner who offers a couple of them and knows each product's ideal patient selection well....

Can I have Profhilo when I'm breastfeeding?

Difficult one to answer - in that technically the treatment won't harm you. Not that there are studies to show this, as no companies want to use pregnant women as a test group for any cosmetic treatment. But legally, doctors should not treat a woman who is pregnant or breast-feeding with anything unless there is a medical need to do so.

In your opinion is Dermalux able to tighten the skin enough I would not need Morpheus8 if I used it regularly?

Hi, short answer - no. these are two very different treatments. Yes they both work by stimulating collagen production in the skin, but they work in different ways. The Dermalux Flex is using red LED light to gently rejuvenate the skin, by improving hydration, prompting the development of more collagen and reducing inflammation in the skin so it takes down redness and also reducing uneven brown pigmentation. As you say, the benefits are cumulative, so you need to use it consistently - and the more the better. Morpheus8 and other forms of radiofrequency microneedling  cause huge immediate damage to the skin, by creating thousands of...

What do you think about Ulthera for skin tightening? Or just ultrasound in general?

I prefer Ultherapy (Ulthera) to other types of HIFU skin tightening as it has a visualiser in the device so the practitioner can "see" into the skin and position each pulse at the right depth so it hits the collagen layer, not the fat.