Age, gravity, genetics, rapid weight loss, and environmental factors all contribute to sagging skin.
The skin is elastic, which means that it stretches and shrinks to adapt to our body shape as required. However, with age the skin looses some of that elasticity. Collagen and elastin form a crisscross pattern in the deep layers of the skin giving the skin its structure. This structure is what makes our skin firm and supple. Unfortunately as we age collagen fibres break down and our skin does not renew itself as often as it used to.
Environmental factors such as the sun, pollution, smoking, poor nutrition, and harsh chemicals also contribute to the breaking down of the collagen matrix. To combat sagging skin you need to take a multi-facet approach. There are many things you can do at home, there are also many treatments that do not involve the knife. Maintaining a healthy skin can go a long way in preventing sagging and promoting collagen formation.
Things you can do at home to prevent and reduce sagging skin
- Ensure you use a good sunscreen every day, even if it is cloudy. Be aware that greater SPF is not the answer, 15+ is sufficient. Except for Zinc or Titanium based sunscreens the extra protection is provided by adding more chemicals that release free radicals when interacting with the sun. An SPF15+ will filter 93% of UVB rays, SPF30+ 97% and SPF50+ 98%. The small additional protection comes at the price of the damage that free radicals can cause to the skin. You should also choose a broad spectrum sunscreen which will also protect you from UVA rays.
- Makeup can also be very damaging to the skin. Choose a good brand of mineral makeup, I recommend Jane Iredale because it not only feels and looks great but its is made with pharmaceutical grade and certified organic botanicals and antioxidants. It also provides with broad spectrum sun protection.
- A good, medical grade skin care range it is also essential. Products that have therapeutic ingredients in appropriate concentrations to stimulate collagen formation. Vitamin A, to help create new healthy collagen and repairs damaged DNA. Vitamin C, to even skin tone. Hyaluronic acid to increase hydration. Alpha or beta hydroxy acids (AHAs or BHAs) to hydrate and renew the skin cells. Antioxidants to combat the effect of free radicals and Peptides to stimulate growth factors and relax muscles.
- Having a balanced diet with plenty of vegetables and low in sugars will also help you fight sagging skin. Sugar attaches to proteins creating harmful molecules that cause Glycation. Glycation not only destroys the collagen in the skin but it damages muscles and organs resulting in overall premature aging.
- Other factors such as smoking (or secondary smoke), drinking alcohol, being exposed to chemical fumes or cleaning agents are also very harmful to the skin’s structure. Avoid these things as much as you can.
- Topical application of compounds such as magnesium, glucosamine, msm would also help stimulate the regeneration of the collagen and elastin matrix. For example, adding Epsom Salts that are rich in magnesium chloride, to the bath water will nourish and help tighten your skin. A facial masque can also be prepared with glucosamine and msm powder mixed with honey.
Sagging skin due to rapid weight loss
If your sagging skin is due to rapid weight loss, depending on your age, the amount of time that your skin was stretch out, and the amount of sagging, it may be possible for the skin to contract with regular exercising. This however, may take one or two years. In most cases surgery is the only option.
Sagging skin due to pregnancy
Sagging skin due to pregnancy can be fixed with abdominal exercises. As soon as your doctor gives you the all clear start with sit-ups and other exercises targeted to the areas of concern. Start with small sets and gradually increase the number. Breast feeding also helps to lose any excess weight you may have put on while pregnant.
A good body oil will also help with stretch marks and sagging skin.
There are many treatments that stimulate collagen formation and reduce sagging skin. It is also important to start early and after a course of treatments follow-up with maintenance once or twice a year.
Radio Frequency treatments
I find that RF treatments are one of the best for skin tightening. They are a few different modalities in the market. RF treatments work by heating up the deep layers of the skin. The heat improves circulation and lymphatic drainage allowing for better oxidation and nutrition to the skin cells. It also contracts stretched out collagen fibres and stimulates the production of new collagen. In most modalities, the treatment is painless and there is no down time.
It is recommended a course of 6 treatments spaced every 2 weeks and afterwards, a maintenance treatment every 6 months. Because new collagen formation requires time you will see progressive improvements long after the initial treatment course.
Collagen Induction Therapy (Skin Needling)
Collagen Induction Therapy (CIT) it is also a fantastic treatment for sagging skin. A pen or roller with tiny micro-needles is used to cause micro bruises in the deep layers of the skin. This treatment enhances the absorption of serums and stimulates the formation of new collagen. It also evens skin tone and texture. Depending on the size of the micro-needles it may require a topical anesthetic. After treatment your skin will look like a mild sunburn and you may experience a light burning sensation. These symptoms will disappear within 1-2 days. Mineral makeup can be used.
It is recommended a course of 6-8 treatments spaced every 2-4 weeks, with maintenance every six months. However, new research have found that a course of 6 treatments spaced every 3 days produces the best results.
Laser or IPL Photo Rejuvenation will also improve sagging skin. Flashes of intense light target proteins in the skin delivering thermal energy to the deep layers. This treatment will trigger cell repair mechanisms as well as collagen regeneration. It will also even skin tone and texture improving the overall health of the skin. Some redness may be present after treatment, however it will disappear within a couple of hours. Freckles and pigmentation will look darker and may scab after a day or two.
Depending on the condition of your skin, 4-6 treatments may be recommended. Treatments are spaced every 2-4 weeks.
Derma fillers such as Juvederm, Restylane, Perlane, Voluma, and Radiesse are used to create volume and diminish the folds of the jowls. Injected in key areas they can lift the skin and give the appearance of higher cheekbones, and soften the shadows in the nasolabial folds.
Skin peels can stimulate cell regeneration and increase collagen production. I don’t however, recommend harsh chemical peels but rather cool peels such as lactic acid. Lactic acid exfoliates the horny layer of the skin without destroying the cells protective membrane. It also increases hydration to the deep layers, plumping up the skin.
Surgical options for sagging skin
There are several surgical options to remove sagging skin depending on the area to be treated and the condition. A doctor may be able to offer you various alternatives and suggest the one that will help you reach your goals more closely. Have in mind that many of these procedures will leave a scar.
As with most operations they will require you to take time out of work from one or two days to a couple of weeks, and avoid any strenuous exercise or movements.
A Panniculectomy is a surgical procedure to remove loose skin and soft tissue in the lower abdominal area (abdominal panniculus). It is mainly performed to relieve symptoms caused by excess skin hanging over the genital area. These symptoms include: rashes, hygiene issues, itchiness, infections.
Abdominoplasty (Tummy Tuck)
A tummy tuck will not only remove excess skin, but will also tighten the upper and lower abdominal muscles, contour the abdominal wall, re-insert the belly button and perform liposuction if needed. This is the best option for removing sagging skin after rapid weight loss.
For facial sagging skin a facelift may be the most appropriate solution. During a facelift the neck is sculpted to remove excess fat and tighten muscles. The jaw line is also tightened as well as the facial muscles around the mouth.
Fat Grafting also called a Fat Transfer involves harvesting fat cells from an area of your body such as abdomen or thighs and injecting them into the face or other areas as required.
The cells are harvested with liposuction under local or total anaesthetics. The fat needs to be harvested in such a way that preserves the cell membrane intact. Poor harvesting techniques can make the results short-lived.
Unlike fillers, results of fat grafting are long-lasting and require a very experience surgeon. Poor technique can result in lumpy areas, overfilled and unnatural looks, non symmetrical results, or non lasting results.